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Cdc Diabetes Screening Guidelines

Overview

Overview

The importance of both diabetes and these comorbidities will continue to increase as the population ages. Therapies that have proven to reduce microvascular and macrovascular complications will need to be assessed in light of the newly identified comorbidities. Lifestyle change has been proven effective in preventing or delaying the onset of type 2 diabetes in high-risk individuals. Based on this, new public health approaches are emerging that may deserve monitoring at the national level. For example, the Diabetes Prevention Program research trial demonstrated that lifestyle intervention had its greatest impact in older adults and was effective in all racial and ethnic groups. Translational studies of this work have also shown that delivery of the lifestyle intervention in group settings at the community level are also effective at reducing type 2 diabetes risk. The National Diabetes Prevention Program has now been established to implement the lifestyle intervention nationwide. Another emerging issue is the effect on public health of new laboratory based criteria, such as introducing the use of A1c for diagnosis of type 2 diabetes or for recognizing high risk for type 2 diabetes. These changes may impact the number of individuals with undiagnosed diabetes and facilitate the introduction of type 2 diabetes prevention at a public health level. Several studies have suggested that process indicators such as foot exams, eye exams, and measurement of A1c may not be sensitive enough to capture all aspects of quality of care that ultimately result in reduced morbidity. New diabetes quality-of-care indicators are currently under development and may help determine whether appropriate, timely, evidence-based care is linked to risk factor reduction. In addition, the scientific evid Continue reading >>

Community-based Diabetes Screening And Risk Assessment In Rural West Virginia

Community-based Diabetes Screening And Risk Assessment In Rural West Virginia

Community-Based Diabetes Screening and Risk Assessment in Rural West Virginia Ranjita Misra ,1,* Cindy Fitch ,2 David Roberts ,3 and Dana Wright 4 1Department of Social & Behavioral Sciences, Robert C Byrd Health Science Center, School of Public Health, West Virginia University, 3313A, Morgantown, WV 26506-9190, USA 2Programs and Research, Extension Service, West Virginia University, P.O. Box 6031, 812 Knapp Hall, Morgantown, WV 26506-6031, USA 1Department of Social & Behavioral Sciences, Robert C Byrd Health Science Center, School of Public Health, West Virginia University, 3313A, Morgantown, WV 26506-9190, USA 2Programs and Research, Extension Service, West Virginia University, P.O. Box 6031, 812 Knapp Hall, Morgantown, WV 26506-6031, USA 3WVU Extension Service, Lincoln and Boone Counties Extension Agent, Hamlin, WV, USA 4WVU Extension Services, 815 Alderson Street, Williamson, WV 25661, USA Received 2015 Sep 14; Revised 2015 Nov 20; Accepted 2015 Dec 10. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC. This project utilized a cross-sectional study design to assess diabetes risk among 540 individuals from 12 counties using trained extension agents and community organizations in West Virginia. Individuals were screened for diabetes using (1) the validated 7-item diabetes risk assessment survey and (2) hemoglobin A1c tests. Demographic and lifestyle behaviors were also collected. The average age, body mass index, and A1c were 51.2 16.4, 31.1 7.5, and 5.8 0.74, respectively. The majority were females, Non-Hispanic Whites with no prior diagnosis of diabet Continue reading >>

So...do I Have Prediabetes?

So...do I Have Prediabetes?

With a little exercise and a change in diet, it often can be reversed. Let's face it, there are millions of reasons why we don't find the time to make healthy lifestyle choices. Kids, jobs, cat videos on the Internet — we're busy. But whatever your reason, prediabetes is real. So find out if you have prediabetes by taking the test now. You won't regret it. Join the National DPP You're not alone in this. There are hundreds of Diabetes Prevention Programs in local communities that are proven to help people with prediabetes make lifestyle changes to prevent or delay type 2 diabetes. We're sure there's one that's right for you. "But I'm a busy mom...I don't have time to eat right and exercise!" Yes, making lifestyle changes may seem hard. But it doesn’t have to be. In fact, some of them can even be fun. Continue reading >>

A New Diabetes Screening Tool To Promote Early Detection

A New Diabetes Screening Tool To Promote Early Detection

A New Diabetes Screening Tool to Promote Early Detection by Physicians Weekly | Jun 30, 2010 | 2 comments Heejung Bang, PhD, has indicated to Physicians Weekly that she has or has had no financial interests to report. Heejung Bang, PhD, has indicated to Physicians Weekly that she has or has had no financial interests to report. Researchers have developed and validated a simple self-assessment questionnaire for the detection of diabetes in an effort to identify more of the millions of patients who are unknowingly living with the disease. Research has shown that more than 60 million adults in the United States have diagnosed diabetes, undiagnosed diabetes, or prediabetes. Approximately 30% of diabetes cases are estimated to be undiagnosed, says Heejung Bang, PhD. Diabetes is a silent killer and many patients dont know they have it, but clinicians can help patients by steering them to assess their risk on their own. With the steadily increasing prevalence of the disease, prevention of diabetes has become a major health priority, and the identification of high-risk people who may benefit from early lifestyle interventions is paramount. National guidelines for diabetes screening are available to help detect undiagnosed disease. In addition, several risk assessment tools for prevalent or incident diabetes have been developed to identify patients who are most in need of screening. In the United States, national guidelines for diabetes screening have been released by the CDC, the American Diabetes Association (ADA), and the Preventive Services Task Force. In addition, two risk-scoring algorithms for undiagnosed diabetes have been derived from nationally representative samples. These methods have been developed using slightly different frameworks and purposes, but they are not Continue reading >>

Cdc Recognizes Dps Healths Digital Diabetes Prevention Program

Cdc Recognizes Dps Healths Digital Diabetes Prevention Program

Click Here to Receive Diabetes news via Email TheCenters for Disease Control and Prevention (CDC) has recognized that DPS Health meetsits standards inproviding programs that are focused onhelping prevent type 2 diabetes . DPS Health is atop leaderin clinically-proven interventions to change digital behavior ofthe emergent-risk population. This is the very first time that digital programs areincluded in the CDC guidelines within its Diabetes Prevention Recognition Program . In the past, the standard programs for diabetes prevention only allowed the utilization of face-to-face interaction programs. The CDCs recognition of remote and online services as viable for those at risk for diabetes is a significant step forward for not only the diabetes community, but also the medical community.Since our online DPP program called Virtual Lifestyle Management (VLM) rolled out in 2006, weve successfully supported quantifiable behavior change for tens of thousands of people. This recognition will help patients feel confident that these tools are viable and results-driven, stated Neal Kaufman, who is theDPS Healthschief medical officer. Adam Kaufman, theDPS Health CEO,said in a press release :As concern grows around the rate of pre-diabetes and obesity in the U.S., these new guidelines provide clarity to the market on which programs are proven and evidence-based and committed to supporting consumers in formats that directly address their needs. This is a very exciting development for our industry, and we look forward to helping lead the movement behind the continued acceptance of digital tools for healthcare. DPS Health was founded in 2004and helps empower organizations to improvethe health of their patients, employees and members thanks to research-proven, mobile andweb self-manageme Continue reading >>

Zzz_prediabetes: Page 12

Zzz_prediabetes: Page 12

Current Reimbursement for Prediabetes Care The American Diabetes Association supports lifestyle modification as the best method of treating prediabetes because there is insufficient evidence to support the cost-effectiveness of medication interventions. The completed prevention trials indicate that an intensive lifestyle intervention provides the greatest reduction in the occurrence of diabetes, along with a modest reduction in cardiovascular disease risk factors (CDC, 2007). Assessing costs and savings can be a challenge in determining the best strategies for preventing diabetes among those with prediabetes. For example, lifestyle changes are usually paired with medical treatment, making it difficult to decipher which prevention strategy is most cost effective. Also, the brief duration of some trials limits the ability to determine long-term effects, such as morbidity (complications) or mortality (CDC, 2007). Insurance plans differ in reimbursement for diabetes and prediabetes screening and treatment. Most insurance plans cover testing for people suspected of having diabetes. Because the tests and risk factors are the same for both conditions, a prediabetes test may be covered (CDC, 2007). As of 2005, the Centers for Medicare and Medicaid Services (CMS) cover screening tests for diabetes for those who have been diagnosed with prediabetes. The CMS policy covers the following: Two diabetes screening tests per year for individuals with diagnosed prediabetes. One diabetes screening test per year for individuals who were never tested or whose test results were negative for prediabetes. Covered tests include the fasting blood glucose (FBG) test and the post-glucose challenge test (OGTT). Medicare-covered diabetes screening tests do not require co-payments, deductibles, or c Continue reading >>

A Patient Self-assessment Diabetes Screening Score:

A Patient Self-assessment Diabetes Screening Score:

A patient self-assessment diabetes screening score: development, validation, and comparison to other diabetes risk assessment scores Heejung Bang , PhD,1 Alison M. Edwards , MStat,1 Andrew S. Bomback , MD, MPH,2 Christie M. Ballantyne , MD,3 David Brillon , MD,4 Mark A. Callahan , MD,5 Steven M. Teutsch , MD, MPH,6 Alvin I. Mushlin , MD, ScM,4,7 and Lisa M. Kern , MD, MPH4,7 1Division of Biostatistics and Epidemiology, Department of Public Health, Weill Medical College of Cornell University, New York, NY 1Division of Biostatistics and Epidemiology, Department of Public Health, Weill Medical College of Cornell University, New York, NY 2 Division of Nephrology, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY 3Section of Atherosclerosis and Lipoprotein Research, Department of Medicine, Baylor College of Medicine, and Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart Center, Houston, TX 4Department of Medicine, Weill Medical College of Cornell University, New York, NY 7Department of Public Health, Weill Medical College of Cornell University, New York, NY 4Department of Medicine, Weill Medical College of Cornell University, New York, NY 7Department of Public Health, Weill Medical College of Cornell University, New York, NY 1Division of Biostatistics and Epidemiology, Department of Public Health, Weill Medical College of Cornell University, New York, NY 2 Division of Nephrology, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY 3Section of Atherosclerosis and Lipoprotein Research, Department of Medicine, Baylor College of Medicine, and Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart Center, Houston, TX 4Department of Medicine, Weill Medical Colleg Continue reading >>

Should You Get A Free Type 2 Diabetes Screening?

Should You Get A Free Type 2 Diabetes Screening?

Free screenings for diabetes are sometimes available at pharmacies, and even in big-box stores, like Walmart. You may also be able to get a free blood sugar test at your local hospital. But before you go, it’s important to understand the limitations of this blood sugar test. "In most cases, the diabetic test given at a free screening is a point-of-care blood sugar test," says Shannon Knapp, RN, CDE, manager of diabetes education in the department of endocrinology, diabetes, and metabolism at the Cleveland Clinic in Ohio. These tests measure blood sugar with a finger prick and a glucose monitor. "Free screenings for diabetes are beneficial but have a lower accuracy rate than lab tests done in a doctor's office," Knapp notes. "They may be given at health fairs, community centers, or local pharmacies, but they are not a substitute for your primary care doctor." There are reasons that free screenings for diabetes may be an early indicator of the disease but still don’t provide a complete picture on their own. "To diagnose diabetes, you generally need two elevated fasting blood sugars," explains Knapp. "It's important to know that if you have free screening for diabetes without fasting, the results are not very useful. Any abnormal diabetic test needs to be followed up with your doctor." Why Get a Free Diabetes Screening? The purpose of this type of screening is to serve as an early alert, hopefully cutting down on the damage done by type 2 diabetes by uncovering it and addressing it early, before you have any complications of high blood sugar. Also, "These screenings have the potential to catch other types of diabetes," adds Knapp. Since more than 29 million Americans have diabetes, and another 86 million are at risk for the disease, early diagnosis is more important th Continue reading >>

Prevent Diabetes Third Way

Prevent Diabetes Third Way

David went to his physician in the Minneapolis area for a check-up and found out he was at risk for getting Type 2 diabetes. His physician found his blood sugar in the prediabetic range, and explained to David that he has prediabetes and how that condition could affect his life. David was alarmed because he had seen his mother-in-law and friends struggling to deal with diabetes. He enrolled with a local diabetes prevention program at the Y which helped him realize how poorly he was eating and showed him how to lose weightdrastically decreasing his chance of getting diabetes. The physician got Davids commitment to the program, which was covered by Davids health plan, and he learned healthy diet and exercise tips that he incorporated into his daily life. After a year, David has lost a significant amount of weight and greatly reduced his risk of developing diabetes.1 Davids story is how our health care system should operate. But, currently there are too many obstacles to adequate diabetes screenings and getting patients into effective prevention programs. By changing the way we diagnose and treat diabetes, patients will live a longer, healthier life and the federal government could save as much as $8.1 billion over 10 years. This idea brief is one of a series of Third Way proposals that cuts waste in health care by removing obstacles to quality patient care. This approach directly improves the patient experiencewhen patients stay healthy, or get better quicker, they need less care. Our proposals come from innovative ideas pioneered by health care professionals and organizations, and show how to scale successful pilots from red and blue states. Together, they make cutting waste a policy agenda instead of a mere slogan. What is Stopping Patients from Getting Quality Prediab Continue reading >>

Hedis Spotlight: Comprehensive Diabetes Care (cdc)

Hedis Spotlight: Comprehensive Diabetes Care (cdc)

HEDIS Spotlight: Comprehensive Diabetes Care (CDC) About 29.1 million people (about 1 in 11 people) in the United States have diabetes. In 2012, the American Diabetes Association (ADA) reported that diabetes care cost $245 billion, with $69 billion attributed to a reduction in productivity as a result of diabetes. Due to the complexity of this disease, health plans collect data for diabetes monitoring and screening for patients 18-75 years of age. The measure looks for the percentage of members with diabetes (type 1 and type 2) who had each of the following during the year: Nationally-recognized clinical guidelines recommend that: HbA1c tests are done three to four times per year; Retinal eye exam by an optometrist or ophthalmologist is conducted one time per year; Nephropathy screening is completed one time per year; Blood pressure readings are done at each outpatient medical visit, not including ones that might be done on the same day as a procedure/diagnostic screening test or an acute inpatient hospital or emergency room visit. Reviewers looking at medical charts to report for the 2016 HEDIS rates found the following anecdotal factors to be the most common contributors to non-compliance: Lack of communication and continuity of care between primary care and specialists. Test results may not have been clearly recorded in the patient's medical chart. Member with a prescription, but no record of an office visit or lab test/result over the course of the year. Tests may not have been done or recommended. If the tests were recommended, patients may not have followed through. Strategies to improve compliance rates and population health management: Establish and maintain a secure office registry to identify your patients with diabetes to help track lab test appointments, ba Continue reading >>

Diabetes Prevention Resources

Diabetes Prevention Resources

Home > Meet PAF > About PAF's Patient Services > Prevention Resources > Diabetes Prevention Resources Early detection and prompt treatment may reduce the burden of diabetes and its complications. The following are resources are available to help you understand the screenings that are recommended for diabetics and when, and to help you understand the benefits, and any risks, of regular diabetic screening. Center for Disease Control and Prevention Remember, under the Patient Protection Affordable Care Act (PPACA) some diabetic screenings are covered at no cost to insured patients. Contact your health insurer to verify benefits available to you. The following are the guidelines under PPACA: Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes Type 2 Diabetes screening for adults with high blood pressure Life Line Screening is coming to your community to provide affordable, reliable health screenings for our consumers because of the high incidence of diabetes, stroke, heart disease, and other health issues. National Underinsured Resource Directory is intended to help underinsured individuals and families locate valuable resources and seek alternative coverage options or methods for better reimbursement. NeedyMeds makes information about medication assistance programs available to low-income patients and their advocates at no cost; linking you to programs such as Patient Assistance Programs, Disease-Based Assistance, Free and Low- Clinics, government programs and other types of assistance programs. The Partnership for Prescription Assistance helps qualifying patients without prescription drug coverage get the medicines they need for free or nearly free. The cost of diabetic treatment can be burdensome, es Continue reading >>

About Diabetes

About Diabetes

Diabetes is a chronic (long-lasting) disease that affects how your body turns food into energy. Most of the food you eat is broken down into sugar (also called glucose) and released into your bloodstream. Your pancreas makes a hormone called insulin, which acts like a key to let the blood sugar into your body’s cells for use as energy. If you have diabetes, your body either doesn’t make enough insulin or can’t use the insulin it makes as well as it should. When there isn’t enough insulin or cells stop responding to insulin, too much blood sugar stays in your bloodstream, which over time can cause serious health problems, such as heart disease, vision loss, and kidney disease. There isn’t a cure yet for diabetes, but healthy lifestyle habits, taking medicine as needed, getting diabetes self-management education, and keeping appointments with your health care team can greatly reduce its impact on your life. 30.3 million US adults have diabetes, and 1 in 4 of them don’t know they have it. Diabetes is the seventh leading cause of death in the US. Diabetes is the No. 1 cause of kidney failure, lower-limb amputations, and adult-onset blindness. In the last 20 years, the number of adults diagnosed with diabetes has more than tripled as the American population has aged and become more overweight or obese. Types of Diabetes There are three main types of diabetes: type 1, type 2, and gestational diabetes (diabetes while pregnant). Type 1 diabetes is caused by an autoimmune reaction (the body attacks itself by mistake) that stops your body from making insulin. About 5% of the people who have diabetes have type 1. Symptoms of type 1 diabetes often develop quickly. It’s usually diagnosed in children, teens, and young adults. If you have type 1 diabetes, you’ll need t Continue reading >>

Recommendations For Community-based Screening For Prediabetes And Diabetes

Recommendations For Community-based Screening For Prediabetes And Diabetes

AADE White Paper The high prevalence of prediabetes and diabetes represents a major health problem in the United States (U.S.). According to the Centers for Disease Control and Prevention (CDC), in 2012 persons with diabetes in the U.S. accounted for 9.3% of the nation’s population or 29.1 million people. Of those affected, only 21.0 million people were diagnosed with diabetes; thus, 8.1 million individuals (27.8%) were undiagnosed.1 In addition, the 2012 CDC statistics for the US population estimated that there were 86 million adults with prediabetes.1 Clearly, an unacceptably high percentage of persons with or at risk for diabetes in the U.S. are undiagnosed and, as a result, not receiving proper care to avoid or manage diabetes and its complications. Groups within the population who are at higher risk include individuals over 45 years of age, racial and ethnic minorities, women who have had gestational diabetes but do not receive adequate follow-up testing postpartum, and those without access to medical care, such as the uninsured.1,2,3 Given that our current prevalence of diabetes (9.3%) is nearly triple that of 1990 (3.6%), there is almost universal agreement that we must take effective steps to reduce the growth of this epidemic. Among such steps, there is strong support for earlier diagnosis and intervention to minimize the progression of diabetes and the development of associated complications.4-6 In response to the diabetes epidemic, many diabetes stakeholder groups and organizations in the U.S., especially at the local level, advocate for community-based screening (CBS) in venues such as health fairs or diabetes awareness events. Thousands of individuals throughout the nation have been and continue to be screened at such events in the hope that those wh Continue reading >>

Prediabetes

Prediabetes

Prediabetes is a serious health condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. Approximately 84 million American adults—more than 1 out of 3—have prediabetes. Of those with prediabetes, 90% don’t know they have it. Prediabetes puts you at increased risk of developing type 2 diabetes, heart disease, and stroke. The good news is that if you have prediabetes, the CDC-led National Diabetes Prevention Program can help you make lifestyle changes to prevent or delay type 2 diabetes and other serious health problems. Causes Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into cells for use as energy. If you have prediabetes, the cells in your body don’t respond normally to insulin. Your pancreas makes more insulin to try to get cells to respond. Eventually your pancreas can’t keep up, and your blood sugar rises, setting the stage for prediabetes—and type 2 diabetes down the road. Symptoms & Risk Factors You can have prediabetes for years but have no clear symptoms, so it often goes undetected until serious health problems such as type 2 diabetes show up. It’s important to talk to your doctor about getting your blood sugar tested if you have any of the risk factors for prediabetes, which include: Being overweight Being 45 years or older Having a parent, brother, or sister with type 2 diabetes Being physically active less than 3 times a week Ever having gestational diabetes (diabetes during pregnancy) or giving birth to a baby who weighed more than 9 pounds Race and ethnicity are also a factor: African Americans, Hispanic/Latino Americans, American Indians, Pacific Islanders, and some Asian Americans are at higher risk. Getting Tested You can get a simple blood Continue reading >>

Tailoring Treatment To Reduce Disparities:

Tailoring Treatment To Reduce Disparities:

The American Diabetes Association (ADA) publishes the Standards of Medical Care in Diabetes annually, based on the latest medical research. The following narrative provides a summary of the 2017 updated recommendations that have been developed for clinical practice. The ADA guidelines are not intended to aid or preclude clinical judgment. The full guidelines can be accessed at ADA’s Diabetes Pro website. Tailoring Treatment to Reduce Disparities: Updated guidelines focus on improving outcomes and reducing disparities in populations with diabetes such as: Ethnic/Cultural/Sex/Socioeconomic Differences and Disparities: Provide structured interventions that are tailored to ethnic populations and integrate culture, language, religion, and literacy skills. Food Insecurity: Evaluate hyperglycemia and hypoglycemia in the context of food insecurity (FI), which is defined as the unreliable availability of nutritious food. Recognize that homelessness and poor literacy and numeracy often occur with FI. Propose solutions and resources accordingly. Comprehensive Medical Evaluation and Assessment of Comorbidities: The clinical evaluation should include conversation about lifestyle modifications and healthy living. PAs should address barriers including patient factors (e.g., remembering to obtain or take medications, fears, depression, and health beliefs), medication factors (e.g., complex directions, cost) and system factors (e.g., inadequate follow up). Simplifying treatment regimens may improve adherence. This section highlights the elements of a patient-centered comprehensive medical exam, including the importance of assessing comorbidities such as: Cognitive Dysfunction: Tailor glycemic therapy to avoid significant hypoglycemia. Cardiovascular benefits of statin therapy outweigh Continue reading >>

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