How the Federal Government Should Step Up Diabetes Prevention Modernization

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Diabetes is one of the most prevalent chronic diseases in the United States, affecting the quality of life of sufferers. Doctors and researchers have worked to improve treatments and they have achieved dramatic results, but they face many challenges in implementing evidence-based guidelines and providing their patients with the care they need.

The National Clinical Care Commission — made up of heads of federal agencies and nonfederal employees with expertise in the prevention, care, and epidemiology of complex metabolic or autoimmune diseases — released a report on take advantage of federal programs to prevent and control diabetes and its complications.

Submitted to Congress and the Secretary of Health and Human Services earlier this year, the report makes clear what needs to happen. First, stakeholders need to view diabetes as much more than a medical issue. Second, and perhaps most importantly, the federal government needs to revamp its policies to support programs and clinical guidelines that have been shown to be effective in preventing and treating diabetes.

The report emphasizes that policy makers need to address the social and environmental factors that complicate the management of diabetes. For this reason, the commission’s recommendations go beyond health care and include the need to improve nutritional assistance programs overseen by the United States Department of Agriculture, to expand housing options in health benefits and improve neighborhood walking and access to green spaces.

As the commission developed its report, WADA presented testimony and commented on the draft report. This has led to many of the committee’s recommendations being consistent with WADA policy and advocacy. These include:

  • Better coverage of screening tests for prediabetes.
  • Adoption of Quality measures developed by the AMA for the prevention of diabetes (PDF).
  • Covering in-person and virtual diabetes prevention services.
  • Make Medicare’s diabetes prevention program a permanent covered benefit.
  • Support the use of metformin to prevent type 2 diabetes.
  • Consider health equity in all federal diabetes policies.

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This report was produced by the Office of the Assistant Secretary for Health, Adm. Rachel L. Levine, MD. In one blog postDr. Levine’s deputy, Rear Admiral Paul Reed, MD, emphasized the need for a national paradigm shift.

“The scale of the problem and the rate at which diabetes is becoming more prevalent in the United States means that everyone, in all sectors of society, must take notice and act with greater urgency,” wrote Dr. Reed. “Especially now, when our collective awareness of well-being is front and center in our minds, we should work hard to tackle issues like diabetes as the complex, socially determined conditions they represent.”

Little can change without making diabetes prevention and treatment a priority for all federal agencies, the report says. One of the keys is to embrace research.

“We work with many healthcare organizations and physicians, so we see the barriers they face when trying to improve diabetes care and prevention,” said Kate Kirley, MD, chief prevention officer. Chronic Diseases at WADA. “We live in an obesogenic environment. Many diabetes policies and regulations are outdated and do not meet the needs of healthcare professionals and patients.

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Another key is to support new technologies, especially telehealth, which can overcome huge geographic and economic barriers to care.

“The report recognizes that when it comes to diabetes prevention, there really isn’t a difference between care delivered in person and care delivered virtually,” Dr. Kirley said. “Telehealth should be covered by all federal programs.

theAMA Diabetes Prevention Guidesupports physicians and healthcare organizations in defining and implementing evidence-based diabetes prevention strategies. This comprehensive and personalized approach helps clinical practices and healthcare organizations identify patients with prediabetes and manage the risk of developing type 2 diabetes, including referring at-risk patients to a national change program. DPP lifestyle based on their individual needs.

Discover six tips to keep in mind when screening patients for prediabetes.

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