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A Growing Medical Community Seeks To Treat Diseases Before They Set In

Jessica Kourkounis
About 70 percent of people diagnosed with prediabetes go on to develop diabetes. A growing medical community is asking how much impact a patient's choices could make on how the disease develops.

On today's program: Potential solutions to Pennsylvania's growing pension crisis; former mined lands are being converted into forests; and how preventive medicine can inform a diagnosis before disease takes root. 

Can Pennsylvania reduce the size of its pension debt?
(00:00 - 12:20)

Pennsylvania officials are staring down a projected $71 billion shortfall in pension obligations for public school teachers and state employees. This problem has been growing since the recession, but proposed changes froma 2018 report could help fill the gap with a hybridized pension system and the consolidation of pension investment offices. 

Reporter Mike Wereschagin of The Caucus, a weekly print-only newspaper in Harrisburg, looks at potential solutions, including one proposed by Glen Grell, executive director of the Public School Employees' Retirement System, or PSERS. Wereschagin joins The Confluence to talk about the likelihood of those solutions coming to pass. 

Former mines get an ecological makeover 
(13:17 - 17:52)

Jumbo-sized, bladed bulldozers were dispatched earlier this year to till former coal mines still fallow from misguided conservation efforts that previously packed soil too tight for tree growth. Guided by state foresters in Elk County, conservationists and volunteers are now planting over 2,100 saplings on two acres of land, which could grow into a mature forest in the next 50 years.

The Allegheny Front’s Andy Kubis talks about the project with Scott Eggerud, forester and regulator for the state Surface Mining and Reclamation Enforcement office.

“You can’t replace everything that was here,” Eggerud says. “You replace the major components, and it speeds up the healing process.”

Treating disease before symptoms arrive
(17:53 - 38:55)

Pittsburgh is perched on the edge of America's “diabetes belt,” stretching from the South up through Appalachia where diagnoses like diabetes and hypertension are extremely common. When patients are diagnosed with prediabetes, their doctors often suggest practices and behaviors to ward off the disease, and a recent PublicSource report found a growing local community is adopting the approach.

Today's panelists include: 

  • Dr. Raghu Tadikamalla, Allegheny Health Network cardiologist and hypertension expert;
  • Diane Battaglia, registered nurse and UPMC Diabetes Self-Management Education Program instructor;
  • Karen Bryant, a Pittsburgh writer who participated in Battaglia's class; and
  • Oliver Morrison, PublicSource reporter.

While easy in theory, patients like Bryant say taking the initiative to make healthy lifestyle changes can be fear-inducing and difficult to sustain alone. Morrison notes some medical experts worry these new terms are pathologizing otherwise healthy people. Many patients diagnosed with prediseases, they argue, never develop the conditions associated with higher risk.
90.5 WESA's Julia Zenkevich, Julia Maruca and Hannah Gaskill contributed to this program.

The Confluence, where the news comes together, is 90.5 WESA’s daily news program. Tune in weekdays at 9 a.m. to hear newsmakers and innovators take an in-depth look at stories important to the Pittsburgh region. Find more episodes of The Confluence here or wherever you get your podcasts.

Kiley Koscinski covers city government, policy and how Pittsburghers engage with city services. She also works as a fill-in host for All Things Considered. Kiley has previously served as a producer on The Confluence and Morning Edition.
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