Diabetes in the Workplace Presented by: Becky Goldsmith, RN, BSN, CDE Program Manager Seton Diabetes and Nutrition Education Center

What You Should Know About Diabetes 29.1 Million people in the U.S. have diabetes (9.3% of the population!) - Diagnosed: 21 million - Undiagnosed: 8.1 million!!! 1.4 Million New Diagnoses each year

By 2025, 91 Million Cases Expected 79 Million Americans Have Pre-Diabetes By 2025, 91 Million Cases Expected

Diagnosis Fasting Blood Sugar Above 125 Random Blood Sugar 200 and Above, with symptoms Hemoglobin A1C 6.5% or greater Pre-Diabetes Fasting Blood Sugar of 100 – 124 Random Blood Sugar 140-199

Common Symptoms Excessive Thirst Excessive Urination Unexpected Weight Loss Headaches Fatigue Often – No Symptoms at All

Why is Diabetes Such a Costly Disease? Uncontrolled diabetes is associated with: Heart Attacks, Strokes Leading Cause of Kidney Failure Leading Cause of Non-Traumatic Amputations Leading Cause of Blindness Heart disease is the leading cause of death

Total Economic Cost of diagnosed Diabetes in the US $175 million annually? $124 billion annually? $150 billion annually? $245 billion annually?

$245 Billion in 2012 Increase from $174 billion in 2007, A 41% increase over 5 years

Breaking Down the Costs $176 billion direct medical costs $69 billion indirect costs - reduced productivity - lost days of work - premature death Source: http://www.diabetes.org/advocacy/news-events/cost-of-diabetes.html

Largest Components of $176 Billion Hospital Inpatient Care 43% Prescription Medications 18% Anti-diabetic agents & supplies 12% Physician Office Visits 9% Nursing/Residential Stays 8%

Projected Diabetes Diagnoses and Costs http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/pdf/diabetes.pdf 2034 – projected to be at $336 Billion Dollars Annually Source: http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/pdf/diabetes.pdf

What Do We Know About Diabetes in the Workplace?

Employers spend on average $4,413 more for employees with diabetes compared to employees who don’t have diabetes Source: National Business Coalition on Health Action Brief, Feb.2012

than those without diabetes People with diagnosed diabetes have medical expenditures 2.3 times higher than those without diabetes

Diabetes in the Workplace For a company with 1000 employees: 120 employees have diabetes 34 of them are undiagnosed 370 have pre-diabetes

How Effective Diabetes Management Benefits Employers A supportive environment builds dedicated employees Well-managed diabetes results in: lower health costs for employer fewer lost days at work increased employee productivity

Dazed and Confused

Diabetes Education A Tremendous Return on Investment Reduces Hospitalizations and ER visits Every $1 invested in such training can cut health care costs by up to $8.76 Source: http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/pdf/diabetes.pdf

What Seton Diabetes Education Has Done with the City of Austin Began in 2013 Delivered our Program to 800+ of their employees 73 COA worksites and taught 219 classes Employees are allowed to attend diabetes education during work hours Program completion rate is 90%

Seton Diabetes Program at City of Austin Total of Two 4-hour classes (plus an extra class for those on injectable medications) Quarterly meetings with a pharmacist Annual Refresher Course Diabetes Education and Pharmacy visit notes are communicated to employees’ physicians Employees with Diabetes and Pre-Diabetes may self-refer

Classes are Interactive and Cover: Monitoring of Blood Sugar (receive a free meter) Meal Planning and a lot of practice Exercise Benefits and Recommendations Short and long-term complication prevention

Class Content (cont.) Recommended Medical Care Heart Healthy Nutrition Guidelines Review of Food and Blood Sugar Records with Feedback And Much More………….. Taught by Registered Nurses and Registerd Dietitians/CDEs

Results at City of Austin Medical costs PMPM were 21% lower than those not in the program Decreased inpatient hospital stay by 11% Decreased ER visits by 18% Much higher compliance with recommended screenings/exams 97% saw their MD 2x/yr vs. 80% of those who didn’t go through program, 97% had A1C drawn 2x/yr vs. 60% who didn’t go thru program

More Results from City of Austin

Worksites Where We’ve Taken Our Diabetes Classes Texas Department of Transportation State Comptrollers’ Office University of Texas

How To Bring Seton’s Diabetes Classes to Your Worksite Your role: Schedule dates/times that work for your group Provide a classroom that can accommodate 12-15 employees – conference style rooms work best Send several emails announcing dates/times of classes Provide an on-site contact person We can send you sample emails from other worksites

What’s Involved in Getting Seton’s Diabetes Classes at Your Worksite? Seton’s role: We handle all registrations and reminder calls We provide a Registered Nurse and a Registered Dietitian to teach the classes We provide a free glucometer and all class materials We send written record to each attendee’s physician regarding their participation and any medical concerns/safety issues

What’s the Cost? The State’s UHC HealthSelect Plan includes a Wellness Program called Optum Health Once scheduled with Seton Diabetes Education, we will facilitate their enrollment in Optum Health Once enrolled in Optum Health, diabetes education will be covered at 100% 

We Can Deliver Our Classes to Sites Outside of Austin Your site will need one the following:   1.  A Video Conferencing Equipped Meeting Room OR 2.  A computer Including: - Webcam - Internet Access - External speakers (optional) - Access to a projector (optional) Seton is capable of connecting your site to one of our video based Virtual Meeting Rooms (VMR) which will allow us to connect to you via a web browser.  No accounts will need to be set up in order to connect. 

Other Worksite Programs Covered at 100% With A United Healthcare Referral We Will Help Employees Get the Needed Referral

Heart Disease Risk Reduction Program At The Heart of Health Heart Disease Risk Reduction Program Eight 1-hour classes Personalized Risk Assessment Weekly accountability with food diary and RD feedback Emphasis on improving risk factors associated with heart disease

Weigh to Health Weight management program Eight 1-hour weekly classes Participants receive a personalized meal plan Weekly motivational emails Focus is on the Lifestyle Patterns Approach Each participant’s individual eating, exercise and coping patterns will be identified Strategies for addressing patterns Interactive group support and peer coaching Designed for work in small groups – lots of interactive discussion, peer coaching, accountability, keep food logs, engage in weekly challenges to keep focus 75% is behavioral based, 25% is nutrition education – focus is really on sustainable behavioral changes

Interested in Hosting Classes At Your Worksite? Call Becky Goldsmith 512-324-3321 Bgoldsmith@seton.org