Prediabetes Is Skewing Younger: Four Interventions to Turn the Tide

Feb 16, 2022 8:00:00 AM

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One out of every four young adults, aged 19-34, and one out of five adolescents, aged 12-18, has prediabetes, according to an analysis of 2005-2016 data published in JAMA Pediatrics. Those statistics do not bode well for the future health of the United States.

If left unchecked, prediabetes can develop into Type 2 diabetes, a disease that increases risk for cardiovascular disease, nerve damage, blindness, kidney disease, foot damage and more. There are financial costs, as well, to those with diabetes, and to their employers, health insurance providers and society as a whole. The average person with Type 2 diabetes has medical expenses of $16,752 every year. As a whole, diabetes is estimated to cost the nation $90 billion in lost productivity.

However, there’s hope for young adults with prediabetes if they receive support and thoughtful interventions that help them make healthy lifestyle and behavior changes while they are still young and relatively healthy. Here are four cost-effective ideas that health plans can put into practice quickly:

  1. Earlier, more widespread screening

New guidelines by the United States Preventive Services Task Force have lowered the recommended age for diabetes screening from 40 to 35 for overweight or obese patients. That’s a move in the right direction; however, health plans would be smart to cover testing even earlier for members with risk factors such as excess weight and family history of the disease. 

According to the 2020 JAMA report, young adults with prediabetes typically have other concerning health conditions, such as high cholesterol, high blood pressure and low insulin sensitivity – all precursors to Type 2 diabetes and cardiovascular disease. Screening at a younger age alerts members to the trajectory of their health at a time of life when their habits are still in formation and can be redirected more easily. Members in their 20s or early 30s may be motivated by personal transitions, such as marriage and parenthood, that make self-care more important.

Earlier screening also gives doctors an opportunity to have a serious discussion with their young-adult patients about diabetes, how it would change their lives if they developed it, and how to prevent it through healthy lifestyle and behavior change, perhaps in combination with new drugs like metformin. Getting the wake-up call of a prediabetes diagnosis may open the ears of patients who would normally shrug off health warnings.

  1. Digital tools to make behavior change easier and more fun

Young adults are used to doing life on their cell phones and tablets, so why not offer them digital tools that make improving their health easier and more engaging? Health plans can cover subscriptions to these all-mobile platforms or offer them at a discount. 

To make sure you pick a tool that will appeal to younger members and accomplish the goal of diabetes prevention, you’ll want to make sure it offers:

  • A Diabetes Prevention Program fully recognized by the CDC – This way, you’ll know the platform uses evidence-based curriculum and instruction.
  • Professional human coaches – Young adults respond well to sound, trustworthy advice and, for that, you need coaches with real qualifications: nutritionists, exercise physiologists, psychologists and wellness experts. Some programs only use “bots,” which are perfect for getting a banking or retail issue handled, but terrible for motivating members to persist with the hard work of weight loss and habit change.
  • In-the-moment feedback – Programs with access to coaches only offered at weekly, scheduled times, leave members flying solo the rest of the week, when they most need advice, feedback or encouragement. Better to choose a platform with on-demand coaching, so your members can post their meals or workouts, or reach out with a question, and receive a quick, helpful response.

With the right digital tool, you’ll get your young adult members quickly making better choices around nutrition and exercise, knowing they have coaches only a click away, cheering them on.

  1. Support to reduce alcohol abuse

Young adults tend to consume the most alcohol of any age group, with more than a third of 18-25-year-olds reporting binge drinking in the past month. That practice puts them at higher risk for diabetes, since heavy drinking can cause inflammation of the pancreas that interferes with insulin secretion.

Health plans should educate their young adult members about the risks of heavy drinking, including its link to diabetes, and how to know if they have an unhealthy dependency on alcohol.  Payers also can encourage physicians to conduct alcohol screenings for young adults as part of their usual services, and expand coverage for counseling services for those who need help getting alcohol use under control.

  1. Financial incentives

Sweetening the deal with a financial incentive may be just the hook to get young adult members invested in a lifestyle and behavior change intervention, such as a Diabetes Prevention Program. Studies have shown small, monetary perks can be quite successful, especially among lower-income populations. For instance, one study showed Diabetes Prevention Program participation, program completion and weight-loss milestones improved when monetary incentives were offered.

Incentives can come in many forms, including cash rewards, prepaid debit cards and gift certificates to be used for health-related purchases. Health plans can also choose to enhance or restrict benefits based on health behaviors. The important thing is to consider what incentive will speak most to your young adult population and then promote it vigorously. 


What Matters With Prediabetes

People with prediabetes can reverse their risk by focusing on losing weight (at least 5% of total body weight) and improving nutrition and exercise. The last pillar of diabetes prevention is education, preferably through a National Diabetes Prevention Program, so members understand their risk for the disease and know how to protect their bodies.

Yes Health is an all-mobile health platform that addresses all these elements – weight loss, nutrition, fitness and education – through professional, in-the-moment coaching. Your members can log on, post a photo of a meal or workout, and receive feedback within minutes. They can also ask coaches questions, or access helpful videos, articles and recipes in an online library. And, particularly important to young adults, our coaches do not subscribe to a one-size-fits-all approach, but instead work to customize their feedback based on the member’s preferences, health situation and goals. 

Learn why many health plans are providing Yes Health as a benefit to their members. Reach out today to talk to one of our product specialists.