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AOA joins alliance in drive for diabetes prevention

March 21, 2012

As part of its “Let’s Prevent Diabetes” advertising and public relations program to reach federal legislators and policymakers, the Diabetes Advocacy Alliance last year leased, for a week, every available advertising space in Washington’s landmark Union Station, a few blocks north of the Capitol.

With the nation’s diabetes epidemic continuing unabated, a broad-based coalition, backed by the AOA, is launching a drive for expanded screening programs to identify people with undiagnosed diabetes, as well as those with early signs of the disease who could then be referred to formal prevention programs.

At a  Washington, D.C., news conference last month, the Diabetes Advocacy Alliance (DAA) called on the U.S. Preventive Services Task Force (USPSTF) to expand its Type 2 diabetes screening recommendations to cover a broader range of patients.

The event coincided with the publication of an article in the annual diabetes issue of the influential health policy journal, Health Affairs, (Should Screening for Type 2 Diabetes be Broadened?  A Review of the United States Preventive Services Task Force 2008 Recommendation for DM2 Screening) that calls on the government’s preventive services task force to consider a body of new evidence on the benefits of diabetes screening when the group next updates its recommendations on screening for Type 2 diabetes.

The authors also recommend primary prevention of Type 2 diabetes be added as an important near-term health outcome when assessing the value of screening.

The USPSTF now recommends Type 2 diabetes screening only for individuals who have high blood pressure and may be at risk for cardiovascular disease.

The USPSTF does not call for screening of individuals who have other risk factors, such as being overweight or having a family history of diabetes, noted Michael Duenas, O.D., of the AOA, which is one of the alliance’s three co-chair organizations.

The USPSTF recommendations are important because they offer guidance to primary health care practitioners on the providing of appropriate preventive care, and health insurers often consider them in making decisions about whether or not to cover preventive services, Dr. Duenas said.

Expanding the Type 2 diabetes screening criteria to cover a broader range of patients could help to identify the estimated 7 million American who have undiagnosed diabetes, as well as up to 79 million U.S. residents believed to have elevated glucose levels that put them on the verge of the disease – a condition known as pre-diabetes, according to the DAA.

“We could very likely prevent millions of those people from experiencing the terrible complications of diabetes—such as heart disease, stroke, blindness, amputation, and even death—if we institute expanded diabetes screening guidelines that identify more people who are truly at risk for this disease,” said Martha Rinker, chief advocacy officer of the American Association of Diabetes Educators, another DAA co-chair organization.

Once identified via screening, patients with confirmed cases of diabetes can receive care that helps reduce complications of the disease; while those on the verge of diabetes can reduce their risk of developing Type 2 diabetes through lifestyle changes such as weight reduction and increases in physical activity, the DAA noted.

In addition to broadening its screening recommendations to cover more patients, the alliance wants the USPSTF to recommend pre-diabetes patients be referred to formal diabetes intervention programs now being established around the nation.

One such lifestyle intervention program is the Diabetes Prevention Program currently offered at YMCAs across the United States, in cooperation with the U.S. Centers for Disease Control and Prevention’s (CDC) National Diabetes Prevention Program (NDPP). Such intervention programs are generally community-based and offered at low cost.

The federal Affordable Care Act authorized the CDC to establish a framework for making diabetes prevention programs more widely available to people with pre-diabetes. 

In addition to petitioning the USPSTF to amend its screening guidelines, the DAA is asking Congress and the Obama administration to appropriate funding for the development of those centers.

Last month’s Health Affairs report notes recent studies that show the impact of screening and treatment in populations at particularly high risk for diabetes, including blacks, Hispanics, and families with a history of diabetes.

The DAA was established in January 2010 to inform legislators and other policymakers about the challenges diabetes and pre-diabetes pose to U.S. health and prosperity, as well as how legislation and public policy could help reduce increases in the population with Type 2 diabetes and the rate of complications associated with the disease.

The alliance is a diverse group of 18 patient advocacy organizations, professional societies, trade associations, nonprofit organizations, and corporations.  Members of the DAA currently include the AOA, the Academy of Nutrition and Dietetics, American Association of Clinical Endocrinologists, American Association of Diabetes Educators, American Clinical Laboratory Association, American Diabetes Association, American Podiatric Medical Association, Healthcare Leadership Council, Medicare Diabetes Screening Project, National Association of Chain Drug Stores, National Community Pharmacists Association, National Kidney Foundation, Novo Nordisk Inc., Pediatric Endocrine Society, Results for Life, The Endocrine Society, VSP® Vision Care, and YMCA of the USA.

The AOA is one of three organizations on the alliance’s governing board.

Over its first two years, the alliance has begun holding Capitol Hill diabetes briefings, producing broadcast public service announcements with Washington officials, and conducting various efforts in support of the federal government’s Healthy People 2020 public health program. 

The DAA has developed an extensive “Let’s Prevent Diabetes” advertising and public relations campaign targeted to legislators. 

In addition to advertising in key Washington publications and on one of the city’s top news radio stations, the alliance last year leased for a week every available advertising space in Washington’s landmark Union Station, a few blocks north of the Capitol.

Additional information on the DAA can be found on the alliance’s Web site (www.diabetesadvocacyalliance.org).

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