The coronavirus pandemic further complicates this health challenge, as people with type 2 diabetes are more likely to have serious complications, more intensive care unit (ICU) admissions, longer length of stay, and higher mortality from COVID-19.2
Given the depth and complexity of the problem, healthcare organizations intent on making a positive impact on diabetes prevention and management — as well as lowering the associated healthcare costs and drain on clinical resources — should adopt an evidence-based, targeted approach that directly involves patients.
Increasing evidence shows that patient partnership in care can improve health outcomes, practice efficiency, and patient and provider satisfaction.3 Since patients today are much more informed healthcare consumers, building trusted patient-provider partnerships and empowering patients as active participants in their own care is a natural evolution in their healthcare journey.
According to the International Diabetes Federation (IDF) Diabetes Atlas, 463 million adults are living with diabetes, and 10% of global health expenditure is spent on diabetes (USD 760 billion).
Diabetes risk factors
For U.S. adults aged 18 years or older with diagnosed diabetes4:
- 89% were overweight
- 68% had high blood pressure
- 43% had high cholesterol
- 38% were physically inactive
- 15% were active smokers
Trusted patient partnerships translate to optimized care and outcomes
Since better diabetes management and good glycemic control can also reduce the risk of serious complications — including cardiovascular disease, blindness, kidney failure, lower limb amputation, and stroke — and their associated costs, improving diabetes care has far-reaching benefits for both patients and healthcare organizations.
The American College of Physicians’ Patient Partnership in Healthcare Committee developed principles that position patients at the center of care while acknowledging the importance of partnership between the care team and patient in improving healthcare and reducing harm. “The principles state that patients and families should be treated with dignity and respect, be active partners in all aspects of their care, contribute to the development and improvement of healthcare systems, and be partners in the education of healthcare professionals.”5
Respectful communication, understanding, and support are essential elements of effective diabetes care. Healthcare organizations that foster partnership, education, and engagement are better able to provide consistent, authentic, and personalized connections that:
- Build trust
- Encourage alignment among patients and care teams
- Empower patients to make shared, evidence-based decisions
When patients feel they are not alone in their care journey, they are more willing to follow treatment plans and make lasting lifestyle changes that result in better outcomes. Improved patient compliance reduces the risk of a patient developing more serious complications and the associated drain on healthcare resources.
Adults with food insecurity may be at high risk for undiagnosed diabetes. Evidence from the English Longitudinal Study of Aging suggests that focusing on people from lower socioeconomic groups may help early diagnosis of diabetes for older adults.
Within South America, Brazil has:
- The highest mean annual health expenditure per person with diabetes (USD 3,117)
- The highest number of adults with diabetes (16.8 million)
- An estimated 95,800 children and adolescents under the age of 20 with type 1 diabetes
Identify social determinants and barriers to change
Patients are often aware they must eat healthier and lose weight but changing habits is not easy, particularly habits that require major lifestyle changes. However, since obesity is a major risk factor for diabetes, overcoming barriers and motivating both children and adults to control their weight is crucial. An analysis from the Organization for Economic Cooperation and Development (OECD) shows that every dollar spent on preventing obesity generates more than a six-fold economic return.6
It’s important to recognize the unique aspects of a patient’s life circumstances that influence these factors and the ability to change. Education levels, finances, cultural background, transportation, access to affordable housing, and healthy foods have a direct impact on patient health and healthcare spending.
According to the International Diabetes Federation, the burden of managing diabetes “increasingly falls on low and middle-income countries and impacts disproportionately on poorer, disadvantaged, and vulnerable groups, including indigenous peoples and minority communities in high-income countries.”7
To better support these populations, healthcare systems must become more creative to help patients overcome the obstacles they face. For example, if low income or elderly patients lack transportation, some health systems are working with ridesharing services and public transport systems to ensure patients get to their appointments. If access to healthy food is a problem, a service agency may be able to connect a patient with food assistance programs. Patients who struggle to pay for prescriptions may be eligible for help from prescription assistance programs.