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MARCH / APRIL 2012 :: 73(2)
Oral Health

This issue's policy forum focuses on initiatives that promote oral health and on challenges the state currently faces. Commentaries discuss new practice models and trends in dental practice, dentist workforce numbers, the East Carolina University School of Dental Medicine education model, and insurance innovation in dental coverage. Several articles focus on access to oral health care in specific populations including children, adult Medicaid recipients, and people with special needs. Original articles examine reasons for tanning bed use among community college students and evaluate the effectiveness of mailed interventions to increase colon cancer screening.


Facing Down Diabetes: Are We Putting Our Best Foot Forward?

Allen J. Smart

N C Med J. 2012;73(2):149.PDF | TABLE OF CONTENTS

To the Editor—The September/October 2011 issue of the NCMJ, Confronting the Diabetes Epidemic, was full of some wonderfully promising work as well as some daunting descriptions of the barriers and burdens of the disease. There is clearly a high degree of interest in the issue in North Carolina and a lot of very talented people working toward better outcomes.

So now it’s time to issue the challenge. Who is going to align the best of this work and drive the state towards a fundamental decrease in diabetes morbidity and mortality?

What we hear from our grantees in the field is that there is no affordable and widely accessible program of diabetic care and follow-through that is embraced by the intended user and their community. The corollary to this that we hear is a version of the following: “We have a great program, but x number of factors prevent us from recruiting/retaining participants and sustaining impact.”

So a broader question remains. Can we program our way out of the diabetes crisis? If we think so, than we have got to go at it much more vigorously than our current promising but scattershot approaches allow. If we don’t have hope that these types of programs can really gain us traction, we need to change the entire paradigm of the discussion and start looking at how we got into this mess in the first place.

Potential conflicts of interest. A.J.S. has no relevant conflicts of interest.

Allen J. Smart director, Health Care Division, Kate B. Reynolds Charitable Trust, Winston-Salem, North Carolina.

Address correspondence to Mr. Allen J. Smart, Kate B. Reynolds Charitable Trust, Winston-Salem, NC 27106 (