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IN CLOSING, LET’S TAKE a brief look back at where we began: with 10 children who developed type 1 diabetes in 24 months within two miles of one another in the upscale suburbs of Boston. Rather than bemoan their fate, parents there organized and asked for an investigation to be conducted by the state, which is ongoing. Among those who have participated in organizing meetings are Ray Allen, the Celtics star, and his wife, Shannon, whose son, Walker, was the seventh child diagnosed there. “Shannon and Ray have turned out to be the most incredible advocates,” Ann Marie Kreft recently told me. “We have fabulous people on board who are spending inordinate amounts of their time on advocacy.” I asked her what they are advocating for. “I think we all agree that mandatory case reporting would be the ideal,” she said. “That would be the dream come true. I think we may be building up to that.” Rather than have to design a special survey every time an apparent cluster of type 1 cases emerges, mandatory case reporting, on a national level, would permit the CDC to automatically track cases as they emerge, to see not only the big national picture, but also local variations that could prove crucial in unraveling the riddle of why type 1 diabetes continues to rise, each and every year, by 3 percent. Presently, however, no national organization is advocating for mandated case reporting of type 1. Where is the line of protesters holding placards, marching outside the Atlanta offices of the CDC? Perhaps we need to look farther back, to the period before the diabetes pandemic began. In 1866, you might recall, the death rate from diabetes in New York City was 1.3 per 100,000 residents. If that rate held today for the 306 million residents of the United States, there would be 4,284 deaths due to diabetes each year. Instead, in 2006, there were 72,507 death certificates on which diabetes was listed as the underlying cause. The official national death rate from diabetes now stands at 23.3 per 100,000, according to the CDC — nearly 19 times higher than it was following the Civil War. And that doesn’t count the additional 200,000 or so deaths each year for which diabetes is listed as a “contributing” cause.
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Dan Hurley (Diabetes Rising: How a Rare Disease Became a Modern Pandemic, and What to Do about It)