As Diabetes Costs Rise, Nutrition Education Can Help Companies and Employees

As Diabetes Costs Rise, Nutrition Education Can Help Companies and Employees
Diabetes is a very expensive health problem for employees,
people with diabetes, and ultimately everyone. The
American Diabetes Association reports in the United States
we have 17.5 million people with diabetes. The total
estimated cost of diabetes in 2007 was $174 billion, with
$116 billion being medical spending and $58 billion coming
from reduced productivity at work. (Source: Diabetes Care
March 2008) Ultimately diabetes increases costs for
everyone due to higher insurance premiums.

How can employers help reduce cost from diabetes? Until we
have a cure there are two ways to decrease cost. One is to
screen for diabetes at the workplace to catch diabetes in
the early stages when it is easier and less costly to
manage. The second strategy is to help employees with
diabetes get better control of their diabetes to reduce the
chance of costly complications.

To explain further these two strategies, we need to
understand where the highest costs of diabetes occur. The
average cost for a diabetes hospital stay is $1853 per day.
Compare that to a doctor visit for diabetes at $132. Which
one is more cost effective? Regular doctor visits every
3-6 months are recommended for achieving optimal diabetes
care. The physician will ideally have diabetes educators
also to help the patient learn how to better manage their
diabetes with medication, monitoring, food and exercise.
However, what if your employee does not like to go to the
doctor? Then they will not be getting the blood tests, exam
and education that help them manage their diabetes and
prevent costly complications. If they are not feeling well
they may miss more work days as well.

What if you have a diabetes nutrition educator at your
workplace? Registered dietitians that are also certified
diabetes educators are a great resource for the worksite.
They have the nutrition, exercise and diabetes knowledge
and can set up education and diabetes screening programs.
Many dietitians are already contracting with companies to
nutrition and wellness programs for worksites.

Early screening for diabetes can catch prediabetes, which
is diagnosed when blood sugars are higher than normal but
not yet high enough to be diagnosed as Type 2 diabetes.
Learning how to make lifestyle changes at this stage can
delay the onset of diabetes for years, thus reducing the
overall cost of diabetes.

The April 2008 issue of Diabetes Care discusses how
nutrition education is linked to fewer hospitalizations. In
a study of 18,404 diabetic patients that were followed for
4.7 years on average, 9.1% had at least one nutrition
visit. Compared to those patients who had no education,
those who had one education visit had 34% lower
hospitalization rate. This lower rate was associated with
$11,571 less in hospital charges. Nutrition visits were
associated with the greatest reductions in hospitalization.

To quote the American Diabetes Association position
statement regarding the economic costs of diabetes, "Much
of this cost is preventable through improved diet and
exercise, prevention initiatives to reduce the prevalence
of diabetes and its co-morbidities, and improved care for
people with diabetes to reduce the need for costly
complications." Dietitians who specialize in diabetes are
the experts to look for in helping to accomplish these
three tasks because they have a combined knowledge of food,
nutrition and diabetes treatments.

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Karen Marschel, RD, LD, CDE is a registered dietitian and
certified diabetes educator with 15 years experience
teaching about diabetes. She owns KM Nutrition Consulting,
Inc. and offers online nutriiton programs at
http://www.dietmn.com