Secretary of Health and Human Services (HHS) Tommy G. Thompson has identified diabetes prevention, detection, and treatment as important components of his health agenda. Activities supporting the Secretary’s focus on diabetes include Steps to a HealthierUS: Putting Prevention First (Appendix A), the Diabetes Detection Initiative, and the Small Steps, Big Rewards, Prevent Type 2 Diabetes campaign. In addition, the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003, establishes coverage of a one-time “Welcome to Medicare Physical Examination” within 6 months of a beneficiary’s first coverage under Part B to encourage health promotion and disease detection. The MMA also adds coverage for cardiovascular and diabetes screening for Medicare beneficiaries. Both benefits take effect January 1, 2005. More information on MMA and Medicare benefits in general can be found at http://www.medicare.gov/ or 1-800-Medicare (1-800-633-4227). Appendix B provides additional information on diabetes benefits offered through Medicare.
Diabetes: A National Plan for Action (hereby referred to as the National Diabetes Action Plan—NDAP) is the latest initiative to address diabetes. This action plan was prompted by the Secretary’s commitment to disease prevention and health promotion. It utilizes a comprehensive action-oriented approach to identify activities to improve diabetes prevention, detection, and care.
The goals of the NDAP are to:
- Increase national awareness of diabetes, its impact, and what various stakeholders can do to prevent or manage the disease;
- Reduce the prevalence of diabetes and factors that increase the risk of diabetes;
- Promote improved detection, monitoring, and treatment of the disease; and
- Identify existing public and private efforts to facilitate coordination and to leverage existing resources for detection, prevention, and treatment of diabetes.
An advisory committee composed of senior officials within the U.S. Department of Health and Human Services (HHS) was named to direct the development of the NDAP. This committee provided recommendations to reduce the prevalence and burden of diabetes. In addition, the Secretary and his senior staff hosted several town hall “listening sessions” in different parts of the country to highlight the important steps that individuals, health care practitioners and providers, businesses, and communities can and are taking to prevent, detect, and treat diabetes and educate patients, their families, and other Americans. The first town hall meeting focused on prevention of diabetes and was held in Cincinnati, Ohio, on March 29, 2004. The second town hall focused on diabetes detection and education and was held in Little Rock, Arkansas, on June 18, 2004. The third town hall focused on diabetes treatment and was held in Seattle, Washington, on July 26, 2004. In all, more than 1,200 people attended the three town halls.
During the public comment period at these town hall meetings, individuals and those representing organizations were able to ask questions, express their views, and provide input to the national diabetes action plan. Hundreds of people shared their thoughts about the burden of diabetes and solutions for preventing or delaying the disease and its complications. The public comment period identified issues of concern to the diabetes community. These included:
- The key role that schools and teachers can play in educating students and parents about the importance of healthy behaviors (i.e. physical activity, nutrition) to reduce their risk for diabetes;
- The important role health insurance plays in the ability of people with diabetes to manage their diabetes and the need for policymakers to continue to strive to improve the health insurance system for people with diabetes and other chronic conditions;
- The need to educate and train healthcare providers in state-of-the art diabetes prevention, detection, and management strategies;
- The importance of continued research into effective and innovative prevention strategies and treatments for diabetes; and
- The need for focused prevention, detection, and treatment efforts targeted specifically to individuals at higher risk for diabetes, including Blacks, Hispanics, American Indians, Alaskan Natives, Asians and Pacific Islanders using culturally sensitive materials and messages emphasizing the importance of early detection and optimal treatment.
See Appendix C for more information on the development of the NDAP.
The remainder of this document is organized around three key components: prevention, detection, and treatment of diabetes. Within each component, action steps are provided for individuals, friends and family, health care providers, schools, the media, community organizations, health insurance providers, employers, and government agencies to improve the quality of life for people living with diabetes and reduce the burden of diabetes on the nation.