Your organization needs a type 2 diabetes strategy. Here’s why.


 

Type 2 diabetes is a significant burden on our healthcare system and likely worse than current estimates. Despite this, the real issue is what will happen in the next 10, 15 or 20 years.

There are at least three reasons for concern.

1. Current population estimates are wrong.

Recently published research would suggest that screening with fasting blood glucose is inadequate – significantly under-reporting actual numbers. For example, research using HbA1c as a screening tool showed that more than 50% of the adult population has some form of diabetes – diagnosed type 2 diabetic, prediabetic or undiagnosed. This means if you use fasting blood glucose as the primary measure for screening, you’re only getting part of the picture from your employee population.

This is an easy issue to fix and I discuss it below.

2. Long-term, it is the most expensive condition to treat.

While medications for some diseases and conditions receive headlines for high cost – hepatitis and cancer, for example. Costs for type 2 diabetes medications receive little press. This lack of coverage doesn’t mean treatment is inexpensive, as anyone who knows the cost of insulin understands.

Without getting into a discussion of why certain prescription drugs receive media attention and others do not, drugs for hepatitis and cancer are taken for a short time – usually no longer than 24 months. By comparison, type 2 diabetics can take insulin and other medications for years, even decades. These costs add up. And as the condition deteriorates and co-morbidities increase, additional medication and more expensive treatment options are needed.

A recent study looked at the long-term costs of more than 100 conditions over more than 10 years. Type 2 diabetes was the most expensive condition to have and treat, even more expensive than cancer.

3. Treatment protocols keep people diabetic

Current guidelines target a symptom of the condition rather than the cause. While there is mention of weight loss, exercise and diet, the primary method of treatment involves medication to control blood sugar. This is problematic for two reasons: 1) Individuals become dependent on medication to control their blood sugar; and, 2) It implies that elevated blood sugar is the problem.

Elevated blood sugar is a symptom, insulin resistance is the cause. Since diabetics are taking medication for a symptom of the problem, the cause of the problem doesn’t get better. In fact, it gets worse over time. This means type 2 diabetics will eventually need additional medication and will also further increase their risk for co-morbidities.

With this as our approach to treatment, there is little hope to eliminate the condition once a person has been diagnosed. They get stuck in our healthcare system. And since almost no one is eliminating the condition, the percentage of people with type 2 diabetes only grows.

Looking down the road

This is why there is a tidal wave on the horizon and it forms the crux of why every organization needs to implement a type 2 diabetes strategy. If we continue in this manner, things will be exponentially worse in a few short years. Since diabetes is already the most expensive condition to have and treat, this does not bode well.

So it is important we all do something and here is what you can do.

Commit to a type 2 diabetes strategy

Your organization can have a significant impact by implementing three steps.

Step 1. More appropriate screening

Earlier I mentioned that population estimates are wrong. You can get accurate population estimates within your organization by making a small change. Measure HbA1c (or simply A1c) in your annual HRA or biometric screenings.

HbA1c provides information on blood sugar control over the previous 2-3 months, which is a better indicator of diabetes risk than fasting blood glucose. Request this test from your provider. The same blood test used to measure fasting glucose can be used, so there is zero impact on your employee population.

If your provider is unable or doesn’t want to do this, contact me. I will help you find someone that can. If there is additional cost, the benefits of having accurate information outweigh the additional costs.

Step 2. Find providers with proven results

Do this specifically as it relates to type 2 diabetes. You should be able to find providers that can work with your existing wellness offerings. General programs that offer health/phone coaching usually don’t meet the standard of proven results for type 2 diabetes. Their message tends to be directed at the masses, which is not helpful or productive for type 2 diabetics. This step is important since, as noted above, more than 50% of adults have some form of type 2 diabetes.

There will likely be additional cost for this but a program with proven results will pay for itself. For example, if you have 100 type 2 diabetics using insulin in your organization, the cost for insulin alone is about $500,000 per year! When you consider other medications, lost productivity, time at the doctor’s office, etc., actual costs are higher. A good provider should be able to cut this in half or even eliminate it completely. If you save more than $500,000 per year, their costs are almost irrelevant.

Step 3. Everyone wants the same thing

At HPI, our most important corporate mission is to eliminate type 2 diabetes in the US population by the year 2020. You can help us achieve this, because all business leaders want the same thing – happy, healthy and productive employees. Guess what? Your employees want to be happy, healthy and productive too.

However, those needing our help (and yours) the most, don’t get too excited about the standard “wellness” offerings. Why? Because it is too generic and not focused on them. Besides, they’ve heard the message before.

So what to do?

Leadership by example is often used, but it is appropriate in this case. From the top of your organization, implementing a strategy for type 2 diabetes needs to be important. And when you implement steps 1 and 2 above, the importance message filters down. We see it all the time in our work.

When you do this correctly, it is easy to see, feel and measure.

We are here to help!

By now, I hope you realize that implementing a strategy for type 2 diabetes is important. Done properly, it will help your organization and your employees. The proverbial win-win. However, if you do nothing, all the negatives mentioned above will be exponentially worse.

I also understand the prospect of this can be a bit overwhelming. So we are here to help. If you have questions about anything within this article or need additional information on implementing any of these steps, let me know. Send me an email. Message me on Twitter, Facebook or LinkedIn or comment below and I will help.

Since this is an important message, please share with your colleagues, co-workers and leadership within your organization.

Thank you!

2015 Member of the Year: Kathryn

Meet Kathryn!

To be the HPI Academy Member of the Year, you have to exhibit more than just results. Kathryn did that in a big way!

Kathryn did not miss a single session. She was always there. Smiling. Happy. Ready to listen and ask questions. And she asked great questions, which meant she was paying attention!

Her excitement and enthusiasm rubbed off on the others.

It was all of this that made her an easy selection for Member of the Year.

Congratulations, Kathryn! This is well-deserved.

Her Results

While this is about more than results, here are hers.

Before and after pics.

That smile never disappears.

Some of the details!

In 6 months she:

  • Lost 30 pounds
  • Lost a total of 13.75 inches
  • Saw her blood pressure drop nearly 20 points
  • And most importantly, nearly 100% of the weight she lost was fat weight

Great numbers but there is more!

The Interview

We ask each of our members of the year a series of questions. Here are some of the questions we asked Kathryn and her responses.

What did you like about The Academy?

My experience with the Academy was a delightful experience. I was a skeptic at first because I am very self-conscious when it comes to my weight. But I must tell you that all of that dissipated after the first Module.

Do you have suggestions on how we can make The Academy better?

I have no complaints about he Academy at all. It is very easy to follow if you have the intent in your mind to make constructive changes in your life style.

The literature presented in each module was informative and easy to understand. The facilitator was “excellent”. He has been deemed my “five flavor lifesaver for life”. I will continue to work on my health initiative.

It’s a life saver.

Where do you have your plaque displayed?

At the present time, my plaque is proudly displayed here in my office. I want to rub it in on my coworkers. I have them bow when I enter the room, and have been called “Ms. HPI” on several occasions. I wear the title proudly.

Special shout out to Dr. Brian Sekula.

He’s my hero!!!

Excellent Stuff!

To have someone say what we did was a “life saver” doesn’t get much better.

We don’t take any of this lightly. It is very gratifying that we were able to play a role in guiding Kathryn to this outcome.

So we said there was more than just numbers. There was. We could not be more happy for Kathryn or proud to have her as our Member of the Year.

The last thing we will leave you with is Kathryn receiving her plaque. We did this in front of her co-workers. They were also very happy for her!

Congratulations Kathryn on a job well-done and an award well-deserved!

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10-26-2015: This week on FB

The week of October 26, 2015, these are some of the posts from our Facebook page.

Note: Posts on our Facebook page are public, so a FB account is not needed to view/read them. You only need an account if you want to comment. But you can also comment below.

“This is a very powerful force and industry.” Jamie Oliver, famed chef. Read our post to see what “powerful force” he was talking about.

Did you know that public policy could “discourage” obesity? Us neither. But this article we link to seems to think so.

And another…”Self awareness may help reduce the risk of obesity.” Really? Another new one to us. It’s as if people that are obese don’t know they are obese!

The IARC: Meat and Cancer

It seems all corners of the earth are discussing the report from IARC on processed and red meat and cancer. It also seems everyone has an opinion. We do too. Here are some of ours.

First, some clarification is in order. The IARC (International Agency for Cancer Research) is part of WHO (World Health Organization). They do all the work and WHO simply publishes it.

Banana peels are dangerous!

Let’s clarify what seems to have everyone talking: smoking equals bacon.

We get statements like this because the classification system used by IARC is confusing. So most don’t understand (or are willfully lying).

This classification system is designed to answer a simple yes or no question.

While it seems simple, there can be four different answers:

  • No.
  • Mixed or Maybe. Think of it this way: Not enough evidence to say no but not enough to say yes.
  • Probably. Evidence is tilting toward yes but not convincing enough.
  • Yes.

There is more explanation of these categories on the IARC website.

With that out of the way, the IARC set out to answer two questions. Does processed meat cause cancer? They conclude yes. Their other question: Does red meat cause cancer? They conclude probably. Based on their hierarchy, they are less convinced about the evidence for red meat to cause cancer than they are for processed meat to cause cancer.

These two answers have led to cheers or an uproar.

We get the silliness of equating bacon to smoking because the IARC system only classifies risk. It does not quantify risk.

I read a good analogy on this but can’t remember where.

Think of it this way…

Let’s say we used this system to classify danger. The question: Are banana peels dangerous? If falling is dangerous and stepping on a banana peel would lead to falling, then we would have to classify banana peels as dangerous. To illustrate, let’s ask another question.

Is being a firefighter dangerous?

Of course it is. So we would have to classify banana peels the same as firefighting. But as a firefighter, your risk is greater – more frequent and severe.

This is simply how the IARC classifies their answers. No quantification of risk.

Your risk increases but not by much

Given the current environment (food, lack of exercise, poor sleep habits and stressful lives), your current risk of developing colo-rectal cancer is about 5%. But if you eat 2 or 3 pieces of bacon per day, your relative risk for colo-rectal cancer increases by about 18%, which means your overall risk goes from 5% to about 6%.

By comparison, smoking increases your relative risk by about 2500%. Or an increase of about 140 times compared to the increased risk of eating 2 or 3 pieces of bacon per day.

While both processed meat and smoking are put in the same cancer-causing category, the risk from smoking FAR outweighs the risk from 2 or 3 slices of bacon.

So what about the other question: Does red meat cause cancer? The answer on this one is probably.

It’s even lower on the classification scale than processed meat.

Relax and enjoy your bacon

While eating 2 or 3 pieces of bacon per day increases your relative risk by about 18%, the overall risk is low to begin with. So the change in risk is not much – from about 5% to 6%.

If this change in risk is too high for you or you are still not convinced, please stop eating bacon.

There’s that much more for the rest of us! And I for one will promise to do my part to consume that crunchy and delectable food.

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10-19-2015: This week on FB

The week of October 19, 2015, these are some of the posts from our Facebook page.

Note: Posts on our Facebook page are public, so a FB account is not needed to view/read them. You only need an account if you want to comment. But you can also comment below.

Starting insulin therapy earlier for type 2 diabetics. Is this a good idea? Conclusions in this article seem to think so. What are the ramifications? See what we think.

Is exercise more difficult for type 2 diabetics? This isn’t a question about exercise intensity. It’s a question about metabolic flexibility and why it is more difficult for type 2 diabetics to burn fat.

Is breakfast the most important meal of the day? Everyone has an opinion. It’s either yes or no, right? Read our post to see what we think.

Thoughts on a study linking antibiotic use in children to weight gain. A case can be made for this to occur.

Generic drug prices are skyrocketing too. We summarize an article that covers some of the reasons.

A study on the sleep habits of 3 groups that live without electricity. We talk about some of the interesting findings.

Looking at trends and prevalence of type 2 diabetes from 1988 to 2012. The numbers are pretty alarming and made worse when you consider that current testing methods miss a large chunk of pre-diabetics. A fact that led us to write this Call to Action.