Dr Fatima Cody Stanford Supports Focus on Diabetes Prevention, Not Just Treatment

Preventing the progression of diabetes can help patients maintain a healthy quality of life while saving significant costs, said Fatima Cody Stanford, MD, MPH, MPA, FAAP, FTOS, of Harvard Medical School and Massachusetts General Hospital.

Transcript (slightly modified)

What is the importance of Medicare paying for the National Diabetes Prevention Program?

When you’re looking at the DPP, we’re specifically looking at diabetes, and I think that that’s important. When we look at the breadth of obesity with over 93 million patients struggling with obesity in the United States, those numbers by far surpass any other disease process. So we want to get them before we’re getting into that prediabetes or diabetic state.

We know already, for example, that most patients that have prediabetes, so a hemoglobin A1c that falls between 5.7 and 6.4, have no clue that they have prediabetes. So we’re not getting to them, they all of a sudden end up in the office and they have diabetes and they’re like, “I never knew.” But their physician may have already checked their A1c and did not inform them that they’re falling within this gray zone that’s progressing relatively rapidly to type 2 diabetes, which is the one that we can potentially have an impact on.

I think that what’s happening is that we’re so treatment-focused that we’re often forgetting that we can avoid these treatments, which are very expensive over the lifetime, and also often significantly affecting the quality of life that the patient has. If we can get to them before then, then they can have a nice, healthy quality of life without a lot of the morbidity and mortality and associated costs, if we get to them earlier.

So I think that’s really part of what we need to think about when we’re looking at the Affordable Care Act and its coverage, Medicaid and its coverage, we need to look at these things: getting to people before these disease processes become prominent, and are costly to patients for their lives, their health, et cetera.