An epidemic more deadly than coal dust is sweeping through the dogwood-dappled hollows of eastern Kentucky. The new threat: diabetes. In Kentucky and across the broad Appalachian region, a third of the population is estimated by health officials to have diabetes, double the rate for the country as a whole. Ads for diabetes counseling and testing clinics have replaced those for supermarkets as a major revenue source in local newspapers, and billboards urging middle-aged people to get tested appear almost everywhere there’s a straight stretch of highway.
Three risk factors-insulin resistance, fatty liver, and overweight/obesity-that are commonly associated with the onset of type 2 diabetes can each, by itself, substantially increase the risk of developing the disease. But in individuals that have all three factors working in combination, the risk of developing type 2 in a five-year period increases 14-fold.
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