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The Chronic Disease That's 90% Preventable

By Phat Chiem | November 12, 2019 | Rally Health

In May, the Centers for Disease Control and Prevention released a remarkable report on the decades-long war against diabetes.

The report offered a rare dose of positive news for employers, but the fact remains that almost 10% of Americans still suffer from diabetes — so we’re bringing you concrete ideas for tackling this chronic disease.

After 20 years of steady increases, according to CDC researchers, new cases of diagnosed diabetes in the US have dropped by 35% since their peak in 2009. New cases have declined from 1.7 million per year in 2008 to 1.3 million in 2017. What’s more, the number of people living with diagnosed diabetes in the US has stayed flat during the past eight years. 

The CDC described the drop in new cases as “the first sign that efforts to stop the nation’s diabetes epidemic are working.” Although the CDC said the causes for the plateau and decrease “remain unclear,” researchers suggested that they may be driven in part by increased awareness of Type 2 diabetes and habits that help prevent it, like changes in diet and physical activity.

As employers know, some of this increased education around diabetes is happening at work. In fact, a new study conducted in Sweden suggests that the workplace could be an excellent place for diabetes prevention because people in certain occupations have triple the level of risk of developing Type 2 diabetes compared with those in other jobs. 

While the downward trend in the US is certainly worth celebrating, employers are still left with some sobering statistics:

  • An estimated 30.3 million people have diabetes (nearly 10% of the US population). Source: CDC
  • Another 84.1 million adults age 18 or older have prediabetes (34% of the adult US population). Source: CDC
  • Health care costs for Americans with diabetes are 2.3 times greater than those without diabetes. People with diagnosed diabetes incur average medical expenditures of $16,752 per year, of which about $9,601 is attributed to diabetes. Source: American Diabetes Association

To be sure, these are scary numbers for employers. But here’s the encouraging thing about diabetes — it’s largely preventable. 

“What's remarkable is that nearly 90 percent of pre-diabetes and Type 2 diabetes can be prevented through lifestyle changes,” said Adam Bernstein, Rally Health’s Chief Medical Officer. 

These lifestyle changes include keeping weight within a normal range, staying physically active, eating a healthy diet, moderating alcohol consumption, and not smoking. Sound familiar? These are all habits that you’re most likely promoting right now with your company’s well-being programs. 

But benefits leaders can take specific steps to target this chronic condition in their workplace. The first step is starting with more awareness and education. You might send your employees to our Diabetes Conditions page, which offers an easy-to-digest primer on symptoms, risk factors, and treatment. 

We’ve created these Conditions pages to put useful information into the hands of members as they deal with chronic ailments such as diabetes, asthma, high cholesterol, and high blood pressure.  

Last year Rally integrated Real Appeal’s weight loss management program, focused on diabetes prevention, which has leveraged the success of the National Diabetes Prevention Program. 

“The landmark Diabetes Prevention Program, which is now about 20 years old, showed that weight loss of 5 to 7% reduces the risk of developing Type 2 diabetes by over 50 percent in high-risk adults,” Berstein said. “As a result, it’s important for employers to offer sustainable, scalable, and cost-effective lifestyle-change programs that help employees manage their eating and exercise habits for the long haul.”

Along with targeted education, here are some other ideas to consider:

Digital health solutions show some promise

Health care is increasingly moving into a digital, mobile-first world. And so is the fight against diabetes. The good news is that some of these digital solutions looking promising.

After reviewing more than a dozen randomized controlled trials of digital health interventions for diabetes in the past decade, one researcher concluded that “although the reported reductions were small and may be considered clinically insignificant in some cases, the results were always consistent in lowering blood sugar levels. The researcher, Joseph A. Cafazzo, a professor at the University of Toronto’s Centre for Global eHealth Innovation, said the findings were significant, considering that some of these tools were first generation, and advances in technology will make future apps and devices even more effective.

Navigating the vast tech landscape can be overwhelming for employers. Fortunately, the Northeast Business Group on Health compiles an employers’ guide to “Digital Tools and Solutions for Diabetes.” The most recent edition is 32 pages and was released in November 2018.

“Digital health tools hold the promise of improved health outcomes and reduced health care expenses through improved engagement, better collaboration, and sustained behavior change,” said Mark Cunningham-Hill, NEBGH’s medical director, in a statement announcing the guide. 

But he cautioned that “digital diabetes solutions are not a panacea,” citing challenges like sustaining engagement, difficulty of enrollment, and cost of deployment.

Weight management is a critical component

There is a strong connection between diabetes and weight. According to CDC data, 87.5%  of adults with diabetes are considered overweight or obese, and 41% are physically inactive.

While it’s not clear why people who are overweight are more likely to become diabetic, the fact is, the more you can help your folks keep off excessive weight, the more you lower their risk of developing diabetes. 

In fact, the CDC says a lifestyle-change program like the one offered through the CDC-led National Diabetes Prevention Program can lower prediabetic individuals’ risk of developing Type 2 diabetes by as much as 58% (71% if they’re over age 60). Clinical research has shown that even modest weight loss, as low as 5%, can help prevent or delay the onset of Type 2 diabetes. 

But for best results, your organization should offer a weight-management program with tools and coaching specifically designed for disease prevention rather than just general advice around healthy eating and exercising. Rally’s Real Appeal is one such program. We recently rolled out a new update to the Real Appeal program specifically targeting Type 2 diabetes prevention. 

Additionally, within the Rally platform, we now have more than 30 condition-specific missions, including several focused on diabetes, and others have been updated to also address various conditions. These missions educate employees about their medical conditions and give them a way to track their progress toward specific health habits, such as tracking your sugar intake, swapping out soda, eating less processed foods, and walking 10,000 steps per day. Employees with prediabetes, or who are currently under a diabetes regimen, can easily sign up for missions that help them tackle key habits in their fight to control the condition.

Why nutrition needs to be a part of the picture

Nutrition is often the missing piece of an overall corporate well-being program. When it comes to what gets served in the cafeteria, left out in the breakroom, or available in vending machines, there is sometimes less thought and intention behind the foods and snacks that are offered.

People spend a big part of their day at work. The work itself can be stressful, which often leads employees toward bad eating habits. So employers have a big role to play in making sure their workers eat right.

Focusing on nutrition in your workplace may involve re-evaluating your food vendors and caterers, removing vending machines, eliminating sugary drinks and highly processed snacks in the breakroom, and offering more fresh fruit and low-carb foods.

Make a choice to focus on diabetes

Simply put, the healthiest and most effective approach to diabetes is preventing it before it starts. 

Employers can reduce their population’s risk of developing diabetes by taking strategic steps to implement programs that specifically address disease prevention. It can’t just be a general approach to good eating and exercising. With a lot of intentional effort up front, you’ll be rewarded with better health outcomes, happier and more productive employees, and lower medical costs.

Phat Chiem
Rally Health