Managing The Cost Of Diabetes

Managing the Cost of Diabetes

Diabetes is one of the most common and costly chronic diseases, affecting more than 30 million Americans, with a total annual cost of $245 billion.1
Prevalence continues to increase as obesity rises, with the highest rates of diabetes found in minorities and older Americans. Consequences of diabetes include hypertension, coronary heart disease, stroke, chronic kidney disease, and blindness.2 Despite significant medical advancement in treatment, diabetes remains the seventh leading cause of death in the United States.3 As a result, health care providers must consider the impact of financial and educational barriers in outcomes associated with diabetic management.
Diabetes is associated with a significant financial burden both to the patient and to the health care system. In 2012, the estimated cost of direct med- ical care in diabetes was $176 billion.1 The cost of prescription medications accounted for 18% of that cost, while diabetic supplies accounted for 12%.1
Individuals with diabetes had more than double the cost of annual medical expenditures compared with those without, with an average annual cost of $13,700.1 Although government and private insurance provide patient assistance in managing these costs, financial barriers may still pose a significant obstacle to patients in optimizing diabetic management. Patients who are unable to afford their medications and diabetic supplies will have less than optimal control of their blood sugar and glycated hemoglobin, putting them at increased risk for diabetic complications.
Current guidelines provide detailed stepwise recomme Continue reading

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Study: Most U.S. Adults with Diabetes are Properly Diagnosed

The proportion of diabetes cases that go undiagnosed in the U.S. may be just 11%, much lower than previous, widely accepted estimates of one-quarter to one-third, a new study suggested.
The previous estimates were based on an analysis of national survey data that used only a single test to identify undiagnosed diabetes, but the new study used a second confirmatory test, as per guidelines from the American Diabetes Association (ADA), explained Elizabeth Selvin, PhD, of Johns Hopkins University in Baltimore, and colleagues.
The proportion of undiagnosed diabetes cases has also decreased over time, from 16% in 1988-1994 to the 11% figure in 2011-2014, they reported online in the Annals of Internal Medicine.
"Establishing the burden of undiagnosed diabetes is critical to monitoring public health efforts related to screening and diagnosis," Selvin's group wrote. "When a confirmatory definition is used, undiagnosed diabetes is a relatively small fraction of the total diabetes population; most U.S. adults with diabetes (about 90%) have received a diagnosis of the condition."
"If we're thinking about screening programs, these findings suggest that healthcare providers are doing a good job at diagnosing people when they're coming in contact with the healthcare system," Selvin said in a statement. "It's those people who are not coming in contact with the healthcare system that need to be a focus of our efforts to ensure cases of diabetes are not missed."
Selvin's group analyzed the same data that was used for the previous estimates, which were published by the CDC: the National Healt Continue reading

Lowering A1C Levels Naturally

Call it what you will: hemoglobin A1C, glycosylated hemoglobin, HbA1c, or just “A1C,” this number plays a huge role in how your diabetes is managed. It’s also used to diagnose diabetes, as well as prediabetes. Your A1C is a blood test that provides information about your average blood sugar levels over the past three months. Your provider and diabetes care team use this number to gauge how things are going and if and how to tweak your diabetes treatment plan. For most people who have diabetes, the American Diabetes Association (ADA) recommends an A1C of less than 7%. The American Association of Clinical Endocrinologists (AACE) advises a tighter goal of 6.5% or lower. Your goal may be completely different, and that’s OK (just make sure you know what it is!).
Why lower your A1C?
A1C goals aren’t decided upon out of thin air. The targets that the ADA, AACE, or your provider advise for you are based on clinical research, as well as other factors, such as your age, your overall health, and your risk of hypoglycemia. Landmark clinical trials, such as the Diabetes Control and Complications Trial (DCCT) and Epidemiology of Diabetes Interventions and Complications (EDIC), for example, have correlated lowering A1C with a decrease in diabetes-related complications. So, for every one point that you lower your A1C, you’ll lower your complication risk as follows:
• Eye disease by 76%
• Nerve damage by 60%
• Heart attack or stroke by 57%
• Kidney disease by 50%
It’s important to realize that your A1C reflects an average of your blood sugar numbers. Your A1C might be Continue reading

Do You Have Diabetes? 5 Tips for Successful Heart Surgery

While having diabetes puts you at a greater risk for complications during surgery, you can put a cap on these risks by being sure your diabetes is well controlled.
Even small changes in blood glucose levels make a big difference. If blood sugar is not well-managed, it raises risks for wound infections, which account for about two-thirds of post-operative problems with diabetes.
High blood sugar also increases the risk for stroke, cardiac arrest, lower limb ischaemia (a sharp decrease in blood flow to the legs and feet) and pressure sores — and may also result in a longer stay in intensive care.
If you need surgery right away, you may not have time to get your blood glucose under control beforehand.
But if there is time, here are five things you can do to improve your numbers:
1. Stay on top of blood sugar levels. It’s important to consistently and carefully measure your insulin levels to keep them under control.
2.Take all your medications. Be sure to follow your doctor’s advice about taking oral medications as well as injections.
3.Watch your waistline. You want to eat right and exercise consistently.
4. Consider seeing a diabetes specialist. Your doctor might recommend working with a diabetes specialist to help you get on track.
5. Don’t ignore other health conditions. If you have another condition besides diabetes, such as high blood pressure, high cholesterol or kidney disease, get those under control as much as possible. Each condition increases your risk for a poor outcome.
No matter what, be sure to talk with your doctor ahead of time about which surgical pro Continue reading

12 ways to manage diabetes during pregnancy

A healthy pregnancy is a priority for every mother-to-be, but for women who have diabetes, including those who are diagnosed with gestational diabetes, their health care can become more complex.
Women with diabetes who are diagnosed prior to pregnancy have a higher risk for complications, including miscarriage and birth defects. As the pregnancy progresses, women with diabetes are at risk for high blood pressure, preeclampsia, eclampsia, preterm and prolonged labor, cesarean section and its associated complications.
Up to 9.2 percent of women have gestational diabetes, according to the Centers for Disease Control and Prevention (CDC), and for these women in particular, their babies have a higher risk for high birth weight and shoulder dystocia, a complication during delivery. Babies born with low blood sugar (hypoglycemia) will likely have to be in the NICU for a few days after birth.
The good news is that with a plan, healthy strategies and support, you can control your diabetes, have a healthy pregnancy, and deliver a healthy baby.
Follow these expert tips:
1. See your doctor before you get pregnant.
If you have diabetes and plan to conceive, you should talk to your doctor to make sure your A1C levels are normal, talk about medication if it’s necessary or ask for a referral to a nutritionist. Women with Type 1 diabetes should ask their doctors about a kidney function test, a thyroid test and an eye exam because other conditions can worsen, said Dr. Lois Jovanovic, an endocrinologist and clinical professor of medicine at the Keck School of Medicine of the University of S Continue reading