Advancements in coverage for diabetes technology and improvement in diabetic retinopathy screening rates appear on this year’s list of most-read diabetes articles.
As diabetes was established as a risk factor for more severe cases of coronavirus disease 2019 (COVID-19) toward the beginning of the pandemic, many of the most popular diabetes stories this year involved the novel coronavirus. However, advancements in coverage for diabetes technology and improvement in diabetic retinopathy screening rates also appear on this year’s list of most-read diabetes articles.
An article published in November 2020 highlighted the 5-year outcomes of the Appalachia Diabetic Eye Network program. Although annual diabetic retinopathy (DR) screening with early intervention has been proven to reduce the risk of severe DR-related vision loss, current screening rates in the United States remain low. The mean screening rate for audited clinics in the year prior to program implementation was 29.9% and increased to 47.7% in the program’s first year, doubling patients’ odds of being screened. Results of this study suggested that large telemedicine DR screening networks based in federally designated safety-net clinics may help increase screening access and compliance among otherwise underscreened populations.
In October 2020, data estimates from the new Global Burden of Disease Study, published by The Lancet, found that metabolic risk factors dominated other leading risk factors for death around the world. Although tobacco was the leading risk factor for total health loss in 2019, high systolic blood pressure, high blood sugar, dietary risks, and high body mass index all were ranked in the top leading risks of death. These metabolic risk factors put millions of Americans at greater risk for developing diabetes, which is currently the seventh leading cause of death in the United States. Diabetes significantly increases the likelihood of developing severe COVID-19 complications, which are now the third leading cause of death in the United States.
In September 2020, it was reported that among patients with type 2 diabetes (T2D) admitted to the hospital with COVID-19, those who received sitagliptin exhibited reduced rates of mortality and improved clinical outcomes compared with patients who received standard-of-care treatment. Due to the underlying mechanism of sitagliptin, an oral dipeptidyl peptidase 4 (DPP-4) inhibitor, researchers hypothesized the drug may be effective in patients with COVID-19 and without T2D. Based on the findings, a randomized, placebo-controlled trial of sitagliptin is now preparing to enroll patients with T2D in Europe.
In the early days of the pandemic, guidelines issued from the CDC listed diabetes as a risk factor for experiencing complications from COVID-19. At the time, in March 2020, it was still unknown whether there was a difference in risk among patients with type 2 and type 1 diabetes, although viral infections can lead to increased inflammation and increased risk of diabetic ketoacidosis in patients with type 1 diabetes. Experts advised that, in addition to social distancing, responsible management of diabetes was imperative to mitigate risk. They noted that for individuals with diabetes who effectively manage their condition, the risk of getting severely sick from COVID-19 is about the same as the general population.
CMS announced proposed changes to the Medicare Durable Medical Equipment Prosthetics, Orthotic Devices and Supplies coverage and payment policies, which would expand Medicare coverage for continuous glucose monitors (CGMs) in October 2020. The move came after years of court battles over whether Medicare would cover CGMs for beneficiaries, as one-third of this population currently has diabetes. The change would reduce administrative burdens resulting from government coverage, payment, and coding processes that can hinder innovators from getting products to beneficiaries. If finalized, the rule would classify all CGMs as durable medical equipment and establish payment amounts for the items and related supplies.