An Urgent Moonshot For Diabetes Prevention (Part 3)

This nation should commit itself to achieve the goal, before this decade is out, of landing a man on the moon and returning him safely to Earth. — John F. Kennedy

What might a moonshot for diabetes prevention, on par with President Kennedy’s literal moonshot, look like?

The key, as Kennedy noted, is to “specify a long-range goal on an urgent time schedule.” “That goal,” Kennedy declared, “will serve to organize and measure the best of our energies and skills. That challenge is one that we are unwilling to postpone.”

As laid out in parts one and two of this series, type 2 diabetes already afflicts 30 million adults in the US and another 84 million are at high risk for developing it. What’s more, the risk factors for diabetes also contribute to heart disease and stroke, two other leading causes of cost, suffering and death.

Here is a moonshot for diabetes prevention worthy of Kennedy's example, structured in two stages:

By 2030, before the next decade is out, at least half of adults with prediabetes will actively control their risk of developing type 2 diabetes. The vast majority of treatment should be through evidence-based lifestyle change, because research shows that this approach more effectively controls risk than medication and helps to lessen other chronic diseases.

By 2050, there should be no new cases of preventable type 2 diabetes.

Kennedy proposed his moonshot at a time when Americans had only spent a combined total of 15 minutes in space. Compared that to baseline, imagining that we could land a crew on the moon and return it safely to Earth was truly audacious. Yet, Kennedy correctly gauged that the US had the resources, skills and stamina to succeed.

Imagining half of adults with prediabetes will actively control their slide into diabetes is perhaps even more audacious. As I discussed in part one, the CDC estimates that 84 million adults have prediabetes today, and less than 10% are even aware of their condition. Of those, only about 300,000—less than 0.4%—have taken advantage of proven lifestyle-focused diabetes prevention programs (DPPs). An estimated 3-4% of those eligible are prescribed a medication, metformin, which research shows to be also effective at reducing risk for developing diabetes (though not as effective as weight loss and lifestyle change). Compared that to baseline, imagining that we could achieve a 50% control rate in a decade is also truly audacious.

But it is possible. Consider the nation’s success with high blood pressure, also known as hypertension. Like prediabetes, hypertension affects almost one-third of US adults. Hypertension is a key risk factor for heart disease and stroke, which are the first and fifth leading causes of death in the United States. Like prediabetes, hypertension is also highly treatable.

Unlike prediabetes, we are relatively successful in treating hypertension. According to the CDC, about 80% of those with hypertension know it and (as shown in the chart below) roughly half have their condition under control.

Age-adjusted trends in hypertension and controlled hypertension among adults aged 18 and over: United States, 1999–2016. (Source: NCHS, NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY)

Heart disease remains a deadly killer and much more progress is required in controlling hypertension; but, our effectiveness to date shows what might be possible for diabetes prevention.

To borrow a phrase from President Kennedy, “It is a challenge that we should be unwilling to postpone.”

-- Read the entire series:

• Why We Need A Moonshot For Diabetes Prevention (Part 1)
• 3 Misconceptions About Diabetes Prevention (Part 2)
• An Urgent Moonshot For Diabetes Prevention (Part 3)
• Dispatch From 2025: How We're Putting A Big Dent in the Spread of Diabetes (Part 4)
• Here's a 10 Point Plan for Diabetes Prevention (Part 5)

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I write, speak and advise on the digital future. I'm the author of four books on technology and innovation. This article is updated from one originally published at Forbes.