Akankasha Goyal, MD: Effectiveness of Fight Against Diabetes


Discussing why initiatives and policy changes in the fight against obesity and diabetes have been perceived as less successful than those against smoking and educating on cardiovascular diseases.

With diabetes impacting more than 30 million Americans and an additional 160 million classified as obese, it is no surprise the onus of many public health policies in recent years were aimed at addressing these issues.

Still, the American Diabetes Association projects 1.5 million Americans will be diagnosed with diabetes every year, which has led some to call into question the effectiveness of these efforts in shifting the course of current disease states.

Often used as a model for effective public health campaigns, policy changes and perception surrounding tobacco use and smoking were incredibly successful for slowing the rise of cardiovascular disease—while programs from groups like the Centers for Disease Control, National Institute of Health, and American Diabetes Association have driven awareness and calls for action, diabetes and obesity are still sometimes considered to be neglected health crises by some.

For more on how clinicians view these trends and whether they feel the tide is shifting in the fight against diabetes, MD Magazine® sat down with Akankasha Goyal, MD, endocrinologist and instructor in the Department of Medicine at NYU Langone Health.

MD Mag: Why has the fight against obesity and diabetes not had the same impact as anti-smoking and other campaigns on curbing cardiovascular disease?

Goyal: Well, because it's a new diagnosis. Smoking has been a public health concern for decades as compared to diabetes and obesity, which basically became a public health concern in the past couple of years, not even a decade, I would say. So, again, it's like the social aspects of changing acceptability of this disease and it's no longer considered that you cannot control it. Now, there is more nutritional counseling available, there's more food packaging available, there are more insights into all these diets—plant-based diets, keto diet, intermittent fasting—which people are aware of and are willing to change.

I would say that, again, smoking has been a public health concern for a long, long time. Obesity is increasingly being recognized and diabetes is increasingly being recognized. That's the first step to combat any health condition and, over time, we certainly have hope that you know, it can be equally tackled, as smoking has been.

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