Addressing chronic diseases could save tens of billions of dollars in healthcare costs annually

Reviewed by James Ives, M.Psych. (Editor)Nov 2 2018

As Americans head to the polls this coming Tuesday, a top issue for all voters is the rising cost of healthcare. A new report has found that addressing chronic diseases, and in particular diabetes, could save tens of billions of dollars in healthcare costs annually.

Released today in the Food & Nutrition Journal, "The Cost and Impact of Type 2 Diabetes: Policy Recommendations for a Growing Public Health Epidemic" demonstrated that if one-fifth of the 30 million Type 2 sufferers in the U.S. used dietary changes to reduce HbA1c levels by one percent, they would not only reverse the course of their diabetes, but the healthcare system would also save at least $10 billion annually and outcomes would improve measurably. If the 84 million prediabetic Americans followed a similar regimen, the savings would increase even further.

Recently, the CDC reported that 30 million people have diabetes and 90 percent of those people are living with Type 2 diabetes. Last year, Type 2 diabetes, and related illnesses, cost the U.S. more than $350 billion to treat, and that number is expected to reach more than $600 billion in the next five years.

Authored by Dr. Paul Keckley, managing editor of The Keckley Report and a prominent healthcare policy analyst and industry expert, the report looks at how the rising costs of diabetes can be reversed if policymakers and public health experts clear up the confusion about the role that nutrition therapy can play in preventing and mitigating the effects of Type 2 diabetes.

"Now is the time to take holistic, comprehensive action that incorporates proven remedies like nutrition therapy to stop the advance of diabetes throughout the American population in its tracks," said Keckley. "Efforts to tackle this crisis head-on have been largely ineffective and the dogma of the past has not solved the problem. Despite widespread evidence that proper nutrition can lead to healthier lives and significantly lower healthcare costs, many policymakers and stakeholders continue to advocate for the same tired, inadequate solutions."

Keckley highlights five major factors that policymakers and healthcare experts have identified as responsible for the increased prevalence and skyrocketing costs associated with Type 2 diabetes:

• Workplace Settings: Workers who spend eight to 12 hours at desk jobs have a 91 percent higher likelihood of developing Type 2 diabetes. Sedentary lifestyles at home and in the workplace have led to decreased physical activity.
• Healthcare Bias Toward Medication: The highly-specialized U.S. health system encourages clinicians to prescribe drugs to treat medical problems. For Type 2 diabetes, over 76 percent of office visits result in a prescription.
• Confusion About Healthy Food Choices: Most Americans remain confused about what foods are "healthy." Nutrition labels are confusing and there is a widespread misunderstanding about how carbohydrates can raise blood sugar and cause problems for people managing diabetes.
• Low Policymaker Prioritization: Nutrition, pricing policies, income inequality and other issues when confronting Type 2 diabetes often require complex solutions across multiple jurisdictions, federal agencies and programs.
• Demographics: Demographic challenges associated with obesity, poverty and food access can cause many families to be at a higher risk for diabetes, heart disease and other health problems. It can also result in shifting definitions of "healthiness," complicating efforts to raise awareness.

Remission of Type 2 Diabetes

Despite the prevalence of Type 2 diabetes, treatments exist that can dramatically improve health outcomes and significantly lower costs. Evidence shows that proper nutrition therapy and exercise can be effective in causing remission of Type 2 diabetes. A one percent decrease in HbA1c, an indicator of Type 2 diabetes, can be achieved through proper dieting alone.

"This is a public health crisis, and policymakers and public health experts have little to lose and much to gain from abandoning a 'one-size-fits-all' approach," said Keckley. "The future of American public health costs and the Type 2 diabetes sufferers in the U.S. require more creative solutions. Many of these - like nutrition therapy - exist. It's time to make the most of them."

Taking Action: Advocating for Nutrition Therapy and Low Carb

Keckley calls on policymakers to refresh the nation's health policies as they relate to the growing prevalence, cost and impact of Type 2 diabetes. Immediate steps that can, and should be taken, include:

• The U.S. Dietary Guidelines should give nutrition recommendations instead of a 'one-size-fits-all' approach to nutrition.
• A major public education campaign can educate consumers about nutrition therapies and healthy choices and help them avoid misleading marketing and health advice.
• Updating of diagnostic screening measures used by primary care clinicians, retail clinics and other primary care venues to diagnose pre-diabetes and Type 2 diabetes. The American Diabetes Association's recent recognition that low carb diets may serve as an appropriate nutrition therapy is a step in the right direction.
• Improvements in medical education to emphasize nutrition therapies.
• Inclusion of explicit nutrition therapy outcomes in alternative payment programs including The Medicare Shared Savings Program and others.
• Appointment of a blue-ribbon commission on nutrition therapy to modernize policies, regulations and food supply chain considerations.