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Diabetes Prevention and Control: Combined Diet and Physical Activity Promotion Programs to Prevent Type 2 Diabetes Among People at Increased Risk

September 9, 2014 Comments off

Diabetes Prevention and Control: Combined Diet and Physical Activity Promotion Programs to Prevent Type 2 Diabetes Among People at Increased Risk
Source: Community Preventive Services Task Force

The Community Preventive Services Task Force recommends combined diet and physical activity promotion programs for people at increased risk of type 2 diabetes based on strong evidence of effectiveness in reducing new-onset diabetes. Combined diet and physical activity promotion programs also increase the likelihood of reverting to normoglycemia (normal blood sugar) and improve diabetes and cardiovascular disease risk factors, including overweight, high blood glucose, high blood pressure, and abnormal lipid profile.

Based on the evidence, combined diet and physical activity promotion programs are effective across a range of counseling intensities, settings, and implementers. Programs commonly include a weight loss goal, individual or group sessions (or both) about diet and exercise, meetings with a trained diet or exercise counselor (or both), and individually tailored diet or exercise plans (or both). Higher intensity programs lead to greater weight loss and reduction in new-onset diabetes.

Economic evidence indicates that combined diet and physical activity promotion programs to prevent type 2 diabetes among people at increased risk are cost-effective.

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Age Differences in Visits to Office-based Physicians by Patients With Diabetes: United States, 2010

August 26, 2014 Comments off

Age Differences in Visits to Office-based Physicians by Patients With Diabetes: United States, 2010
Source: National Center for Health Statistics

Key findings
Data from the National Ambulatory Medical Care Survey

  • Office-based physician visits by patients with diabetes increased 20%, from 94.4 million in 2005 to 113.3 million in 2010, but the rate did not change between 2005 and 2010.
  • The visit rate for diabetes increased with age and averaged 1,380 visits per 1,000 persons aged 65 and over in 2010.
    A majority of visits made by patients with diabetes (87%) were by those with multiple chronic conditions, and the number of chronic conditions increased with advancing age.
  • Medications were prescribed or continued at a majority of visits (85%) made by patients with diabetes, with the number of medications prescribed or continued increasing as age increased.

HHS OIG — Medicare Market Share of Mail Order Diabetes Test Strips From July-September 2013

June 17, 2014 Comments off

Medicare Market Share of Mail Order Diabetes Test Strips From July-September 2013
Source: U.S. Department of Health and Human Services, Office of Inspector General

WHY WE DID THIS STUDY
Medicare covers diabetes test strips provided by mail order suppliers and local pharmacies or supplier storefronts. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 requires CMS to phase in, with several rounds of bidding, a Competitive Bidding Program for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). Under this program, suppliers compete to become Medicare contract suppliers for selected DMEPOS items. The payment amounts resulting from the competition replace the Medicare fee-schedule amounts for these items.

The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) prohibits CMS from awarding Competitive Bidding Program contracts for mail order diabetes test strips to suppliers that do not demonstrate that their bid covers at least 50 percent, by volume, of all types of mail order diabetes test strips. Further, section 154(d)(3)(B) of MIPPA requires OIG to complete a study to determine market shares of diabetes test strips in the Competitive Bidding Program before each round of competitive bidding following Round 1. This report fulfills the MIPPA requirement for the pending third round of competitive bidding.

HOW WE DID THIS STUDY
We determined the Medicare market shares for diabetes test strip types associated with a random sample of Medicare claims for the 3-month period of July to September 2013. Our sample of 1,210 claims was drawn from a population of approximately 505,000 claims for mail order diabetes test strips provided to beneficiaries during this period. To estimate the Medicare market shares, we surveyed suppliers and projected our sample data to the population of mail order diabetes test strips.

WHAT WE CONCLUDED
Twenty-two suppliers submitted at least 43 types of mail order diabetes test strips for the 3-month period of July to September 2013. Two types of diabetes test strips accounted for approximately 45 percent of the Medicare mail order market share. Three types of diabetes test strips accounted for 59 percent of the Medicare mail order market share, and 10 types accounted for 90 percent. CMS may choose to consider these data when determining whether subsequent rounds of suppliers’ mail order diabetes test strip bids comply with the MIPPA 50-percent requirement.

More than 29 million Americans have diabetes; 1 in 4 doesn’t know

June 13, 2014 Comments off

More than 29 million Americans have diabetes; 1 in 4 doesn’t know
Source: Centers for Disease Control and Prevention

More than 29 million people in the United States have diabetes, up from the previous estimate of 26 million in 2010, according to a report released today by the Centers for Disease Control and Prevention. One in four people with diabetes doesn’t know he or she has it.

Another 86 million adults – more than one in three U.S. adults – have prediabetes, where their blood sugar levels are higher than normal but not high enough to be classified as type 2 diabetes. Without weight loss and moderate physical activity, 15 percent to 30 percent of people with prediabetes will develop type 2 diabetes within five years.

Diabetes Spending Dips in States: NCSL Report

April 9, 2014 Comments off

Diabetes Spending Dips in States: NCSL Report
Source: National Conference of State Legislatures

State and federal spending to combat diabetes decreased slightly in 2013 compared to the previous year, according to a new report from the National Conference of State Legislatures (NCSL). The report, “States Address the Costs of Diabetes: A 50-State Budget Survey for Fiscal Year 2013,” tracks the funds specifically appropriated by state legislatures for diabetes in FY 2013. It also reviews the funding provided by the Centers for Disease Control and Prevention (CDC) to states in FY 2012 for Diabetes Prevention and Control Programs (DPCPs), as well as changes in grant funds received from the CDC.

The total of state and federal funding appropriated by state legislatures specifically for diabetes prevention and control was $11,347,038 in FY 2013, compared to $11,947,129 in FY 2012, a difference of about 5 percent. Those figures, however, do not represent total spending by states on diabetes. The CDC also supports state efforts through grant programs, providing roughly $27 million per year.

Self-report of Diabetes and Claims-based Identification of Diabetes Among Medicare Beneficiaries

November 19, 2013 Comments off

Self-report of Diabetes and Claims-based Identification of Diabetes Among Medicare Beneficiaries (PDF)
Source: National Center for Health Statistics

Objective— This report compares self-reported diabetes in the National Health Interview Survey (NHIS) with diabetes identified using the Medicare Chronic Condition (CC) Summary file.

Background— NHIS records have been linked with Medicare data from the Centers for Medicare & Medicaid Services. The CC Summary file, one of several linked files derived from Medicare claims data, contains indicators for chronic conditions based on an established algorithm.

Methods —This analysis was limited to 2005 NHIS participants aged 65 and over whose records were linked to 2005 Medicare data. Linked NHIS participants had at least 1 month of fee-for-service Medicare coverage in 2005. Concordance between self-reported diabetes and the CC Summary indicator for diabetes is compared and described by demographics, socioeconomic status, health status indicators, and geographic characteristics.

Results— Of the Medicare beneficiaries in the 2005 NHIS, 20.0% self- reported diabetes and 27.8% had an indicator for diabetes in the CC Summary file. Of those who self-reported diabetes in NHIS, the percentage with a CC Summary indicator for diabetes was high (93.1%). Of those with a CC Summary indicator for diabetes, the percentage self-reporting diabetes was comparatively lower (67.0%). Statistically significant differences by subgroup existed in the percentage concordance between the two sources. Of those with self-reported diabetes, the percentage with a CC Summary indicator differed by sex and age. Of those with a CC Summary indicator for diabetes, the percentage with self-reported diabetes differed by age, self-rated health, number of self-reported conditions, and geographic location.

Conclusions— Among Medicare beneficiaries who self-reported diabetes in NHIS, a high concordance was observed with identification of diabetes in the CC Summary file. However, among Medicare beneficiaries with an indicator for diabetes in the CC Summary file, concordance with self-reported diabetes in NHIS is comparatively lower. Differences exist by subgroup.

Diabetes Care for Clients in Behavioral Health Treatment

November 4, 2013 Comments off

Diabetes Care for Clients in Behavioral Health Treatment
Source: Substance Abuse and Mental Health Services Administration

Reviews diabetes and its link with mental illness, stress, and substance use disorders, and discusses ways to integrate diabetes care into behavioral health treatment, such as screening and intake, staff education, integrated care, and counseling support.

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