Here in the Rio Grand valley along the border (that Trump wants to wall) the incidence of diabetes is nearing 50%. It’s the result of a combination of factors: (in no particular order) socioeconomic, cultural (diet) and genetic inheritance. A new dialysis center opens about every two months. A college classmate of mine who spent his entire distinguished career in diabetes research told me this area is monitored closely as a forecast of what the rest of the US will face.