Sourse: USPSTF and JAMA

What is this about?

This edition of Connections newsletter provides two recent very important articles/studies on our need to address prediabetes and Type 2 diabetes in our working population.  In June, 2021 an original investigation article was published in JAMA entitled “Trends in Prevalence of Diabetes and Control of Risk Factors in Diabetes Among US Adults, 1999-2018”. Some of its highlighted findings are identified below.  The following August, the U.S. Preventive Services Task Force issued a new recommendation on the need to screen for prediabetes and Type 2 diabetes more aggressively, particularly in working populations.  Both these documents are combined into one as the download in this edition of Connections.

Some of the main findings reported in the article on “Trends” included the following:

• Diabetes accounts for approximately 24% of all U.S. health care expenditures.
• Diabetes was defined by self-report of diabetes diagnosis, fasting plasma glucose level of 126 mg/dL or more, or hemoglobin A1c (HbA) level of 6.5% or more.
• Three risk factor control goals were: individualized HbA(A1c) targets, blood pressure less than 130/80 mm Hg, and low-density lipoprotein cholesterol level less than 100 mg/dL.
• The prevalence of diabetes among the U.S. population increased from 9.5% in 1999 to 14.3% in 2017 – one of the highest rates of increase in the world.
• Only 1 in 5 of those with diabetes met all 3 risk factor control goals (fasting glucose, BP and HbA(A1c))

Some of the main findings reported in the “USPSTF” article included the following:

• An estimated 13% of all US adults (18 years or older) have diabetes, and 34.5% meet the criteria for prediabetes.
• The USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity conditions.

Why is this important?

These two documents are important because they highlight the very substantial morbidity and economic burden that diabetes represents to our adult population.  In addition, diabetes as a disease process and as it progresses, exacts a huge personal toll on an individuals’ activity levels, food choices and co-morbidities, let alone its documented role as a major risk factor for COVID complications and premature death. With 2020’s almost 10% increase in national health care spending its probably time to get more serious about diabetes.

What can you do with this document?

• First, skim the document for the major issues and findings they present.
• Next, identify where and when this information can be used to educate employees and managers.
• Next, determine where diabetes should be addressed, such as adding blood sugar level and the HbA (A1c) to your preventive screening battery of tests. (If you haven’t already!)
• Next, determine how you might emphasize the three key risk factors (HbA(A1c), BP and LDL) in various areas in your program.
• Next, consider diabetes as a special claims analysis metric bundle for your long term health plan management strategy.
• Finally, review your progress as you approach the next budget period and map out some new initiatives to address diabetes and prediabetes.

In summary, these two documents provide a number of important informational insights about the importance and practicality of targeting and preventing diabetes as an important clinical problem of our employee populations. It seems like it is time to get more serious about diabetes in our workplace wellness efforts.

(Everyone can now download this document)

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I hope this tool helps you reach your wellness programming goals!  Drop me a note and let me know if you found it to be helpful.