Across the country and in our state, a growing population of people are being diagnosed with diabetes, a chronic condition that can be effectively managed and treated with proper screening and intervention.
Figures from the American Diabetes Association (ADA) show that nearly 10% of Washington residents have diabetes, and another 34% have prediabetes – higher than normal blood glucose levels that do not reach the level to be diagnosed as type 2 diabetes. The ADA estimates that nearly 50,000 Washington residents a year are newly diagnosed with diabetes.
As one of the fastest-growing chronic conditions here in Washington and across the country, the cost to provide care nears $10 billion annually in our state. A recent report from the ADA shows that in 2022, the direct cost of diabetes care was $6.68 billion and the indirect care costs were $2.51 billion.
Despite the growing costs of treating people with diabetes, there are clear gaps in care for diagnosed cases. In the primary care setting, our performance on key measures tracking how we evaluate and treat individuals with diabetes can vary greatly by where they live.
“Primary care practices play a crucial role in screening for and treating diabetes. Adhering to consistent and thorough screening and treatment in the primary care setting can make a real difference for the hundreds of thousands of Washington residents with diabetes. Moreover, we need to ensure that all residents have appropriate access to high-quality, affordable care,” said the Alliance Executive Director Drew Oliveira, MD, MHA.
To understand where the care gaps exist, the Washington Health Alliance uses our voluntary All-Payer Claim Database representing more than 4.5 million covered lives in Washington, which tracks seven performance measures related to diabetes.
While these rates show the statewide averages, the picture shifts when socioeconomic characteristics, defined by Neighborhood Atlas (Area Deprivation Index), are taken into account.
Across these seven measures, as socioeconomic advantage of the insured population decreases, so does the rate for the measure. For example, for commercially insured residents with diabetes, those at most socioeconomic advantage have their kidney health screened at a rate of 41% but those considered least advantaged are screened at a rate of 36%.
This is important because it is well-documented that the prevalence of diabetes increases as income decreases, and this gap is widening.
While these measures reflect the situation for patients with diagnosed diabetes, the Centers for Disease estimates that as many as 1 in 5 people with diabetes do not know they have it. This further highlights the important role primary care providers can play in early screening and intervention.
However, as many as 35% of residents do not have a primary care provider or no annual care and as such are not often receiving routine screenings that could identify the risk of developing diabetes.