Direct and indirect annual health care costs for diabetes are $13,700 for a worker with diabetes compared to $5,800 for a healthy worker. A 5-year study of 617 foundry workers found that health coaching and monetary incentives led to improved health metrics like HbA1c, blood pressure, and lipids despite higher BMI and waist size. The intervention helped prevent the expected rise in HbA1c levels over 5 years and reduced the number of new diabetes cases, showing that lifestyle coaching can help curb diabetes development and benefit employers through cost savings and productivity gains.

1. DIRECT AND INDIRECT
ANNUAL HEALTH CARE COSTS FOR DIABETES
Diabetic Worker
$13,700
[ Productivity of worker with diabetes
may also be less ]
Healthy Worker
$5,800
BIOMETRIC CHANGES
562
Holding Diabetes at Bay
CAN WE BEAT THE SECULAR TREND?
L.W. Raymond, MD | D.M. Roy , MSN, RN, CHES | S.L. Mullinax, PA-C, MPAS | A. Yanni, ANP-BC | K.C. Pentek, MSN, RN, CHWC, CCP | S.E. Isaacs, BSN, RN, CHC, CPHM
[ Healthcare costs can devour an employer’s profits. ]
Absenteeism: $5 billion
Lower productivity: $20 billion
Lost work from
diabetic disability: $21.6 billion
Lost productivity
from early death: $18.5 billion
Hypothesis
Coaching of workers with prediabetes to embrace healthy lifestyles could prevent or
postpone development of diabetes, benefitting the employer, worker and family.
5.5 6 6.5
5YEARRISKOFDM
60
50
40
30
20
10
HbA1c PREDICTS FUTURE DIABETES
9% of workers with HbA1c levels of 5.5will be diabetic in 5 years
25% of workers with HbA1c levels of 6.0will be diabetic in 5 years
STUDY DESIGN:
5-year comparison in 617 foundry workers.
Metrics were:
• HbA1c
• Lipids
• Blood pressure
• Waist measurement
• Body Mass Index (BMI)
• 10-year cardiac risk
INTERVENTION:
• Health coaching and monetary incentives
(health care premium discount of $800)
• Three or more face-to-face health coaching
sessions were conducted by Advanced
Care Practitioner at the employer’s
on-site clinic
• Employees were given time off for the
coaching sessions
• Wellness program participants volunteered
to participate in the five-year program
MEN (N=531)
HbA1c %
CHOLESTEROL
LDL
HDL
TRIGLYCERIDES
BMI kg/sq m
WAIST/INCHES
CVR %
2010
5.57 + 0.36_
187 + 37_
118 + 33_
41 + 11_
118 + 33_
29.9 + 6.1_
39.1 + 5.2_
5.28 + 4.46_
2015
5.53 + 0.60_
185 + 36_
110 + 34_
45 + 12_
118 + 33_
30.6 + 5.5_
39.8 + 5.5_
7.56 + 6.46_
WOMEN (N=86)
HbA1c %
CHOLESTEROL
LDL
HDL
TRIGLYCERIDES
BMI kg/sq m
WAIST/INCHES
CVR %
2010
5.63 + 0.36_
203 + 36_
127 + 31_
54 + 13_
110 + 57_
29.3 + 6.4_
35.0 + 5.0_
2.43 + 2.16_
2015
5.49 + 0.45_
194 + 32_
112 + 28_
58 + 13_
119 + 58_
30.5 + 6.6_
36.6 + 5.3_
3.81 + 3.18_
1.Over 5 years, health coaching improved the glycemic
control, blood pressure and most lipids in spite of higher
BMI and girth.
2.Higher cardiac risk due to aging and sustained blood
pressure elevation.
3. A review of the control group with no incentive or
coaching (lumber company) showed worse glycemic
control compared to the foundry company’s Wellness
Program Participants:
HbA1c 5.29 + 0.36 5.62 + 0.58_ _
Conclusions
FINDINGS:
• Expected 74 new diabetics,
observed only 24
• Prediabetes decreased 268 to 163
• Average HbA1c decreased:
Hers: 5.63 to 5.49
His: 5.57 to 5.53
Both changes are small but significant
Expected HbA1c to rise over 5 years by
0.20 to 0.36 (“secular” trend).