(Picture from CBS News.)
That means chances are one in three your child, or grandchild, could be at risk for blindness, kidney failure, the loss of their limbs, and health care costs double the national average, maybe within your lifetime. (Probably not in mine -- I'm 55.)
They may not be able to get care for it, either.
Diabetes cost the U.S. $174 billion last year, $116 billion in direct medical costs. (That's out of a total health care bill approaching $2.5 trillion.) About 24 million Americans have diabetes now (although one fourth of them don't know it).
Triple that toll and no system -- public or private -- can sustain it.
It's not just our problem. Diabetes is rising throughout Europe, with rates in Germany now comparable to those here.
Curiously, the rate of diabetes in England is relatively low. A recent RAND study indicated the key factor here isn't body mass index, but waist size. It's not just that we're fat, but that our fat accumulates around the middle of our bodies, that makes the difference.
There is a political dimension to the American epidemic. Rates of both obesity and diabetes are inversely related to education and income. Dropping the poor from care lowers the financial cost of the disease even as it raises its social cost.
Once you have diabetes you have it for life. You can control it with medicine, with diet, and with exercise. But it seldom gets better and won't go away.
Some cases of diabetes can't be prevented. Your genetic history is a factor. (I learned recently my grandmother and her sister had it.) The risk increases with age.
But some risk factors can be controlled, should you decide to. Your weight, for one thing. Your waist size, for another. (Even if you're of normal weight, a wide middle puts you at higher risk.) The guy in the front of the picture above carries a bigger risk of diabetes than the lady behind him.
So the bottom line here is simple. We either get in shape or it doesn't matter at all what we do in terms of health care policy. It will fall from the weight. Literally.
Maybe not in your lifetime, but certainly in that of your children and grandchildren.