How will the Diabetes Prevention Program assist patients with prediabetes

How will the Diabetes Prevention Program assist patients with prediabetes

In the state of California, the law puts it as a requirement for the Department of Health Care Services to set up a Diabetes Prevention Program (DPP) to be a Medi-Cal covered benefit. Medi-Cal’s DPP benefit will be according to the federal Centers for Disease Control and Prevention’s (CDC’s) guidelines. The cover will incorporate components of the centers for Medicaid services and Medicare. The program will benefit those individuals with diabetes especially type 2 diabetes and prediabetes through health coverage. The Diabetes prevention program was set up to help benefit from Medi-Cal with prediabetes to prevent and delay the commencement of type 2 diabetes (Kim, 2019).

Problem statement

How will the Diabetes Prevention Program assist patients with prediabetes in management and delay the onset of type 2 diabetes?

Background of the problem

Diabetes is a significant and rising public health problem. The disease affects both children and adults. It results from lifestyle changes and can be prevented. The prediabetes state can go unnoticed for a long time, therefore, leading to the rise in the number of individuals who are diagnosed with type diabetes which has already complicated. The disease can cause several serious complications such as cardiovascular disease, blindness, amputation, kidney disease, and premature death. According to the UCLA study, almost half of California adults have either prediabetes. The study gives the first analysis of prediabetes rates in California by county, ethnicity, and age. This gives us an insight into the future of the epidemics of diabetes. The prevalence of diabetes in California increased by up to 35 percent between the years 2001 and 2012 (Herman, Wilson, & Becker, 2017).

Prediabetes is a state in which blood glucose levels are higher than normal but not high for a diagnosis of type 2 diabetes. Patients with prediabetes are at increased risk for the development of type 2 diabetes and other complications such as cardiovascular disease. The major causes of the disease are physical inactivity, obesity, unhealthy diets such as consumption of foods high in cholesterol, smoking and many more. Research indicates that about 13 million adults in California have prediabetes. About 2.5 million adults have diabetes which leads to about 55% of all adults in the state suffering from diabetes. The most affected age group is adults aged between 18-39 years because of their lifestyle (Babey et al., 2016).

Outcomes from the Diabetes Prevention Program (DPP) clinical trial shows that improvements in diet, increased physical activity, and weight loss can delay the onset of diabetes for patients with prediabetes. The program incorporated in Medi-Cal benefits helps more than just medication or a placebo. The research also shows that lifestyle is more than the medications for the management of the disease. More than one in three adults is approximated to be having prediabetes nationally (Babey et al., 2016). Between 1999 and 2008, the prevalence of diabetes and prediabetes among adolescents increased significantly from 9 percent to 23 percent. This indicates that the diabetic epidemic is not controllable therefore getting to its worst. There are very effective ways of managing diabetes that is available and this includes lifestyle modification programs recognized by the CDC’s National Diabetes Prevention (Backman et al., 2015).

According to the executive director of the health advocacy center in the state of California, the high prevalence is caused by limited access to healthy foods especially in low-income communities, availability of junk foods, and increase in the urban populations which leads to lack of playgrounds where people can carry out excises. The director advocates that if there is health insurance and programs to help in covering all programs in preventing diabetes, many people in California will be free from unnecessary amputations and other health complications related to the effects of diabetes. Diabetes does not only increase the medical costs but also affects families functioning (Herman, Wilson, & Becker, 2017).

Key stakeholders

Stakeholder engagement is an important methodology for improving public health policy decision making. Key stakeholders in policy formulations include the patients, policymakers, insurance companies, the government, and research participants. Stakeholders’ efforts are important in increasing the trustworthiness and quality of the public health policy (Lemke, & Harris-Wai, 2015). The providers of care such as nurses and physicians are trained people who deliver care modalities. They advocate for quality patient care, therefore, making them key team players in policy formulations. Health insurance companies save money and deliver effective care for patients. Such include Medicare and Medi-Cal. The government agencies collect data and propose solutions for health problems. Researchers provide evidence-based data necessary for decision making (Lemke, & Harris-Wai, 2015).

How the policy has benefited California

The Diabetes Prevention Program is an evidence-based lifestyle change program that assists patients who are the beneficiaries of the Medi-Cal program. The program can help slow down the progression of prediabetes to type 2 diabetes, therefore, decreasing its prevalence. The DPP focused on improving diet, problem-solving skills, and exercise. It is a 12-month behavior change program that has made impacts on the health of people with prediabetes in California. The healthcare costs spent on management of diabetes is reduced as many patients risk for complication of diabetes is reduced. The Medi-Cal coverage helps even those in low-income cities who cannot access proper management in case of diabetes complications (Kim, 2019).

Drawbacks of the Diabetes Prevention Program

First, the Medi-Cal DPP benefits were only available for those people who are prediabetic. It did not explain how those who type 2 diabetes can also benefit by covering them in the policy. This means that those already with the disease will continue suffering even if they are in medication without any other management. Also, the program does not provide the association between the reference point patient activation and the DPP attendance. It did not outline exactly the target patients to be able to trace how many have attended. The health policy research carried out shows whether the patients attending the program continued after four months and whether this lead to the desired health outcome.

Besides, the health policy does not state whether those who benefit the 12-month program can later be assisted because there is a higher risk that after 12 months, the patient may resume normal life like physical inactivity which leads to obesity. The program has not stated whether other prevention programs such as cessation of smoking and alcohol consumption can assist in slowing the progression of diabetes. Finally, the Medi-Cal DPP does not recommend how those who do not achieve and maintain the targeted weight loss will be assisted helped after the twelve-month session of lifestyle change and behavior modification.

Recommendations

Due to the high prevalence of prediabetes and diabetes in the state of California, the policy program should include initiatives to help those who have already acquired type 2 diabetes. This can be through inclusion in the exercise or behavior change programs. This could help them in slowing the development of complications which leads to disease-related morbidity and mortality. By including those who already have the disease, healthcare costs for the disease management will be reduced. The program should provide data on the reference point and those who attend the program. The program should also involve practices such as screening for early diagnosis and management of the disease. The policy program should consider finding ways to trace those who are enrolled therefore determining whether they develop the disease after lifestyle changes. Therefore, I recommend that the policy program should incorporate those with type 2 diabetes to help reduce morbidities due to complications.

Conclusion

All in all, the Medi-Cal Diabetes Prevention Program is the best public health policy that will help reduce the progression of type 2 diabetes in California. The trends in diabetes and prediabetes are worrying because of the association with financial costs hence when an individual enrolls in search programs, the healthcare costs and disease complications are reduced.