Early detection key to fighting type 2 diabetes increase

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Today, 26 million Americans – including children and adolescents – struggle with diabetes. An additional 79 million adults are estimated to have prediabetes, putting them at a higher risk for developing the disease. And, diabetes and prediabetes is projected to cost the federal government $1.7 trillion between 2011 and 2020. 

At this rate, it’s clear that a critical component to getting our country back on track financially is to address one of the root causes of rising health care costs – preventable chronic diseases. We must embrace sound health policies that target diseases, such as type 2 diabetes, which are taking both a human and economic toll on our country.

Specifically, these policies must focus on initiatives that address diabetes prevention, detection, and care.

The National Institutes of Health-funded Diabetes Prevention Program (DPP) demonstrated considerable results through evidence-based lifestyle interventions that decreased participants’ risk for type 2 diabetes by almost 60 percent. And, by as much as 71 percent in seniors.

With those results, the small down payment to scale this program to a national level through the CDC-led National Diabetes Prevention Program (NDPP) could be returned many times over. In fact, implementing this program nationally is estimated to result in savings of as much as $191 billion over ten years, with over $142 billion in savings to the Medicare and Medicaid programs.
 
However, prevention alone is not enough to change our current trajectory. Early detection is the first step. Targeted screening of those at risk for type 2 diabetes is critical to identifying the disease in those who are undiagnosed and preventing its onset in those at risk for the disease. 

Already, the Medicare program covers screening for beneficiaries at risk for type 2 diabetes based on certain risk factors, such as family history, age, hypertension, and body mass index.  However, less than 12 percent of beneficiaries utilize this benefit. 

It is imperative that we find opportunities to ensure that those most at risk, particularly our seniors, are aware of their risk and are appropriately screened.

To this end, bringing the current U.S. Preventive Services Task Force recommended screening guidelines in line with the Medicare program and the recommendations of the diabetes community is a step in the right direction to fighting this deadly disease.

Likewise, there is a need for an increased focus on helping individuals manage their disease after diagnosis. The Affordable Care Act provisions providing new coverage options and prohibiting plans from limiting or rescinding coverage for individuals with preexisting conditions, such as diabetes, go a long way toward making sure individuals have access to the appropriate care to manage their disease.

But more must be done.

Ensuring national access to evidence-based prevention programs, such as the NDPP, and improving upon clinically-recognized guidelines for diabetes screening are not enough. We must think outside of the box and remove the policy hurdles, such as short-term budget scores, stopping us from preventing this disease.  

Changing the course of this disease will be hard. And, recent indications highlighted in the New York Times that type 2 diabetes may be correlated with Alzheimer’s will only escalate the magnitude of this epidemic.  

The Department of Health and Human Services should be commended for their efforts to raise the awareness of type 2 diabetes around the world. In recognition of National Diabetes Month, on November 14, World Diabetes Day, Secretary Sebelius reaffirmed the agency’s commitment to educating ourselves and our communities on how we can prevent, treat, and manage diabetes.  

But, now and going forward, we must call upon all stakeholders, lawmakers, policymakers, and the diabetes community alike to come together around a common set of goals and principles, marshaling resources – as limited as they be – to curb its further spread in a coordinated and effective manner. 

We owe that to ourselves, our families, and our children – not only because it’s good fiscal policy, but because it’s a matter of life and death. 

Daschle, a former Senate majority leader, is now a senior policy advisor at DLA Piper (U.S.), whose clients include Novo Nordisk, a health care company that focuses on diabetes care.