Making the Case for Population Health Management in the Fight Against Diabetes

If you haven’t seen the January Health Affairs, a theme issue on diabetes, make a visit soon. In particular, read Susan Dentzer’s “From the Editor-in-Chief” piece. Beyond summarizing the important research and commentary within this special issue, Dentzer makes a compelling call to arms in the fight against diabetes.

She writes about the “staggering” reach of the disease – 285 million to 347 million affected globally – and its “stunning medical costs”: an estimated $1 out of every $3 in Medicare spending goes toward people with diabetes. Dentzer wryly notes: “You don’t have to be a math major to grasp the likelihood that growing spending on diabetes could easily overwhelm our other efforts at constraining health care costs.”

What caught our eye, though, is the exasperation she expresses. “What’s so frustrating is that we essentially know how to keep most diabetes, once diagnosed, under control – through weight loss, exercise, and appropriate medical management to attain tight control over blood glucose levels and blood pressure,” Dentzer writes. “Still, as is often the case in US health and health care, just because we know what to do doesn’t mean that we do it.”

We share her frustration. Diabetes management is among the most well-studied interventions in chronic disease prevention and care. Yet, a glaring disconnect remains between that strong evidence base and a broader application of it. That can’t continue – not when we face the disease prevalence and costs documented in Health Affairs and not when we have the tools and strategies readily at hand, through population health management, to make a meaningful difference.

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