My father died at age 58 from complications of Type 2 diabetes when I was still in high school. Following his diagnosis, he developed chronic kidney disease, lost two toes to amputation and faced heart challenges that ultimately led to his passing. Because of my family history, my doctor is concerned about my own diabetes lab values and talks to me regularly about the disease.
In my work life, I interact with groups of dedicated Utahns trying to support and help patients with diabetes. The Larry H. & Gail Miller Family Foundation donated $5.3 million to the University of Utah health care system last year on World Diabetes Day to help prevent the growth of diabetes in our state. Larry H. Miller, former owner of the Utah Jazz, died in 2009 from complications related to Type 2 diabetes. A few years ago, HealthInsight worked with the Miller family and the Utah Department of Health to produce a heartfelt TV commercial that aired for six months.
Type 2 diabetes is a difficult and costly disease to treat. Though it typically develops after age 40, it has recently begun to appear with more frequency in the younger population. Those with a Type 2 diabetes diagnosis manage their disease through a combination of treatments, including diet, exercise, self-monitoring of blood glucose, and in some cases, medication. Most health problems resulting from the condition can be lessened or avoided altogether, which is why education is key to prevention, reduction and improvement in quality of life.
In recent conversations with community members and health care providers, I found that confusion exists about what kind of educational resources are available to people with diabetes – all because of the conundrum of acronyms! There are so many great programs out there, but the acronyms can lead to a lack of utilization. Let’s try to fix that with a brief summary of some of the most common educational offerings.
Diabetes Self-Management Education/Training (DSME/T) – This education and training includes personal, customized help for individuals with diabetes. DSME addresses the importance of being active, monitoring diabetes, healthy coping, reducing risks, taking medication, healthy eating and problem-solving. This training is done in a clinical setting, usually by a nurse, dietician, pharmacist or certified diabetes educator (CDE). This training is reimbursed by insurance companies, but the person giving the training must be accredited. The training can be up to 10 hours in the first year of diagnosis and two hours in follow-up years. DSME/T programs are found in every state.
Diabetes Self-Management Program (DSMP) – This is a group training for people with diabetes that addresses monitoring blood sugar, healthy eating, prevention, how to deal with sick days, foot care and complications. This is a six-week course (2.5 hours per week) is usually held in community centers, local health districts, churches and other public locations. The public leader in this course needs to be certified. Stanford and DEEP are two common curriculums for this education. These courses are not currently reimbursed by insurance companies, but many states have grants and funds to help participants. HealthInsight has been working to promote, teach and help patients with diabetes through these classes.
National Diabetes Prevention Program (NDPP) – This is a yearlong, evidence-based program for people with prediabetes focused on positive lifestyle change. The program is focused on eating healthier, reducing stress, increased physical activity and a 10-pound weight loss. This new program was created by the Centers for Disease Control and Prevention. Medicare will begin reimbursing for these classes in April 2018 and many other insurance companies are following suit. In many states, these classes are growing rapidly.
Although these diabetes education programs are found in most states, many health care systems and states have customized versions and other supplemental programs. Coming from a family that has battled this disease, I'm grateful for these resources and recent public health efforts to reverse the negative trends of diabetes in our country. We can provide stronger support and help for ourselves and loved ones who battle this disease by learning about what resources are available and taking part in the offerings. This is going to take effort, but let’s start the New Year off right and do it!