Prevention is the watchword.
Jeanne Ortiz, an obesity and diabetes doctor at Billings Clinic, argues that health care systems are set up to treat diabetes once it's become a full-blown problem, leaving little room to focus on prevention.
But the most effective way to beat a disease like diabetes is to prevent it, Ortiz said.
"We have to be very aggressive at identifying those patients" who are at a high risk of getting the disease, she said.
"We've got to get our patients engaged," said Lisa Ranes, a healthy living specialist and coordinator at Billings Clinic's Diabetes Center.
Those most at risk include people who smoke and are overweight, those who have a family history of diabetes and those who consume large amounts of sweets and soda.
Diabetes rates in Yellowstone County keep climbing, and many of those highest at risk don't know they're at risk. Of the 157,000 people in Yellowstone County, over 9,600 have been diagnosed with diabetes. That's up from 6,600 a decade ago.
Across the state, roughly 64,000 people were diagnosed with diabetes last year, about 8 percent of Montana's population. In 1990, only 3 percent of the state had diabetes.
Nationwide, new figures released last week by the Centers for Disease Control and Prevention show that 30.3 million people, almost 10 percent of the country's population, have diabetes. Punctuating the problem, the CDC estimates that a quarter of them — 7.2 million — don't know they're diabetic.
"A lot of people don't realize they have it," Ranes said.
Which is why Ranes and Ortiz are eager to get high-risk patients identified and treated early, preferably before they become full-blown diabetics. Part of that effort includes a diabetes prevention class given by Ranes.
The class has been in place for years, part of a pilot program started by the state a decade ago when tobacco settlement money was being doled out by Washington. The courses have been successful in helping people create healthier lifestyles and controlling their diet.
"You can reduce the risk of diabetes by 51 percent if you simply change your lifestyle," Ranes said.
These classes — St. Vincent Healthcare, partnering with the YMCA, has its own — have proven so effective that other states have launched programs modeled on Montana's efforts.
"Much of the nation is looking at what Montana is doing," Ranes said.
Ortiz, who regularly encourages her patients to enroll in the classes, has seen the results as her patients begin to apply to their lives the tips and techniques taught by Ranes.
"The patients who do this class, they absolutely love it," Ortiz said.
The class doubles as a support group, and the patients become a close-knit community as they work together, encouraging each other to improve and stick with the lifestyle changes they are trying to make.
It also has a generational impact. Children often form their lifestyle habits by observing their parents. Everything from the types of meals eaten in the home to the amount of activity a child gets is often greatly influenced by their parents' decisions.
"When mom or dad joins (the class) it has a trickle-down effect on the whole family," Ranes said.
Parents begin fixing healthier meals and they start finding ways to be more active, which affects everyone under their roof.
For Ortiz, health care providers have everything they need right now to change people's lives and help them avoid becoming diabetic.
"We can reverse this with these tools now," she said.
"It's going to take a community to make a dent in this," Ranes said.