Insulin and pills, amputations and hospitalizations, lost productivity, disability and early retirement: It all adds up to a $218 billion annual cost of diabetes in the United States, according to a study the Danish drug company Novo Nordisk A/S released today.

And it’s a epidemic no one expects to end soon. Late last month, a Centers for Disease Control study estimated the growth of diabetes cases at 90 percent over the past decade.

“We must step up efforts to prevent and control diabetes, particularly in the Southern U.S. region where we see higher rates of diabetes, obesity and physical inactivity,” CDC data analyst and study lead author lead author Karen Kirtland said in a new release.

Which is why, when Boots came begging for candy this morning, I asked him if he’d finished his peach. Oh yes, he smiled and nodded sincerely. Let’s check, I said, because he’s pulled this one before.

Sure enough, there sat three-quarters of the peach on the kitchen table. Sorry, Boots. No candy for you.

The diabetes statistics are why I’ll keep doing that, even amid the glares, pouts and fussing from the crowd that presents candy as if it’s the Hope Diamond. And that’s just the guys’ reactions. I get even more guff from the adults.

It’s also why I get hot when I see Cheetos on lunch trays in a school district that just this fall hired a single fifth-grade PE teacher to rotate among nine elementaries.

And it’s also why I risked an insurrection Sunday when I limited cartoons to two, telling the guys and their cousin that after that, they would go outside and enjoy the gorgeous weather.

I have no choice but to do it, because the guys have more working against them than a video-crazed culture fueled by junk food and a world where Type 2 diabetes — formerly known as adult-onset — is showing up in more and more children.

They also have to battle genetics.

Among the five people in their father’s immediate family, only one is not diabetic. Of those four cases, three are Type 2 diabetics — the kind most closely linked to obesity. I have a diabetic half-brother. Just as I knew, based on my family history, that asthma and allergies would hit one guy or the other, I fear that with diabetes it’s not a question of if, but of when.

The good news: Diet and exercise can help prevent diabetes. Even in cases where it can’t be prevented, its literally crippling effects can be curbed.

Effects that go beyond surgeries, hospitalizations and constant monitoring, crossing into less enjoyment of life. Impacts far greater than missed work. It also can mean missed days with loved ones.

Which is why pouty-eyed Boots didn’t get the candy this morning. I want him to one day be able to refuse the same request from his kids and grandkids.

Copyright 2008 Debra Legg. All rights reserved.

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