Frank Diamond

Back before our first distant amphibious ancestors emerged from the primeval ooze onto a landscape that looked more like the surface of the moon than Mother Earth, say the 1970s, the great spin on public perception seemed to be that diabetes is not so bad as you might think. I say "seemed" and I mean "seemed." I have no proof, no hard research — only anecdote based on an increasingly faulty memory.

Here's what I recall. In the 1970s, the message was that diabetes is not a death sentence. (Not so different from what's being said about cancer these days.) I remember hearing that Mary Tyler Moore, for instance, has diabetes and look what she's accomplishing. There were other famous sufferers, as well.

The message (at least as received by this non-expert): We can live with diabetes. It now appears that we're living a little bit too much with it as our cover story lays out in some detail.

Contributing Editor Martin Sipkoff shows how the costs are ballooning and incidence is up and going to go higher. Much higher.

For health plans, it is an issue of financial survival. Isn't everything? Numbers help order priorities, however, and should push diabetes management toward the top of the list. Luckily, again as our cover story makes clear, many management approaches are being tried, with some success and more promise.

What I missed back in the 1970s, either because I wasn't paying attention or the message wasn't broadcast, was just how terrible diabetes can be. I've since learned, after watching loved ones die of the disease, and finding out that it runs in my family. Diabetes is chronic, debilitating, and often deadly, and no amount of cheeriness on the part of "Mary Richards" can sugarcoat that.