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Managing Diabetes

An outline of some of the things HR leaders can consider to help employees stay healthy -- especially if they have -- or are prone to have -- diabetes.

This article accompanies Fighting the 'Stealth Scourge'

Saturday, October 16, 2010
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The Centers for Disease Control and Prevention estimate average medical costs among diabetics are 2.3 times higher than what the costs would be for non-diabetics. Similarly, the indirect cost of diabetes in the United States based on disability, work loss and premature mortality was $58 billion in 2007, according to the CDC.

These costs suggest that employers need to work with diabetic employees to help them stay healthy, which in turn can help bring down health care costs.

Healthy Living Begins with Education.

All employees should actively work with their doctors to stay healthy. While genetics are a factor in the onset of diabetes, it doesn't have to pre-determine a diabetic's fate.

For example, pre-diabetic patients who work with their doctor may be able to make lifestyle changes and avoid the onset of diabetes. And, a Type 2 diabetic can work with their physician to manage the condition with exercise and healthy eating, instead of, or in addition to, a drug regimen.

Employers should proactively educate their workforce about the importance of making healthy choices, and the resources available to them through their health plans, such as:

* Care-management programs, designed to help employees (including diabetics) understand the day-to-day management of their conditions, support a physician's plan of care and help improve their quality of life.

* Nurse call lines are another valuable resource. If not feeling well, or for questions about their health, all employees can contact a registered nurse 24 hours a day to receive help in non-emergency situations or to determine if more care is necessary.

These call lines can help eliminate unnecessary trips to the doctor or emergency room, which can help employees keep healthcare costs down.

* Health assessments and screenings are also key resources to keeping diabetic employees healthy. They can identify risk areas that need to be addressed to improve health and well-being.

Hit the Gym, Grab an Apple and Kick the Habit!

Education only goes so far, so employers need to find creative ways to engage their employee population to help them get healthy and stay motivated.

Type 2 diabetes is largely manageable if a person exercises, eats right and doesn't smoke. According to a 2009 study by the Archives of Internal Medicine, people who don't smoke, exercise and limit their use of alcohol have lower incidences of diabetes.

Worksite wellness programs can be an effective way to achieve positive health outcomes. Because obesity and smoking are major risk factors for diabetes, initiatives such as smoking-cessation, weight-loss and fitness programs tied to employee incentives can help improve the health of all employees, especially diabetics.

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Employers should also consider going beyond traditional wellness and support programs to motivate employees to stay healthy. Tailoring programs to employee interests (yoga, walking, etc.), or creating fitness or healthy-behavior challenges that leverage technology and incorporate meaningful incentives are innovative ways to engage employees to stay healthy and motivated.

Your health plan can be a valuable partner in helping design wellness programs to best meet your employees' needs.

It's Not Just Physical, It's Emotional.

Healthy living is not just limited to physical health, it also includes emotional health. When working with diabetic employees, keep in mind that diabetes is typically not an isolated condition, and diabetics frequently have other health problems, including obesity, high blood pressure and, sometimes, depression.

* Type 2 diabetics, especially, need to manage their disease by following doctors' orders, proactively staying on top of their medication and watching their weight.

* Diabetes can be more challenging to control in patients suffering from depression.

* Programs that provide stress management and emotional-health support can be valuable tools in maintaining health and wellness. These programs help diabetics and non-diabetics alike recognize and manage their health by making healthier choices.

By proactively working with your employees to encourage lifestyle changes and diabetes management by quitting smoking, eating right and exercising, employers can engage their employees to lead healthier lives and improve their long-term health, which can have a positive impact on helping to reduce healthcare costs.

Dr. Jan Cook, MPH, is medical director at Blue Cross Blue Shield of Massachusetts.

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