Darcie Drake

Thursday, 28 March 2002 06:55

Preventive medicine

Many employees assume their benefits package will include health care coverage. It's an expensive benefit to provide and administer, with costs to the employer climbing as health care rates escalate and insurance companies require businesses to pay premiums based on employees' policy usage. In response, employers are faced with passing increased premiums on to employees, leaving them with less disposable income and job satisfaction. Employee claims translate into decreased productivity. Businesses lose on both counts. Diabetes is one of the biggest causes of workplace absence, decreased productivity and increased health care costs. More than 10 percent of the nation's health care expenses are for diabetes treatment. Direct and indirect costs of diabetes and its long-term complications totaled $98 billion in 1997, and included hospital and nursing home stays, disability payments, physician office visits and premature mortality. An adult with diabetes loses an average of 8.3 days of work per year; an adult without diabetes, 1.7 days. Workers with long-term complications from diabetes worked 3.2 fewer days out of a two-week period than those with diabetes without complications. Almost one-third of those with diabetes say it limits their work activities.A wide-spread problem Sixteen million Americans have diabetes; approximately one-third are not aware of it. Most adults who are diagnosed with Type 2 diabetes have had the disease an average of seven years before they experience symptoms that send them for tests that reveal diabetes. Even employees who get annual physicals may not be aware they have diabetes because the body identifies the problem and, for a time, is able to correct it. Only when it can no longer keep up with the runaway glucose metabolism does the blood glucose become elevated and tip off the physician in terms of glucose readings above normal and subjective symptoms. Each year, 800,000 new cases of diabetes are diagnosed. A survey by the Centers for Disease Control and Prevention revealed a 49 percent increase in the incidence of diabetes in the last decade. It estimates 4 million people in Ohio are at risk; nearly 700,000 Ohioans have diabetes. While Type 2 diabetes used to strike people after age 60, it's now appearing in the 30- to 60-year-old group with alarming frequency. Contributing and controllable factors to this growing epidemic are lack of regular physical activity, lack of regular, moderate-portion meals and lack of weight control. Cleveland has the distinction of being named the 10th fattest city in the United States by the American Dietary Association. That helps explain a recent report that cited a 42 percent increase in diabetes in Ohio over the last 10 years. Unchecked or poorly treated diabetes on a long-term basis can result in expensive and debilitating complications, such as damage to the eyes resulting in blindness, kidney damage, nerve damage, heart attacks and strokes, and amputation. Smoking also dramatically affects an individual with diabetes and causes long-term problems. Complications are multiplied by smoking and quitting is encouraged.Pre-emptive strike Blood glucose can be controlled by many by eating regular meals and snacks of moderate portion sizes, exercising regularly, practicing weight-control measures and taking medication if prescribed. Other measures include regular blood-glucose monitoring, physician visits and ongoing education. In the last decade, the medical community has learned that not only is Type 2 diabetes treatable and manageable, it is preventable. The key is healthy lifestyle choices. By treating their bodies as if they already have diabetes, people can postpone the onset, avoid it altogether, or, at the very least, minimize the severity if diabetes does occur. So what can the business community do to control the horrendous cost and growing incidence of diabetes? Several companies have implemented programs to control diabetes and limit complications. They report decreased costs, higher attendance and increased productivity. As an employer, you can offer screening programs to identify people at risk. Encourage healthy lifestyle choices. Make it possible for employees to take a short walk at break time. Offer healthy choices in the cafeteria. Reward lifestyle improvements financially, perhaps by tying them to benefits such as offering a health insurance discount to employees who stop smoking, lose weight, exercise, see their doctor regularly or take nutrition classes. Make it unacceptable at work to choose to be unhealthy. Discourage smoking. The benefits will be obvious. A healthier work force is more satisfied, more productive and much less costly. Businesses benefit from a team approach to work problem solving and to maintaining a healthy work force. As an employer, partner with employees to safeguard their health and minimize the effects of chronic, debilitating diseases like diabetes. Darcie Drake (ddrake@swgeneral.com) is a certified diabetes educator/registered nurse at Southwest General Health Center in Middleburg Heights. Southwest General is a private, not-for-profit, 340-bed facility providing medical, surgical and emergency services and extensive social services/support groups. Contact Southwest General at (440) 816-8000.