Diabetes Education is One of the Best Treatments Available. Why is Access so Low?

A standing ovation for Dr. Margaret Powers at ADA last month

At the 76^th American Diabetes Association Scientific Sessions, the diaTribe team heard an exciting talk from Dr. Margaret Powers, President of Health Care and Education at ADA, on the need for increased patient access to diabetes self-management education, or DSME (abbreviated in this article as “diabetes education”).

In her address, titled “If DSME Was a Pill, Would You Prescribe It?”, Dr. Powers argued that diabetes education is one of the best treatments available. She received a standing ovation from the packed ballroom, arguing that access to education must improve. 

Unfortunately, Dr. Powers revealed that only 7% of individuals with private insurance and 5% of those on Medicare receive this type of diabetes education. Those numbers are much lower than many would expect. Here are three highlights from her presentation:

1. If diabetes education were a medication, it would score highly across the official ADA/EASD diabetes management criteria: efficacy, hypoglycemia risk, weight loss, other side effects, and costs. Studies have shown diabetes education provides significant reductions in A1c and the risk of hypoglycemia, improves weight loss and other side effects, and is reimbursable by Medicare and most private insurers.

2. Diabetes education can increase healthcare savings. Dr. Powers pointed to one notable study (Health Care Use and Costs for Participants in a Diabetes Disease Management Program, United States, 2007-2008) that found the average annual hospital charges for 33,000 patients who received any education was 39% less than the yearly average for those who received no education.

3. Diabetes education provides psychological benefits that medications do not. Dr. Powers shared that education reduces diabetes distress and the often hidden emotional burdens that come with managing diabetes (see past diaTribe coverage on distress with insight from Dr. Bill Polonsky). Studies show diabetes education also improves quality of life, coping skills, knowledge, self-care behaviors, healthy food choices, and physical activity.

Though a number of challenges remain to achieve widespread adoption of diabetes education, particularly related to motivation, it is beneficial to look at it from a drug or device perspective – how much does it cost, what is the efficacy, and what are the side effects?

Dr. Powers’ work to promote diabetes education is well appraised by other experts in the field. Dr. Rich Bergenstal, former ADA President and colleague of Dr. Powers at the International Diabetes Center in Minneapolis, shared with diaTribe: “Many ADA Presidents identify an area that needs attention as they start their leadership role but rarely are they as focused and persistent as Maggie to actually research the topic, craft, and publish a standards document, then work tirelessly to articulate an effective implementation strategy.” He further noted that as a result of Dr. Powers’ efforts, “many more people will receive timely and effective diabetes self-management education.”

If you would like to receive diabetes education, click here to find a diabetes educator near you. –CA/AB/KC