I never watch C-span...

But, while channel-surfing the other day, I stumbled upon a "Washington Journal" segment with Mark Santora and NR Kleinfeld, New York Times reporters responsible for parts of the recent series on diabetes.

I tracked it down online (c-span.org, video archives under domestic/social) and gave the full segment a listen. Much of what was covered echoed points of the articles, but the emphasis (given the name of the show) was more on public policy.

A few things caught my ear.

First, one of the early callers asked if anyone had looked at the water in NYC, or at the drugs out there that are probably causing diabetes. This caused me to roll my eyes. The guests answered diplomatically, noting that the biggest known 'environmental' factor is lifestyle. After kicking it around a little, the caller's comments made me realize just how much ignorance is out there about diabetes. Ok, theoretically, there may be some insidious cause floating around in our water, but until we zero in on that, why not focus on the documented concerns?

Another caller talked about the nutritional value of food today vs what it was 25 years ago. To be honest, I'm not sure what her point was as I was distracted by an up-way-too-late child, but this call prompted an interesting (and diplomatic) response from Mark Santora, who culled from the caller's ramblings some thoughts about confusion around our food supply, misinformation about how food gets to your plate, and just how separated people have become from something so basic. It was an interesting point, I thought, and a nice save on the part of Santora.

What struck me most was Kleinfeld's response to the question, "How did the series come about?" Apparently, the impetus was last year's NY Health Department report on leading causes of death, where diabetes cracked the top five (coming in at number four). This caught their attention. Kleinfeld commented that most people don't think of diabetes as being a major killer. The feeling that diabetes is not a big deal disease and the 'so what, take some pills' response are pervasive. It is seen as a benign condition, when it's not. And, he noted, it was concerning that diabetes is becoming so prevalent without much public policy addressing its rise.

This comment did a lot to re-cast my view of the series. I, of course, don't think that diabetes (type 1 OR type 2) is benign at all. Which is probably why my reaction to the series focused on the harsh picture being painted, the failure to provide hope or suggest solutions, and the scare tactic approach being used. I forgot that not everyone knows - or pays attention - to the toll diabetes can take on people. I forgot that news blurbs about diabetes that catch my eye or ear go completely unnoticed by most of the population. So, perhaps, a huge slap in the face is what is needed.

I'm still incredibly suspicious about the whole Registry angle. It strikes me as odd that the series never mentioned this new approach by the NYBOH (careful readers have my permission to laugh, as I did go out on a limb after day three of the series and predict that day four would, in fact, focus on the Registry). And I still don't get how a letter from said BOH will make a difference to people who, according to the picture painted by this series, are already way ahead of the curve (in that they are actually being seen by doctors who order A1c's, and they actually go have them done, and they can actually afford them.)

I'm also concerned about the potentially staggering burden that the emphasis on lifestyle places on the patient with few resources available to make an effective change in their lifestyle. Are these folks a 'lost generation'? When complications hit, will we sit on our high horses and say, "You should have known better?" I hope not, because (bleeding heart liberal that I am) I think the 'village' shares some of the blame here.

But I'm on board with the fact that the village needs to pay attention to diabetes. Now.