Curbing the Diabetes and Prediabetes Epidemic

By the year 2020, 52% of adults in the U.S. could be prediabetic or diabetic, up from about 40% today according to a new report....
The report recommended strategies for curbing these costs, particularly lifestyle interventions and programs to increase medication adherence. Instituting such programs could save as much as $250 billion over 10 years, including $144 billion in savings for the federal government, authors of the report estimated.
Simon Stevens, executive vice president of UnitedHealth Group, and chairman of the Center for Health Reform & Modernization, said in a statement, "Our new research shows there is a diabetes time bomb ticking in America, but fortunately there are practical steps that can be taken now to defuse it."
"What is now needed is concerted, national, multi-stakeholder action. Making a major impact on the prediabetes and diabetes epidemic will require health plans to engage consumers in new ways, while working to scale nationally some of the most promising preventive care models."
Weight loss among individuals prone to prediabetes is one area targeted in the report. "Our simulation suggests that a five percent weight loss (the target recommended by the American Heart Association) could reduce prediabetes gradually, leading to a 10% reduction by 2020," the authors wrote. Some reduction in conversion to diabetes also would occur, they suggested.
In addition, the report said that if all of the recommendations were enacted, increases in workplace productivity and increased wages resulting from the health improvements would be worth an estimated $239 billion over 10 years.
The report, "The United States of Diabetes: Challenges and Opportunities in the Decade Ahead," (See this week's Tool for Your Practice.) produced for November's National Diabetes Awareness month, offers practical solutions that could improve health and life expectancy, while also saving up to $250 billion over the next 10 years, if programs to prevent and control diabetes are adopted broadly and scaled nationally. This figure includes $144 billion in potential savings to the federal government in Medicare, Medicaid and other public programs.

Key solution steps include lifestyle interventions to combat obesity and prevent prediabetes from becoming diabetes and medication control programs and lifestyle intervention strategies to help improve diabetes control.
Solutions:

The United States of Diabetes: Challenges and Opportunities in the Decade Ahead focuses on four categories of potential cost savings over the next 10 years:
• Lifestyle Intervention to Combat Obesity: There is an opportunity to reduce the number of people who would develop prediabetes or diabetes by nearly 10 million Americans, through public health initiatives and the wider use of wellness programs to combat obesity.
• Early Intervention to Prevent Prediabetes from Becoming Diabetes: Evidence from randomized controlled trials and UnitedHealth Group's own experience demonstrates that the use of community-based intervention programs -- such as the UnitedHealth Group Diabetes Prevention Program (DPP) in partnership with the YMCA -- could reduce the number of people with prediabetes who convert to diabetes by an additional 3 million. The DPP is based on the original U.S. Diabetes Prevention Program, funded by the National Institutes of Health (NIH) and the CDC, which demonstrated that with lifestyle changes and modest weight reduction, individuals with prediabetes can prevent or delay the onset of the disease by 58 percent.
• Diabetes Control through Medication and Care Compliance Programs: Better management of diabetes through improved medication and care compliance programs can help control the disease and reduce complications, such as UnitedHealth Group's Diabetes Control Program (in partnership with community pharmacists).
• Lifestyle Intervention Strategies for Diabetes Control: The wider use of public-private partnerships to develop the infrastructure to scale nationally the promising learnings of the Look AHEAD Trial.