As cases of type 2 diabetes surge past the nationwide average in East Texas, a recent report claims that a lack of health insurance is a driving factor.

Several counties in East Texas are facing the growing prevalence of type 2 diabetes, a metabolic disorder typically caused by obesity, poor diet, and lack of physical activity. Yet a detailed investigation by Public Health Watch, an Austin-based non-profit news organization, alleged that not having health insurance should be considered.

For instance, while the national average of diabetes among adults aged 20 and over was 8.5% in 2020, it was 11.8% in Smith County, 14.5% in Angelina County, and 12.4% in Sabine County.

The American Diabetes Association estimates that over one-third of Texans have pre-diabetes while approximately 621,000 more already have type 2 diabetes but have yet to be diagnosed. Increasing obesity rates have contributed significantly to the growing number of diabetes cases in the state, with the Dallas-Fort Worth area being ranked the 19th fattest metro area last year.

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Experts say diabetes education is crucial to helping curb these rising statistics of what is a preventable disease.

“It’s kind of like a salmon swimming upstream,” explained Marci Wright, a diabetes educator at UT Health East Texas in Tyler, according to the Texas Tribune. “You have to make a personal decision that you’re going to make healthy choices because our society doesn’t make it easy to do that.”

Noting that East Texas has a high concentration of rural communities, Kim Krisberg, who co-wrote the report, told KERA that rural counties “tend to have historically high uninsured rates, and more poverty,” creating a perfect storm.

Not only does this make it more difficult for someone with diabetes to manage it effectively, she claimed, it hampers the early detection of pre-diabetes.

“The earlier that you can catch it, manage it, and change your behavior, the better your outcomes will likely be,” Krisberg said.

For instance, until recently, the cost of insulin without insurance came at a considerable expense. However, the three largest insulin makers — Novo Nordisk, Eli Lilly, and Sanofi — announced in March that they would be slashing their prices for approved generic medications by up to 75% by 2024, as previously reported by The Dallas Express.

Krisberg said having health insurance not only gives diabetes patients access to newer and more effective medications but also makes people more likely to seek preventive care in the first place.