Optimizing Diabetes Management: How Self-Funded Employers Can Empower Health Plan Members

Diabetes continues to pose a significant challenge in the workplace, affecting employees’ health, well-being, and productivity, and placing substantial financial strain on self-funded employer health plans. Despite advances in medical care and disease management strategies, the prevalence of diabetes remains substantial, and emerging evidence highlights concerning trends in glycemic control. This situation underscores the importance of innovative and proactive solutions to empower health plan members and improve diabetes outcomes.

The Current Landscape of Diabetes Prevalence and Management

Over the past decade, the prevalence of diabetes among U.S. adults has stabilized, offering a glimmer of hope in the fight against this chronic condition. However, recent evidence reveals an alarming deterioration in glycemic control indicating greater severity of diabetes. According to research published in JAMA, the mean HbA1c levels among individuals with diabetes have increased by 1%, accompanied by a 20% decline in glycemic control. These trends are particularly pronounced among younger adults, signaling a potential surge in diabetes-related complications in the years to come.

For self-funded employers, these findings are concerning. As younger generations replace an aging workforce, the future burden of diabetes-related healthcare costs and lost productivity may escalate significantly. Chronic hyperglycemia increases the risk of cardiovascular events, diabetic retinopathy, kidney disease, neuropathy, and other co-morbidities, presenting a formidable challenge for employer-sponsored health plans.

Bridging Gaps in Care: Strategies for Better Diabetes Management

Effective diabetes management requires addressing gaps in care that hinder optimal outcomes. Fortunately, evidence-based solutions exist to help employers support their health plan members in gaining better control of their condition:

Strategic Use of Incentives: Incentives play a powerful role in encouraging engagement with diabetes management programs. Employers can offer financial rewards, reduced healthcare premiums, reduced medical or pharmacy out of pocket costs, or other benefits to motivate members to participate in education, monitoring, and clinical interventions.
Enhanced Diabetes Education: Diabetes is a complex disease for individuals to understand and manage and health literacy among those with diabetes is often limited, particularly for younger populations and the newly diagnosed, and those who are Second Language English Speakers. Education is a key driver of successful diabetes management. Providing access to workshops, webinars, and personalized learning resources empowers members to better understand their condition, make informed decisions, and adopt healthier lifestyles.
Ongoing Clinical Support: Allied health professionals, including diabetes educators, clinical pharmacists, and dietitians, play a critical role in providing personalized care and support. These experts can guide members in diabetes education, medication adherence, nutritional choices, and lifestyle modifications to achieve better glycemic control.

Leveraging Remote Patient Monitoring (RPM)

Remote Patient Monitoring (RPM) has emerged as a transformative approach to diabetes management, enabling continuous oversight and timely interventions. RPM relies on advanced technologies such as Continuous Glucose Monitors (CGMs), which provide real-time insights into blood glucose levels. CGMs are particularly valuable for individuals with type 1 diabetes, newly diagnosed patients, those on insulin therapy, and members at risk of hypoglycemia.

CGMs and RPM offer several advantages:

Enhanced Data Collection: By tracking blood glucose patterns, frequency of hyperglycemic or hypoglycemic episodes, and percentage-of-time within target range, CGMs provide actionable data to guide medication adjustments, dietary changes, and physical activity.
Proactive Interventions: RPM allows healthcare providers to identify trends and intervene promptly, reducing the risk of complications and improving outcomes.
Improved Member Engagement: Members using CGMs often become more aware of their condition and are motivated to take an active role in their management.

The Role of GLP-1 Medications and Updated ADA Guidelines

The American Diabetes Association (ADA) has recently updated its Standards of Care in Diabetes for 2025, incorporating groundbreaking recommendations to optimize diabetes management. Among these updates is the prescription of GLP-1 receptor agonists—a class of medications shown to improve glycemic control, reduce cardiovascular risk, and address diabetes-related liver disease. GLP-1 medications are also effective in managing obesity, a key contributor to type 2 diabetes.

The ADA guidelines emphasize the importance of:

Promoting plant-based protein intake and balanced nutrition to support glycemic control and overall health.
Encouraging the use of GLP-1 medications alongside lifestyle interventions to achieve optimal outcomes.

For self-funded employers, integrating these guidelines into health plan offerings can yield substantial benefits, improving member outcomes while potentially reducing long-term healthcare costs.

Evaluating Market Solutions for Diabetes Management

As the diabetes landscape continues to evolve, self-funded employers must remain vigilant in evaluating market solutions that align with their goals and priorities. The following considerations can help employers identify effective programs and technologies:

Data-Driven Insights: Select programs that leverage data analytics to provide personalized recommendations and track progress over time.
Member-Centric Approach: Prioritize solutions that address members’ unique needs, preferences, and barriers to engagement.
Cost-Effectiveness: Evaluate the financial impact of interventions to ensure sustainable implementation.

By investing in innovative and evidence-based diabetes management strategies, self-funded employers can make a meaningful difference in the lives of their health plan members and contain and avoid significant health care claim costs.

Conclusion

Diabetes remains a significant challenge for self-funded employers, with implications for employee health, productivity, and healthcare costs. While the prevalence of diabetes has stabilized, worsening trends in glycemic control, particularly among younger adults, highlight the urgent need for effective solutions.

Employers have a unique opportunity to address these challenges through strategic incentives, enhanced education, clinical support, and cutting-edge technologies such as Remote Patient Monitoring and Continuous Glucose Monitors. The ADA’s updated guidelines provide valuable insights into the role of GLP-1 medications, nutrition, and lifestyle interventions in optimizing diabetes management.

By remaining vigilant in evaluating market solutions and prioritizing member-centric approaches, self-funded employers can empower their health plan members to gain better control of their diabetes—improving lives, reducing costs, and fostering a healthier, more productive workforce.