Some Suggestions for AADE

In my research since September 29, 2011 about the American Association of Diabetes Educators, I have seen some promising goals and projects mentioned and some areas that are not really discussed.

The problem preventing many solutions is our medical insurance industry, which blocks these from becoming a reality. This is going to become a problem for the states if they do not modernize their laws and force some changes. If the states continue to ignore the problems facing patients needing education for chronic diseases like diabetes and not forcing the hands of insurance companies, the federal government will be called upon to establish the rules, and it is doing its best presently. I can hear the cry of States rights, but ignoring problems is not the right of the states.

With diabetes, we are facing many problems at present:
1. Little or no recognition for prediabetes (I agree we need a different term) and the increased costs when it progresses to type 2 diabetes.
2. Medical insurance companies not assisting patients with medical tests for prediabetes and possible medications.
3. No preventive initiatives to aid in the education of people with this diagnosis to prevent or delay the progression to type 2 diabetes.
4. No education for people with prediabetes – insurance will not cover it and even Medicare says no.
5. Many physicians that will not make an official diagnosis of prediabetes.

These are just a few of the many problems facing people with prediabetes. Yet AADE can do nothing for these people at present or is not interested.

So my suggestion is to work on billable solutions that could help these people that are left falling through the cracks. Find a way to use shared medical appointments (SMAs) for educating people with this diagnosis. Also, work on ways to communicate with physicians to assist physicians in making the proper diagnosis using the proper tests.

If the above is too difficult, then find a way to use peer-to-peer groups for these patients and train one individual that can lead this group as a volunteer if need be. Prediabetes is the beginning of type 2 and much needs to be done to assist people in making lifestyle changes and delaying the onset of full type 2 diabetes. It can be very cost saving for insurance companies and Medicare in the short and long-term. Talk up some preventive medicine with the insurance companies.

The AADE could also work with the FDA to approve metformin for use with prediabetes (instead of the “off-label” when it is prescribed now) while they are making lifestyle changes and especially those able to exercise slowly in the start. Then work with the doctors to provide relief of medication when they have proven that the lifestyle changes are making a difference and their blood glucose level are not trending upward.

Teach them how to test and watch for the trends in blood glucose and how the different foods affect their blood glucose. Let them experiment with lower carbohydrate diets to reduce weight if needed and also what moderate to low carbohydrate diets can do for reduced blood glucose readings. This allows them to become educated and possibly prevent them from have the full onset of type 2 diabetes for many years and possibly some will be able to avoid type 2 altogether. This is possible.