Recently, I attended the annual conference for the American Association of Diabetes Educators, a group of health professionals whose purpose is to help people live with diabetes. Type 2 Diabetes is fast becoming the most serious health crises in the U.S. A third of all children born today (and half of all Latinos) are expected to become diabetic in their lifetimes.

Diabetes, a chronic illness that must be managed with regular blood tests and medications and strict attention to diet and exercise, hits low income people particularly hard because they can’t afford to shop at Whole Foods, and in many cases, lack access to the drugs they need. In this difficult context, diabetes educators are the ones who sit with patients and explain, inspire, badger, and advocate to help them make changes to live healthier lives. It is exasperating and often thankless work. You could win a Nobel prize for developing a life-saving drug. But you’ll never win one for figuring out a creative way – throwing a BBQ, initiating a discussion group -- to make sure that people actually take the drug properly. And yet around the world – whether it is AIDS, TB, heart disease, or other illnesses – the effectivenss of health care hinges more and more on getting the human element right. (See, for example, “When a Pill Is Not Enough,” by Tina Rosenberg, New York Times Magazine, August 6, 2006, which looks at how South Africans are trying to change behavior patterns to fight AIDS.) For insights into how Americans are coping with today’s diabetes epidemic, we need to listen to and honor the work of the diabetes educators – a hidden army in the homeland.