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Type 2 Diabetes: Incremental Medical Care Costs During the 8 Years Preceding Diagnosis. Diabetes Care. 23(11): 1654-1659. November 2000.

This article describes a study that analyzed medical care costs for the 8 years preceding a diagnosis of type 2 diabetes. Study participants were members of a long established nonprofit group model health maintenance organization (HMO). From electronic records of this HMO, the study ascertained the medical care costs preceding diagnosis for members with type 2 diabetes who were newly diagnosed between 1988 and 1995. To isolate incremental costs, the costs of individually age and gender matched HMO members without impending diabetes were subtracted from the costs of members who were destined to receive this diagnosis. The study also compared these prediagnosis costs with the first 3 years of postdiagnosis costs. The study found that an economic burden from impending diabetes is apparent for at least 8 years before diagnosis, beginning with costs for outpatient and pharmacy services. Diabetes associated and incremental costs averaged $1,205 per type 2 diabetic patient per year during the first 8 prediagnostic years, including $1,913 each year for the first 3 years preceding diagnosis. In the year immediately preceding diagnosis, incremental costs were equivalent to those observed in the second and third years after diagnosis. The article concludes that incremental costs of diabetes begin at least 8 years before diagnosis and grow at an accelerating rate as diagnosis approaches and immediately after diagnosis. These incremental costs span the full range of medical services. Furthermore, the majority of these costs are for conditions not normally associated with diabetes or its complications. 1 figure. 3 tables. 20 references. (AA-M).

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What is Diabetes? (Type 2). Timonium, MD: Milner-Fenwick. 2000. (videocassette).

The goal of this video program is to help patients newly diagnosed with type 2 diabetes understand the disease and minimize their risk of complications. The program describes how blood sugar (glucose) builds up in the bloodstream and summarizes the components of the treatment plan (exercise, nutrition, drug therapy) to help patients keep their blood glucose in their target range. The program offers bright graphics to help explain blood glucose meters, medication monitoring and changes (administration and dosage), complications, and information about the hemoglobin A1c test (for glycosylated hemoglobin; a measurement of blood glucose values over time). The videotape was produced in cooperation with the American Association of Diabetes Educators (AADE), which defined the content of the video, selected the program consultants, and approved production at each stage of development. The program is closed-captioned.

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What to Eat When You Get Diabetes: Easy and Appetizing Ways to Make Healthful Changes in Your Diet. New York, NY: John Wiley and Sons, Inc. 2000. 240 p.

This book serves as a step by step guide to making informed nutrition choices for people newly diagnosed with type 2 diabetes. The book begins with a chapter that discusses the basics of eating with diabetes. This is followed by a chapter that addresses the issue of weight loss, focusing on increasing physical activity and modifying eating behaviors. The chapter stresses the importance of determining goal weight by blood glucose numbers rather than numbers on a scale. Subsequent chapters deal with understanding the food pyramid plan, learning that calories count, watching out for portion sizes, consuming sugar and carbohydrates, determining which fats to consume, and understanding food labels. Topics of remaining chapters include continuing to enjoy favorite foods, eating out healthfully, consuming adequate amounts of vitamins and other helpful substances, balancing food and medication such as insulin and oral diabetes medications, finding a dietitian, and living with diabetes. The book also includes sample meal plans and recipes and a list of diabetes cookbooks, helpful organizations, and useful web sites. 1 appendix.

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