It’s Time for Action on Prediabetes

Diabetes rates over the past 10 years have continued to rise. Today, almost 10 percent of the U.S. population are affected. Unfortunately, there is even more reason to be concerned.

According to the American Diabetes Association, in 2012, 86 million Americans age 20 and over had prediabetes, which is a state of being at extremely high risk for developing Type 2 diabetes. Although, a diagnosis of prediabetes can seem hopeless, it is not. There are interventions that are proven to prevent and delay the onset of Type 2 diabetes. One of the most successful interventions is medical nutrition therapy, or MNT. This effective and comprehensive treatment is an evidenced-based service performed by registered dietitian nutritionists for disease management, such as delaying and preventing the onset of Type 2 diabetes. Numerous studies support the effectiveness of MNT, showing recipients losing weight and improving blood glucose levels.

The use of MNT as an intervention is strongly supported by research and professional organizations. In summer of 2015, the American Diabetes Association, the American Association of Diabetes Educators and the Academy of Nutrition and Dietetics released a joint position statement at the American Diabetes Association’s 75th Scientific Sessions. It outlined a new algorithm for starting and advancing self-management education for those with Type 2 diabetes, and also applies the model to individuals with prediabetes. Several studies have indicated that those who see diabetes educators and registered dietitian nutritionists have improved diabetes outcomes and quality of life.

MNT Needed for Prediabetes

There is one huge obstacle to preventing new cases of diabetes in the Medicare population. While Medicare currently covers MNT for individuals with diabetes and end-stage renal disease, it does not cover MNT for individuals with prediabetes. Without this coverage, many of those with prediabetes are unable to afford services to treat and manage their disease. Legislation to allow Medicare beneficiaries to receive MNT coverage for prediabetes will help millions of Americans receive the services they need and prevent a massive increase in the number of people with Type 2 diabetes.

In June 2015, the Academy, in conjunction with the Diabetes Advocacy Alliance, presented at a briefing to the Congressional Diabetes Caucus. This group comprises members of Congress with an interest in diabetes-related legislation. At this briefing, I shared these staggering statistics and the impact diabetes has in my community. We are still waiting for a hearing on diabetes, which would elevate interest in and visibility of current diabetes legislation and allow legislation to move forward that would improve the detection, prevention and treatment of diabetes.

While we wait, millions continue to struggle.

Make Your Voice Heard

I'm urging all members of the Academy of Nutrition and Dietetics to tell Congress to conduct a hearing on prediabetes coverage. Do your part by completing the Action Alert for the Preventing Diabetes in Medicare Act using the Academy's Action Center!

Carol Brunzell
Carol Brunzell, LD, RDN, CDE, is the policy and advocacy leader for the Academy of Nutrition and Dietetics' Diabetes Care and Education DPG. She is a registered dietitian nutritionist and certified diabetes educator at the University of Minnesota Medical Center.