Julie Funk, MS, RD, CDE, LDN
Director, Community Health and Wellness
If you saw a bulldozer driving straight towards you, there is no doubt that you would jump out of the way, right? Fortunately, that kind of threat we usually see coming and, hopefully, have time to react. A far less visible, but just as powerful threat to your business is the epidemic of Pre-Diabetes. Though the Centers for Disease Control (CDC) estimates that one in every three American adults already has pre-diabetes, the vast majority of this population is unaware of the ticking time bomb inside them.
Pre-Diabetes is a condition where blood sugars in the body are higher than normal, but not yet high enough to be diagnosed with diabetes. Without intervention many of those with pre-diabetes will continue to develop full blown type 2 diabetes. Once this happens, the bulldozer has hit and damage is already taking place! The average annual medial claims cost for an employee with diabetes is $13,243 compared to $2,560 for an employee without diabetes (Diabetes America). If the disease is not managed properly, costs to treat related complications can escalate, per national averages, in the range of $6,000 per person annually. Amputations, blindness, heart disease, kidney disease and stroke loom on the horizon for those with uncontrolled diabetes.
The bottom line is that the cost of preventing diabetes (and diverting the bull dozer) is much smaller than the cost of managing Type 2 Diabetes and its related complications.
The startling fact is that prevention of this cascade is as simple as modest weight loss and increased physical activity. This may not seem possible, but the evidence is clear. Research of many thousands of people over nearly a decade showed that diabetes risk was reduced or delayed in 58% of those who participated in the National Diabetes Prevention Program (DPP). This program produces what the $60 billion weight loss market industry has yet to accomplish - consistent and significant results. The difference is in the approach and the length of time a person engages the program to foster positive lifestyle change. Short-term programs often produce short-term results, if any. Below are listed some of the characteristics of the Diabetes Prevention Program that make the difference:
- Program length is one year
- 16 weeks of one hour classes with approximately 10 to 15 participants/class
- Monthly follow-up classes through the end of the program year
- Instruction is provided by lifestyle coaches trained to teach an approved curriculum
- Program targets those at high risk, so participants must qualify to participate. (To view a risk assessment, visit www.cdc.gov/diabetes/prevention).
- Specific goals are defined:
- Modest weight loss of 5% to 7%
- 30 minutes of exercise 5 days-a-week
The cost of the program is approximately $500 per participant. There are several potential payment models that can be considered, including:
- Addition of the program as a covered benefit of your insurance carrier
- Payment through the employer's wellness budget or wellness incentive program
- Cost-share with employees based on participation and results
- A Pay-for-Performance Model whereby the company pays at regular milestone intervals and final payment is only made for those participants that achieve above weight loss and activity goals.
Chester County Hospital can help outline how the National Diabetes Prevention Program can help you control your healthcare costs. If you are interested in learning more about bringing this program to your workplace, and how to identify your high risk employees, contact Sara Pevoto, Client Services Manager at the Occupational Health Center and Travel Medicine Program (Sara.Pevoto@uphs.upenn.edu or 610-738-2455). Sara will set up a time to meet with our diabetes prevention team and discuss how we can work with you to offer the National Diabetes Prevention Program at your workplace.