Pharmaceutical giant GlaxoSmithKline has announced an initiative designed to improve the health of employees with diabetes. Yes, the company's head honchos decided they would take the bull by the horns: if employees have difficulty taking care of their health, they determined to find out why and correct the problem. Result: an internal analysis of healthcare spending within GSK.

Turns out diabetes was one of the biggest problems for Glaxo employees. Glaxo's number-crunchers found the company spends more on diabetes medications, but less on medical care, than the national average. GSK's report states the company spent a total of $26.2 million on diabetes treatment for employees in 2005. Glaxo has now launched what it describes as a multilateral plan to address the needs of employees with diabetes. Leading the charge: a patient education campaign ("Know Your Numbers") and a physician intervention program.

Says Glaxo's US benefits chief, Michael Killian, "As a nation, we are seeing our healthcare costs soar and patients' health decline due to chronic diseases such as diabetes. GSK faces these same challenges and is prepared to meet them." Translation: prevention, prevention, prevention.

Glaxo figures there is nothing to lose, but lots to gain. Healthcare plans for employees already cost a bundle. By targeting the health issues that are hurting employees the most, the company can give those employees a better life and save a lotta money. In addition to making the results of its internal analysis available to the general public, Glaxo has invited other employers to utilize this same approach.

Drug War '07: drug giants Novo Nordisk and Sanofi-Aventis have been sparring recently over their insulin pen designs. Novo alleges Sanofi has stolen its design ideas, basically. Check out Bev's post on this to learn more.

The reason it's such a big deal to them is money. The insulin pen could be super-lucrative for investors. Meanwhile, here's some news that's bound to get big pharma even more excited: a new study reports that insulin pens are cheaper and more effective than insulin shots.

Why so good? Fewer trips to the emergency room and fewer visits to the doctor. Insulin pens boast a pre-measured dosing system, with each dose of insulin contained in a single, disposable cartridge. This eliminates the risk of over- or under-dosing, says senior author of the study, Dr. Rajesh Balkrishnan of Ohio State University in Columbus. The researchers say that study participants who used an insulin pen instead of a regular syringe ended up reducing their annual healthcare costs by nearly $17,000. Wow.

What I'm not clear on here is whether or not they factored in the added expense of upgrading from syringes to insulin pens.

Want to know more? The study has been published in the latest issue of Clinical Therapeutics, but you can click here to read a summary.

It's a pretty well-known fact that type 2 diabetes is hitting New York City hard. And the powers-that-be in the City are doing something about it: New York City was the first place in the nation to initiate a diabetes-tracking registry intended to guide healthcare spending to maximum effect.

So, just how bad is the situation? The city's health department just completed a major study on that very topic and made the results public this week. Some numbers: diabetes causes 20,000 hospitalizations, 3,000 amputations, 1,400 cases of kidney failure, and 4,700 diabetes-related deaths annually. The financial cost of treatment is a staggering $6.5 billion annually.

The report clearly shows that people in lower socioeconomic groups, clustered in a handful of poorer neighborhoods, are suffering disproportionately to the well-heeled and well-educated residents of the chic Upper East Side.

As is the case everywhere in the US - not to mention, globally - a great many people with type 2 diabetes or who are at risk for the disease do not know it, and city officials are aiming to exponentially increase awareness in coming years. The entire report is accessible online in PDF-form at the NYC Department of Health and Mental Hygiene's website.

Researchers found that using a systematic approach for the treatment of depression in diabetics will not increase health care spending, and might actually decrease the overall costs.

Researchers evaluated the cost and cost-effectiveness of a systematic depression treatment program versus the usual care for 329 outpatients with diabetes and depression. The intervention involved specialized nurses who provided a 12-month stepped-care depression treatment program using psychotherapy or antidepressant drugs or both. Systematic depression treatment significantly reduced the patients' average depression scores after 6 and 12 months, and these improvements were maintained at 24 months.

Outpatient depression treatment costs were approximately $700 higher in the intervention group during the first year, the results indicate. However the general medical outpatient costs in this group were lower, and offset most of the difference. During the second year, the approximately $100 in higher outpatient depression treatment costs in the intervention group was more than offset by lower outpatient costs of approximately $1400.

The study was designed with the hope of alleviating human suffering caused by diabetes. If reducing the burden of suffering also reduces costs of care, then depression management programs should be routinely integrated into diabetes care. Preempt this mission with the fact that the systematic depression treatment programs were associated with an increase of 61 depression-free days and an estimated cost savings of $300 - that's a monthly stipend of 20% more Happy Days and a half tank of gas. That'll give you something to smile about!

James Hirsch, a type 1 diabetic, agonized when his three-year-old son started showing the symptoms of diabetes. His agony took the form of remarkable brilliance in his book, Cheating Destiny: Living With Diabetes, America's Biggest Epidemic. The book portrays diabetes from the perspective of someone living with the disease. He explains how diabetes is treated in this country, the shortfalls in the governance, both economically and physiologically.

Hirsch, a former reporter for the New York Times and the Wall Street Journal asks the editor of a hugely popular web site about the quality of care for diabetes in this country. The response he received: "It stinks." Hirsch details the physical complications that arise from diabetes and health insurance companies' reluctance to fully reimburse relatively low-cost education programs. These programs are designed to prevent the high-cost diagnostic testing and hospital care resulting from diabetes complications. Makes you wonder if it's unintuitive bureaucracy or intuitive capitalistic malfeasance. Don't be silly -- it's nothing personal, it's just business.

Being a person with diabetes is never simple. Hirsch explains, "insulin and food, food and insulin. I imagine them like armies in the night, battling inside a diabetic's body,"..."the battles never produce a winner. The armies simply live to fight another day." Fight the good fight, James. Thank you for sharing your perspective with remarkable brilliance and enlightening reality.

I think I must've been dreaming. No, it was definitely a nightmare. I only hope the ends justify the means. I'm referring to the dollar-denominated discrepancies between me, Dick and Jane when it comes to the Golden Years. Dick, Jane and I will embark on retirement at approximately the same time, with approximately the same amount of Social Security (not holding my breath), and hopefully adequate retirement savings in relation to our lifestyle and income levels. However it is quite apparent to me that my ticket to ride will not take me as far.

A study paid-for by the Social Security Administration found the following, "understanding the economic impact of diabetes allows a more complete understanding of the cost-effectiveness of diabetes treatment programs and may provide a rationale for employers to begin to address workplace programs to improve health." At the risk of seeming ungrateful for the current programs supported by good old Uncle Sam, I have an idea.

My medical bills will cost significantly more than Dick and Jane's. My tenor in retirement will likely be shorter. And throughout our working years, I know I've spent a majority of my disposable income on healthcare and other miscellaneous medical expenses. So I find myself wondering why I do not have some other form of supplemental compensation for my hard working career as a diabetic. How about a federally subsidized pension for diabetes? Or a presidential pardon to retire 10 to 15 years early? The government knows, statistically speaking, I'm going to be gathered a decade or so before my peers. It seems like a fair tradeoff.

When it comes to diabetes, this is a full-time job. The funny thing about this job is that I don't remember applying for it, it doesn't pay well (an economic catastrophe, in fact) and my life depends on my job performance. Oh, and the benefits? I'm proud to share with everyone reading this blog: you are the greatest benefit of my preoccupation with diabetes. Thank you for making this the most rewarding diabetic experience of my life.