DIVISION OF PUBLIC HEALTH DELIVERS BIENNIAL REPORT, IMPACT OF DIABETES IN DELAWARE, 2023, TO DELAWARE LEGISLATURE

DOVER, Del. (July 3, 2023)  - The Division of Public Health (DPH), on June 30, 2023, issued its biennial report, Impact of Diabetes in Delaware, 2023, to members of the General Assembly. The report provides up-to-date information on diabetes prevalence, programming, costs and progress.

The report is a collaboration of three agencies: DPH and the Division of Medicaid & Medical Assistance (DMMA) under the Delaware Department of Health and Social Services (DHSS), and the Delaware Department of Human Resources, Statewide Benefits Office (SBO). The document is prepared for the Delaware General Assembly in accordance with 16 Del. Code, Chapter 1, Subchapter II, Section 140A, which requires it to be published by June 30 every other year.

Diabetes is a chronic disease that occurs when the body does not produce or use insulin properly. Left untreated, diabetes can lead to poor health outcomes including heart disease, stroke, kidney disease, lower limb amputations, blindness, and death. Individuals with diabetes can effectively manage their condition through healthy lifestyle behaviors and a medication regimen to control blood glucose levels.

According to DPH's Diabetes and Heart Disease Prevention and Control Program (DHDPC), 24.6% of Delaware adults have either diabetes or prediabetes, a condition that places them at greater risk of progressing to diabetes. More than 95,000 Delaware adults (12%) reported on the 2021 Delaware Behavioral Risk Factor Survey that they had been diagnosed with diabetes; 84,800 additional Delaware adults (12.6%) reported being diagnosed with pre-diabetes.

While the overall five-year age-adjusted mortality rate for diabetes has continued to decline, there are concerns about disparities by race. Non-Hispanic Black adults have a five-year age-adjusted mortality rate for diabetes (34.5 deaths per 100,000 population), which is twice that of non-Hispanic White adults (17.2 deaths per 100,000 population). 

According to the report, prediabetes and diabetes cost Delaware $1.1 billion each year - $818 million in direct medical expenses and $293 million in indirect costs. On average, medical expenditures for a person with diabetes are 2.3 times higher than for a person without diabetes. Prevention, early diagnosis, and management can prevent and reduce the costly outcomes associated with diabetes. The American Diabetes Association recommends at least 150 minutes per week of moderate-intensity physical activity and weight loss of 5% to 7% to prevent or delay the onset of diabetes in populations at high risk for the disease.

In Fiscal Year 2022 (FY22), diabetes was the costliest clinical condition by episodes of care among the State's 13,123 Group Health Insurance Plan (GHIP) members with diabetes. In FY22, costs related to diabetes episodes of care represented 5.0% of all GHIP net payments. The FY22 total allowed amount for diabetes reached $85.3 million - an increase of almost $9 million compared to FY21.

In FY22, Delaware Medicaid Managed Care Organizations directly reimbursed providers $49.0 million for diabetes-related care. An additional $2.6 million was paid directly to providers via fee-for-service claims for diabetes-related care among Delaware Medicaid clients.

The agencies make seven recommendations to reduce the burden of diabetes:

• Recommendation 1: Continue to educate Delawareans about diabetes risk factors while encouraging healthy lifestyle behaviors.
• Recommendation 2: Increase referrals to the nationally recognized, evidence-based National Diabetes Prevention Program for Delawareans at high risk for diabetes.
• Recommendation 3: Increase referrals to Diabetes Self-Management Education and Support programs (DSMES) for adults with diabetes.
• Recommendation 4: Increase medication adherence among Delawareans with high blood pressure and/or high cholesterol.
• Recommendation 5: Increase the proportion of Delawareans with diabetes who follow the evidence-based Centers for Disease Control and Prevention Diabetes Care Schedule.
• Recommendation 6: Leverage electronic health record (EHR) capabilities to promote the adoption of organizational guidelines for the clinical care of patients with or at risk for diabetes.
• Recommendation 7: Enhance care coordination to improve the clinical care of Delawareans with or at risk for diabetes, share resources, and reduce health care costs.

Read the full report at www.dhss.delaware.gov/dhss/dph/dpc/diabetes.html.

To learn more about diabetes management and prevention programs including the National DPP and DMES, visit https://www.healthydelaware.org/Individuals/Diabetes or call DHDPC at 302-744-1020.

Learn more about DMMA at https://www.dhss.delaware.gov/dhss/dmma/. Visit the SBO at https://dhr.delaware.gov/benefits/

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware's citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.

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