MHealthy: Focus on Diabetes

MHealthy: Focus on Diabetes was a ground-breaking two-year pilot program that eliminated or reduced the cost of selected medications for U-M faculty, staff and their dependents who have diabetes. Launched in July 2006, the program encouraged the proper and sustained use of specific drugs that affect blood sugar, blood pressure, cholesterol and depression with the goal of preventing or reducing the long-term complications of diabetes. It was the first in the nation designed specifically to evaluate the impact of targeted co-pay reduction for preventive medications.

Current Program Status

The university will discontinue the diabetes medication cost reduction program on January 1, 2013 based on pilot study findings. A team of university researchers, clinicians, and benefits administration staff studied the effects of this copay relief program on medication adherence at U-M and found no significant change. Overall, U-M faculty and staff have a high level of adherence in taking their recommended medications, so the pilot program did not have a significant effect.

The copay reduction for medications for diabetes, cholesterol and high blood pressure will continue through December 31, 2012. Members who currently take insulin will continue to receive their insulin and supplies with no copay.

Learn more on effective ways to continue to reduce out-of-pocket medication costs at http://benefits.umich.edu/plans/drugs/special.html#diabetes

Diabetes: Background information

Adapted from information provided by the U.S. Centers for Disease Control & Prevention

Diabetes is a chronic, or lifelong, disease in which blood sugar (glucose) levels are above normal, either because the body doesn’t make enough of a sugar-converting hormone called insulin or can’t use its own insulin as well as it should. This causes sugar to build up in the blood, which over time can harm the blood vessels, heart, nerves, eyes, kidneys and other body systems. Problems that result from this harm are called complications, and include everything from heart attack to kidney failure. They can be fatal or disabling.

There are two kinds of diabetes: Type 1 (formerly called “juvenile diabetes”), which results when the pancreas stops making insulin for reasons that are still unclear, and Type 2, (sometimes called “adult” diabetes) which results when the body becomes resistant to the effects of insulin, especially when a person is obese. People with Type 1 diabetes need to take insulin to stay alive, while people with Type 2 diabetes may be able to keep their blood sugar in check through diet, exercise and medications, although many also take insulin.

In recent years, research on diabetes and its complications has yielded valuable information that has allowed experts to develop guidelines for the treatment of people with either form of diabetes. Such guidelines stress the importance of not only blood-sugar control, but blood-pressure and cholesterol control, and periodic tests to spot the early signs of eye, kidney and nerve damage. Patients who follow these guidelines with their doctor’s help may greatly reduce their chance of diabetes complications, or at least delay them until later in life. Diet, exercise and medication can all be used to keep blood pressure, blood sugar and cholesterol low.

Statistics

20.8 million Americans, or 7 percent of the population, have diabetes. 14.6 million of them are aware of this, but 6.2 million people have undiagnosed diabetes. About 1.5 million new cases of diabetes were diagnosed in people aged 20 years or older in 2005.

Diabetes costs America $132 billion each year, including $92 billion in medical costs and $40 billion in costs related to disability, work loss and premature death.
Diabetes was the sixth leading cause of death listed on U.S. death certificates in 2002 – and is likely to be under-reported on death certificates

Members of some ethnic groups are more prone to develop diabetes. About 8.7 percent of non-Hispanic whites have diabetes. By comparison, the odds of developing the disease are 1.8 times higher among non-Hispanic blacks, 1.7 times higher among Mexican-Americans, and 2.2 times higher among American Indians and Alaska Natives. (odds are age-adjusted)

Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes, and their risk of stroke is 2 to 4 times higher. About 73 percent of adults with diabetes either have high blood pressure or use medicine to control their blood pressure.

Diabetes is the leading cause of kidney failure, accounting for 44 percent of new cases in 2002. More than 44,000 people with diabetes begin kidney dialysis each year.

About 60 percent to 70 percent of people with diabetes have mild to severe forms of nervous system damage. Severe forms of this damage contribute to many foot and leg amputations.

Prevention really works: For every percentage-point drop in blood sugar levels (using a test called A1C), people with diabetes reduce their risk of eye, kidney, and nerve diseases by 40 percent. For every 10-point drop in blood pressure, they reduce their risk of any complication by 12 percent. Improved control of cholesterol can reduce heart and blood-vessel complications by 20 to 50 percent. And detection and treatment of diabetic eye disease can reduce the development of severe vision loss by an estimated 50 percent to 60 percent.

Diabetes Resources