Diabetes Self-Management Training helps to prevent complications in pre diabetes patients

American Association of Diabetes EducatorsAug 5 2010

Diabetes Education Proven to Delay Onset And Prevent Complications in Pre-Diabetes Patients, Relieve Burden on Health Care System

Citing research that demonstrates the cost savings and health benefits of providing Diabetes Self-Management Training (DSMT) to patients with pre-diabetes, the American Association of Diabetes Educators today called on private insurers and Medicare to include education as a covered benefit for this population.

DSMT programs taught by a professionally qualified diabetes educator reduce health costs for those diagnosed with diabetes and for those at high risk of diabetes:

• In a study of more than 32,500 high risk pregnant women with gestational diabetes, DSMT reduced overall pregnancy-related health costs by an average of $13,000 per pregnancy;
• A three year retroactive claims analysis of 4 million covered lives, including 250,000 Medicare beneficiaries, showed an average Medicare cost savings per month/per patient of $135 for those individuals who complete a DSMT program, and inpatient hospital cost savings of $160 per month/per patient;
• A study of more than 3,200 overweight or obese pre-diabetes adults found that lifestyle intervention techniques, such as those taught in DSMT programs, reduced the incidence of diabetes by 58% overall, and 71% for older adults.

"We really view this as common sense. It is clear that diabetes education not only improves the health of people at risk, but generates a net savings to the health care system, to Medicare and to private insurance," said AADE President Deborah Fillman, MS, RD, LD, CDE.  "We are simply calling on Congress and the private sector to recognize this obvious fiscal and public health benefit."

Fifty-seven million Americans are estimated to have pre-diabetes, a condition in which a person's blood glucose level is above normal but below a level that indicates diabetes. Pre-diabetes may have no outward symptoms, and is diagnosed with a blood glucose test.

Left untreated, pre-diabetes will almost always become type 2 diabetes within a few years. In addition to serving as a definitive precursor to the onset of diabetes, individuals with pre-diabetes are at increased risk for a variety of cardiovascular problems, high cholesterol, and polycystic ovarian syndrome for women.

And pre-diabetes is a burden on the health care system. A 2009 study commissioned by the National Changing Diabetes Program, published in the peer-reviewed Population Health Management, quantified these costs and provides a comprehensive estimate of costs for people with pre-diabetes ($25 billion, including 34% more ambulatory visits than the population at large, 92% more physician visits for hypertension, and 9% more visits for cardiovascular disease), those with pregnancy-related gestational diabetes ($636 million, or $3,305 per pregnancy plus $209 in the newborn's first year of life) and those who are as yet undiagnosed ($18 billion).

In practical terms, professionally qualified diabetes educators teach individuals with diabetes and pre-diabetes the essential tools needed to control their diabetes: accurately monitoring blood glucose levels, adopting healthy eating habits, engaging in appropriate exercise, and coping with specific diabetes-related emotional and physical challenges. Professionally qualified diabetes educators are state licensed or registered health care professionals, most commonly nurses or advanced practitioners, dietitians, pharmacists, or podiatrists.