Memphis is known as a hub for a number of important enterprises, including transportation systems, barbecue restaurants, the cotton industry, healthcare research and, until recently, grit-and-grind basketball.

The city also is a hub –make that the hub – for something far less likely to inspire civic pride: diabetes.

“Four out of the five states with the highest incidence of diabetes touch on Memphis,” says Dr. Jay Cohen, medical director of The Endocrine Clinic, which recently joined Baptist Medical Group (BMG). “There’s Mississippi, Arkansas, Tennessee and parts of Alabama and Louisiana. The only outlier is West Virginia. Memphis is the largest city among those states, and we are the epicenter.”

That is one reason BMG will be the leadership arm in the Memphis community for participation in a national program called “Together 2 Goal” that aims to reduce diabetes through awareness, education and treatment.

Nearly 30 million Americans have diagnosed or undiagnosed diabetes, according to the Centers for Disease Control and Prevention. Despite steady advances in research and treatment, that number has tripled over the past 25 years.

“While diabetes affects 8 percent of the U.S. population, it’s estimated to be 12 to 14 percent in the Memphis area and another 6 to 10 percent have prediabetes,” Cohen said. “Most of that is because of the rise of obesity in our community. Decreased exercise and increased calorie consumption have been the major contributors. There are lots of reasons why people are not exercising as much and consuming more calories, but you combine those two and it leads to diabetes.”

Diabetes occurs when a person has high blood sugar, either because insulin production is insufficient or because the body’s cells do not respond properly to insulin or both.

Doctors often call it diabetes mellitus, with diabetes coming from the Greek word siphon and mel being the Latin word for honey and referring to the sweetness from excess glucose in the blood and urine of those with diabetes.

The ancient Chinese noticed that ants actually were attracted to the urine of diabetics, thus the term “sweet urine disease” was coined. 

People with diabetes become susceptible to a long list of other health problems affecting the heart, eyes, skin, feet, gums, hearing, blood pressure and even mental health.

Diabetes affects the entire community, Cohen added, including families, employers and, by extension, productivity in the workplace.

There are three types of diabetes: Type 1 or juvenile diabetes in which the body does not produce insulin, Type 2 in which the body does not produce enough insulin for proper function or the cells in the body are resistant to insulin, and Gestational Diabetes in which pregnant women have high levels of glucose in their blood and their bodies are unable to produce enough insulin to transport the glucose to their cells.

Type 2 diabetes is by far the most prevalent form, making up nearly 95 percent of all cases.

“Diabetes can be prevented, cured and controlled,” said Cohen, who has practiced endocrinology for more than 30 years. “With a family history of diabetes, if one dramatically changes exercise and food behaviors and makes exercise a daily drug, you can prevent development of Type 2 diabetes in many people. We take people off medication every day. Our goal is education, prevention and aggressive management to prevent complications.

“Everybody with diabetes does not need to see an endocrinologist, but everybody with diabetes needs to have a healthy, positive relationship with their primary care provider to help them manage the multiple aspects of diabetes because they have an 85 to 90 percent chance of being overweight, having high blood pressure, having lipid or cholesterol abnormalities.”

The “Together 2 Goal” program, which involves a number of other large, multi-specialty medical groups around the country, including the Mayo Clinic, aims to launch a multi-pronged attack on diabetes.

“This will go way beyond just awareness,” said Cohen, who recently served on the advisory board of the American Board of Clinical Endocrinologists to develop national treatment guidelines. “It will be awareness and active treatment plans that are individualized for each person and family who is part of this program. We’re going after the problem. We’re going to tackle issues from exercise, heart attack reduction, blood pressure improvements, cholesterol lipid management as well as blood sugar.

“There are a number of reasons for this program. The man with diabetes has a 400 percent increase in the chances for a heart attack over a non-diabetic man. For a woman with diabetes it’s a 500 percent increase in cardiac death. That’s quite a number.”

The reason Memphis is the nation’s hub for diabetes has to do with many factors.

“The areas of the country that are more economically disadvantaged have the highest incidence of diabetes, less access to healthy food, less access to education and prevention and less access to exercise opportunities,” Cohen said. “So when you combine that with healthcare disparities and socio-economic disparities, it becomes a pressure cooker for increased incidence of obesity and development of Type 2 diabetes.

 “The name of the game is that these risks are unnecessary and treatable, but it takes a coordinated effort educating physicians and other healthcare providers, families, patients, employers, the faith-based communities as well as government and strategic partners. Let’s make Memphis America’s healthiest city.”