The American Association of Clinical Endocrinologists 21st Annual Scientific and Clinical Congress:

Integrated Team Program Improves Diabetes Outcomes, Lowers Drug Costs

A multidisciplinary lifestyle approach to diabetes management can improve clinical parameters, lower prescription costs, and decrease doses of insulin and oral medication, researchers have determined from a recent small-scale study. John Gary Evans, MD, et al, from Northeast Florida Endocrine & Diabetes Associates in Jacksonville, Florida, calculated diabetes-related medication expenditures before and after enrollment into a 16-week lifestyle intervention program (The Wellness Life Program), which included behavioral therapy, fitness, and nutrition counseling with specialists. An endocrinologist met with patients during the 16-week period.1

Patients who were overweight or obese were eligible for inclusion. A total of 36 patients were enrolled, with 27 patients having type 2 diabetes and ranging in age from 51 to 80 years. Prior to enrollment, patients’ mean body mass index (BMI) was 40.3±9.4 and hemoglobin A1c (A1c) was 8.0±1.7. Before interventions, 22% of patients were taking 1 antidiabetic agent, 45% were taking 2 agents, and 33% were taking ≥ 3 agents. Average 30-day prescription costs were $412.54.

At the end of the 16-week program, average 30-day prescription costs were reduced by $142.92 per month, and insulin and oral medication doses were decreased by approximately 46% and 16%, respectively. BMI was reduced by ≈3.07 and A1c was reduced by 0.7%, on average.

“An emphasis on behavior is the key to success,” said Dr. Evans. “As part of the interventions, we also included a Web-based program with daily health tips that patients could read each day.”

The American Diabetes Association also advocates lifestyle changes in diabetes treatment in its Standards of Medical Care in Diabetes, saying, “Lifestyle changes are required, in addition to multiple medications, in order to improve blood glucose, reduce the risk of microvascular and macrovascular complications, and produce favorable impacts on comorbidities.”2

Additionally, medical expenditures for patients with diabetes are double those seen in patients without diabetes.3 Investigators concluded that lifestyle interventions using a team of multidisciplinary specialists, including endocrinologists and nutritionists, can be beneficial in improving clinical parameters and reducing medication costs associated with diabetes.

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