Diabetes Education Can Make a
No one is more aware than health plan decision makers that 60% to 65% of the population drives less than 2% of health care costs, whereas 30% of the population drives 90% of costs. Type 2 diabetes is one of the chronic conditions that contribute disproportionately to costs. Improving diabetes self-management care has the potential to save claim costs for plans, improve the efficiency of their providers, and improve disease management for plan members.
Most type 2 diabetes patients have not succeeded in managing the disease. Less than 10% of patients have the 3 major risk factors—A1C, blood pressure, and cholesterolóunder control.
Diabetes is the sixth leading cause of death in the United States. In fact, two-thirds of people with diabetes die of a heart attack or stroke. Educating patients about the benefits of healthier lifestyle choices and motivating them to make those choices have enormous potential to produce benefits in the control of this condition.
Education statistics are moving in the wrong direction
Diabetes educators can play a valuable role in reducing the impact of type 2 diabetes. However, many patients remain undereducated about their disease, and many US health plans need to be more proactive in encouraging their members to take advantage of diabetes self-management education (DSME). In a recent sampling of 29 major US health plans,
- No plans reported actively communicating the availability of reimbursement of DSME services to patients.
- Only two-thirds of plans either offer DSME through disease management or reimburse health care professionals for DSME services.
A disturbing trend is that the average number of annual visits to a diabetes educator decreased from 3.7 in 2002 to 2.9 in 2006. Merck is committed to doing all it can to help reverse that trend by:
- Providing high-quality educational tools like Journey for Control and US Diabetes Conversation Map tools
- Working to make diabetes self-management education a more integral component of type 2 diabetes care
The cornerstone of care
According to the American Diabetes Association, DSME is the cornerstone of care for all those with diabetes who want to achieve successful health-related outcomes. The associationís DSME standards state that the instructional team should, at a minimum, consist of a registered dietitian and a registered nurse, and that the instructional staff should be certified diabetes educators (CDEs) or have recent educational and hands-on preparation in diabetes management.
DSME is most effective when delivered by a multidisciplinary team with a comprehensive plan of care. It can include the following professionals, in addition to the registered dietitian and registered nurse:
- Exercise physiologist
Behavioral and lifestyle changes are critical to successful self-management of diabetes. Successful DSME professionals have specialized training in diabetes, behavioral interventions, teaching and learning skills, and counseling skills. These areas of expertise have been demonstrated as necessary to maintain focus on patient behavior change, which is a critical component of effective disease management.