Among the many crises facing U.S. healthcare, the upward trend of diabetes and chronic disease is a major concern. While healthcare needs to continue treating and addressing diabetes, they also need to address contributing factors with the same vigor.
At this stage, prevention is healthcare’s biggest asset in the battle against chronic disease. Often chronic disease is preceded by a cluster of conditions occurring together, including increased blood pressure, high blood sugar, excess body fat around the waist, high BMI and abnormal cholesterol or triglyceride levels.
These conditions, commonly referred to as Metabolic Syndrome, increase risk of heart disease, stroke and type 2 diabetes. While the outcomes of untreated Metabolic Syndrome are long-term illnesses that cost patients and the healthcare system enormously both in terms of financial cost and poor outcomes, treatment of Metabolic Syndrome is actually inexpensive and doesn’t require lots of special medical devices, drugs, or operations.
Prevention is the best way for patients to reverse Metabolic Syndrome and avoid the onset of dangerous long-term illnesses.
Prevention is a spectrum
When we talk about prevention, it’s not just the well who are at risk of becoming unwell if they don’t change their lifestyle behaviors.
The biggest opportunity for impact and change at a patient level, clinician level and cost saving perspective is the person who doesn’t have diabetes but are at risk of developing it. Or the person who doesn’t have cardiovascular disease - but has the risk factors. Or the person who doesn’t have COPD but has respiratory issues and if left unmanaged - may develop it.
These risk factors are largely a result of how we live, what we eat, how much we move, our stress levels, social interaction and sleep. But they can also be due to genetic predisposition to chronic disease.
If healthcare can stop or delay the onset of chronic disease for the millions of Americans living with risk factors, they will save healthcare billions of dollars. More importantly, perhaps, those individuals will go on to lead healthier, happier lives.
Physical risks for diabetes
Over 90% of people with diabetes are diagnosed with type 2 diabetes. Unlike type 1 diabetes, this chronic disease is largely preventable with healthy lifestyle choices. That means that healthcare could eradicate the majority of diabetes simply with preventative medicine.
Most of medical care has focused on treating diabetes rather than concerted efforts at preventing it. For instance, patients who are inactive, overweight, or are over 45 years of age are at greater risk of developing type 2 diabetes.
Genetic risks for diabetes
While type 2 diabetes isn’t genetic, certain groups of people exhibit higher propensities towards the disease. Studies conducted by the Center for Disease Control reveal that Native Americans, non-Hispanic blacks, and Hispanics have higher chances of developing chronic conditions.
Strategic measures must be focused at these patient groups if they exhibit any other diabetic risk factors such as obesity and inactivity. Not addressing these health needs, will result in elevated diabetes diagnoses among these groups.
Above all, healthcare needs to make concerted efforts at addressing pre-chronic conditions. One in three Americans already have prediabetes or some form of Metabolic Syndrome. As Metabolic Syndrome and prediabetes progresses to chronic illness, the healthcare crisis in the United States will only continue to escalate.
These patients need to be made aware that without lifestyle changes they will likely develop chronic illness. At this stage in their health, the best treatment plan for them is self-management - ensuring they are enabled and know how to engage in their own health.
The high cost of no prevention for pre-chronic disease patients
Future cost predictions for Metabolic Syndrome
If not addressed, those living with undetected chronic disease or at-risk of developing long-term illness will cost a fortune for healthcare. Not only is the cost per diabetic case increasing, but the number of people diagnosed each year is increasing, as well.
Think of it this way: each year, everyone in America contributes about $1000 in expenses towards managing diabetes. And that number isn’t going down. The CDC predicts that by 2050, 1 in 3 Americans will have diabetes (in comparison to the 1 in 10 that are currently diagnosed).
Enabling pre-chronic disease and low-risk chronic disease patients with self-management tools
As it stands right now, healthcare has two choices. Either we enable self management, or we prepare to pay for more costly medical interventions.
Currently, healthcare is focused on treating the 15-20% of patients whose chronic illness has progressed to acute while leaving the 70-80% of chronic disease patients to gradually enter the high risk category.
However, what if we could focus on those 70-80%, support them to self-manage and walk back their chronic illness through lifestyle and behavior change?
What self management can do for patients
Self management puts patients in control of their own health. They take an active role rather than letting chronic illness take its course. This ownership means that symptoms get attention immediately. And while primary care physicians provide medical advice and guidance, treatment isn’t primarily dependent on medical interventions.
The long and short of it? If caught early enough, at-risk patients can treat themselves through supported lifestyle and behavior change.
How can we help people living in the ‘pre’ and low-risk range?
At first glance, it may seem impossible to provide people with more support. Clinicians are already bearing the burden of those who have developed chronic disease. They simply can’t take on the management of more patients, especially considering that enabling patients to self-manage can be time-consuming.
However, with a few strategic measures, healthcare can decrease cost while increasing better outcomes without burdening clinicians. Here are a few solutions to get you started.
Help reduce physical risk factors
In addressing risk factors, patients need support - support that goes beyond the clinic. That’s why those living with undetected or not-yet-acute chronic disease need access to professional support. Increasingly, trained health coaches fill this role. They monitor symptoms and advise patients on how to strategically make small changes that have a big impact.
Help people believe they can change
The at-risk populations face hurdles other than physical risks. Many people struggle to believe they can make the necessary lifestyle changes for a better life when dealing with all other lifes’ domains.
This is where a community of peers can provide the kind of support that only someone else who has walked in your shoes can bring. People in the trenches with them. Being able to see the success and struggles of others, people are empowered to innovate new solutions for their own symptoms. Along the way, they’ll learn to believe in themselves, as well.
Help people know how to improve their health
Knowledge is power. In all of this, patients need an understanding of what they need to do to improve their health. Without a basic level of health literacy, they can’t be expected to make good health decisions.
Clinicians, health coaches and peers have an opportunity to help people on the verge of developing a chronic illness by helping them understand the risks - and what changes they can make that will reduce those risks. Education needs to be easy to access, simple to understand, user-friendly and engaging.
Give people the tools they need
Encouraging people to use educational materials means providing them with easy access to them. In this tech-driven age, patients want tools that are convenient.
Healthcare organizations need to consider how leveraging digital platforms can make these tools more accessible, more widely available and via a channel most consumers prefer to engage with - online.
By making peer support, health coaching and educational materials available online you’re providing anytime, anywhere, care. Think of it as having your coach, care-plan and support crew in your pocket. The more convenient the experience, the more likely patients will engage with it.