Medicare Levels Up Protection Against Diabetes; Broadens Lifestyle Intervention

November 13
6:00 AM 2016

One of the worldwide health problem nowadays of people is their weight and that they are less active than ever before. Taken together, this toxic lifestyle can lead to serious health problems. 

Prediabetes is when your blood glucose level is higher than normal but not high enough to be diagnosed as type 2 diabetes. The condition increases your risk of type 2 diabetes, heart disease, stroke and other serious complications such as blindness and kidney failure.

Yet this downward spiral could be averted in the first place, with a change in lifestyle.

People with prediabetes who lose weight by eating healthy and being more active can significantly lower their risk of getting type 2 diabetes. That's one finding that emerged from the Diabetes Prevention Program (DPP), a landmark research trial that ended in 2000. The study, which Joslin Diabetes Center took part in, showed that people with prediabetes who lost five to seven percent of their body weight and exercised daily reduced their risk of developing type 2 diabetes by over 50 percent.

That is changing. The Centers for Medicare & Medicaid Services (CMS) recently announced that they will be expanding the pilot DPP to benefit more Medicare beneficiaries. Beginning in January 2018, the program will be available to older adults with prediabetes or those who have had gestational diabetes and are high risk for developing type 2 diabetes.

Since 2000, numerous programs have taken the principles and protocols of the original Diabetes Prevention Program and embedded them into the community in a variety of ways, says Dr. Gabbay. "This has given us real-world evidence that there is significant potential to improve health, prevent diabetes and reduce long-term medical costs incurred by this disease."

The DPP is a lifestyle intervention that includes stress reduction, dietary coaching and moderate physical activity. Ultimately, the goal of the year-long program is to prevent the onset of diabetes in individuals who have prediabetes.

While this program will only be available to people 65 and older, what typically happens with health care benefits it that CMS weighs in first, and once they start covering the service, other insurers often follow suit.

What is unique about this effort is that it is bringing to light the concept that behavior change and a lifestyle intervention is a treatment that is reimbursable, opening the door for similar programs in other areas that will halt or reverse a disease.

What's more, a number of innovative diabetes prevention programs are looking into using technology, such as digital coaching and telehealth, to help people adopt a healthier lifestyle. From smartphone apps to regular emails, these different technologies give patients easy access to encouragement, reminders and coaching.

Diabetes is a national epidemic. In fact, one third of 15-year-olds today are likely to develop diabetes in their lifetime, says Dr. Gabbay. But a lifestyle intervention like this gives us the ability to turn things around.

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