More aggressive tests for diabetes urged

Washington state’s top health officer is urging doctors and other providers to begin aggressive patient screenings for pre-diabetes in an effort to curb soaring disease rates.

Type 2 diabetes has become a health care crisis in the past two decades, now affecting 14 percent of Washington residents, Dr. Maxine Hayes said Friday to regional caregivers.

Studies now indicate such numbers might just be a start. About 33 percent of Washington residents are suspected of being pre-diabetic, she said. The consequences for patients can include blindness, heart and kidney disease and other health problems.

There’s a cost to taxpayers, too. Diabetes rates are highest among seniors, the poor, racial minorities and those with little if any postsecondary education – most of whom depend upon government health care programs Medicare and Medicaid.

Pre-diabetes is a condition in which a person’s blood sugar levels are higher than normal but not high enough to merit a diabetes diagnosis.

Screenings could be just the sort of jolt many pre-diabetics need to change their lifestyles and avoid developing a full-blown case of diabetes.

While many patients get screened, the numbers aren’t high enough, Hayes said.

“It could be one of the single most important things we can do for people,” Hayes said.

Dr. Lynda Williamson, a sole practitioner in Spokane, said screening efforts are stymied by insurance plans that don’t cover such tests.

If insurance doesn’t pay, clinics either anger their patients by billing them for the lab work or absorb the cost as uncompensated care.

“It’s a problem,” Williamson said. “This kind of nonsense is exhausting and keeps us from getting important information.”

The screening can be done easily as part of a standard blood test that measures cholesterol levels and triglycerides.

Hayes said some of the health care reforms now being implemented should better mandate and fund such preventive measures.

Attempts to slow diabetes rates cut across the health care spectrum, from private clinics and drug researchers to universities and federal and state government programs.

There are an estimated 48,000 people with diabetes in Eastern Washington and North Idaho. Another 114,000 are suspected of being pre-diabetic.

The federal government has awarded a $15.7 million grant to help erect an electronic medical records system to help specialists and family clinics share information about diabetic patients and best treatment plans.

Hayes also said the Rockwood Clinic is participating in a patient-centered project undertaken by 32 clinics with 700 doctors and 600,000 patients centering on diabetes care.

The project attempts to better coordinate care and more closely tracks patients, and shows promise, she said. One measure: money.

Results are indicating that diabetes patients participating in the medical home model need less outside care such as emergency room visits, and thus are spending hundreds of dollars less on medical care than their peers.

“There’s a way for us to stop this rise in diabetes,” Hayes said. “It won’t be easy but … we’re figuring it out.”