AACE: New Team Approach Improves Diabetes Outcomes and Lowers Medication Costs

Researchers John Gary Evans, MD, et al noted that by participating in this program, patients were able to decrease their doses of insulin and oral medication, on average, by 46 percent and 12 percent, respectively. In addition, on average, patients were able to reduce their 30-day prescription costs by nearly $143 per month. Participants also decreased their body mass index (BMI) by 3.07 and hemoglobin A1c (HgA1c) by 0.7 percent. HgA1c was reduced by an average of 1.3 percent for patients with a baseline HgA1c of 8 percent or more.

Lead author Dr. Evans said, "These results demonstrate that engagement leads to a greater understanding of a healthier lifestyle."

The program, developed by Dr. Evans' Jacksonville-based endocrinology group, enrolled adult patients with type 2 diabetes in an intensive wellness program that addressed multiple aspects of diabetes care. Patients were counseled in nutritional, fitness, and behavioral elements of diabetes management in a customized 16-week curriculum while their doctors monitored BMI, weight, HbA1c levels and diabetes medication dependence. Medications were reduced as needed to reduce the risk of low blood sugars. The group strived to improve diabetes outcomes and reduce complications and expenditures by tailoring the approach to each patient.

"The multi-disciplinary program creates a timeframe that gives patients time to absorb the information, revisit strategies for management and engrave the behaviors into their minds," explains Dr. Evans. "Covering those key elements is what it takes for patients to grasp and embrace the strategies to be successful and improve their condition."

In November 2011, the Centers for Medicare and Medicaid (CMS) ruled that intensive behavioral therapy for obesity is covered as a benefit under some Medicare plans. Dr. Evans says that he hopes the success of this program will illustrate the need for lifestyle intervention and wellness training as part of comprehensive care plans for all diabetes patients.

"It is our hope that the success of this curriculum will create a pathway for intensive wellness programs to be recognized as medical benefits for diabetes patients by insurance companies," said Dr. Evans. "The only way to be successful with long-term goals is to effect a lifestyle change."

Presented at the American Association of Clinical Endocrinologist (AACE) May 27, 2012