Talking with Payers, Providers and Patients About Diabetes:
An AAPPO Toolkit for PPOs

Tab 11: Talking with Patients: Risk Factors and Behavior Change

Patients need to understand what factors make them at risk for developing diabetes. Controlling “modifiable” risk factors is key to prevention, early diagnosis and delay of diabetes and its complications. Nearly one third of all diabetics do not know they have the disease and go untreated until complications begin to occur. This can lead to poorer outcomes and high costs. There are many tools available to help individuals assess their risk of developing diabetes and to identify concrete ways to prevent diabetes. The two crucial pieces of prevention for individuals are assessing risks, and making behavior changes to prevent diabetes. These elements are addressed in the tools recommended here. Tools to identify risk and make changes can be offered by PPOs, payers or employer or can be accessed directly by patients using resources on the Internet.

Resources to share with patients:

NDEP “Your Game Plan to Prevent Diabetes
http://ndep.nih.gov/diabetes/pubs/GP_Booklet.pdf

Other resources include the NIDDK clearinghouse and other sources of patient focused information:

American Diabetes Association Health Risk Assessment “PHD” (for individuals)
https://www.diabetes.org/phd/profile/start.jsp

Points for PPOs to make with patients:

• Factors that play a role in increasing a person’s risk include: age; ethnic/racial background; family history; HDL and triglyceride levels; inactivity; obesity; hypertension; gestational diabetes; alcohol/tobacco use. The message to patients is the good news that many of these factors can be modified through lifestyle changes. 

• Many assessment tools do more than just calculate generic risk. Assessments often offer information and knowledge to help individuals understand their personal level of risk and what to do about it. Several key pieces of information that should be offered from a credible diabetes risk assessment tool include:
  • How often a person should be screened for diabetes
  • Why the various factors measured are important 
  • What the different kinds of diabetes are and which is more likely to affect you
  • What steps the person can take to reduce risk

• Patients need educational tools to help them understand and manage controllable risk factors. Many free educational resources are available for patients including those referenced in this toolkit. Patient information is available at varying reading levels and in multiple languages. 

• Without education, information and motivation, risk assessments alone are not effective at reducing diabetes risk. Disease management programs are designed to work with patients to help them understand risk of diabetes or co-morbidities, and to develop effective strategies to modify risk. Physicians, other professionals and community support groups can also support patients in addressing risk factors.