When I was a junior medical school faculty member, we spent a lot of time talking about the special educational needs of the Millenial generation. At the time, as a proud Gen Xer myself, Millenials seemed so...distant. But now the oldest millennials are 40(!), and the youngest are 25. As the age of Millenials has risen, so have rates of obesity and diabetes. About one in three Americans now has “prediabetes,” meaning a blood glucose level that is abnormally high but not high enough to be declared diabetes mellitus. Around ten percent of Americans are currently diabetic, and the rate of diabetes in people under age 20 has gone up a staggering 95% in the last twenty years (paywall).

So, inevitably, these streams have crossed, and the United States Preventive Services Task Force, or USPSTF, has now reduced the recommended age to screen for diabetes down from ages 40-70 to ages 35-70, starting smack dab in the middle of the Millenial bracket. They recommend we repeat the screening every third year. The screening recommendation applies only to people with a body mass index of 25.0 kg/m2 or above, but that is still a huge population, more than 40 percent of Americans by some estimates. And the guideline recommends considering even earlier screening for “...American Indians, Black people, Hispanics and other groups with ”overweight or obesity with “disproportionately high diabetes rates.”

The purpose of screening people for diabetes and prediabetes, typically with a fasting blood test, is not to simply attach a hurtful label to someone; it is to find people whose progression from prediabetes to diabetes, which normally proceeds at a rate of ~5-15% per year, can be slowed or halted with lifestyle changes or medications. The most tried-and-true program to accomplish this is the National Diabetes Prevention Program, or DPP, a one-year behavior change program conducted by peer coaches in-person or virtually. The USPSTF “found evidence that medical interventions for newly diagnosed diabetes have a moderate benefit in reducing diabetes-related deaths and heart attacks over a span of 10 to 20 years.” But the most compelling reason for screening for and preventing diabetes may be monetary savings. In addition to being the seventh leading cause of death in the United States, diabetes is an astonishingly expensive disease. The American Diabetes Association estimates that the cost of caring for a person with diabetes is roughly 2.3 times the cost of caring for the average person without diabetes. Diabetes accounts for about one in seven dollars spent in the American medical system. At a cost of around $500 for a year of the DPP, then, with one in seven participants subsequently avoiding a diagnosis of diabetes, it is no surprise that diabetes screening and the DPP are wildly cost-effective. And that is without taking into account that people enrolled in the DPP have lower rates of absenteeism and a reduced need for blood pressure and cholesterol medications.

We at KBGH so believe in the DPP that we’ve offered two employers funding for pilot programs. If you’re interested in exploring offering the DPP as a medical benefit, please reach out to us!

[disclaimer: KBGH receives CDC and KDHE funding in part for increased detection and prevention of type 2 diabetes]

As the Medical Director of the Kansas Business Group on Health, I’m sometimes asked to weigh in on hot topics that might affect employers or employees. This is a reprint of a blog post from KBGH.