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Workplace wellness programs; link between type 1 diabetes and heart disease

May 17, 2013
FOCUS Editorial Director Maria Perno Goldie, RDH, MS, discusses the issue of the value of workplace wellness programs in terms of effectiveness and cost. She also reports that type 1 diabetes and heart disease have been found to be linked by an inflammatory protein.
Recent commentary questions the return on investment of workplace wellness programs closely tied to routine screenings.(1) The contributors argue that routine heart disease screening, as an example, is not a cost effective approach to identifying risk factors and avoiding heart attacks among employees and that health risks need to be reduced. The contributors conclude that other types of wellness interventions may be more effective and less costly.(1) What the Affordable Care Act’s (ACA) terms “participatory wellness strategies,” subsidized healthy choices in the cafeteria, gym memberships or on-site fitness, flexible scheduling to facilitate physical activity, automated health kiosks, nutrition education, and free smoking cessation programs, would cost much less than what is being spent now on biometrics and incentives. What do you think? As dental hygienists, we are prevention oriented, but the question of screening and over diagnosis is not a new one. This is from a poll, albeit with only 5 votes.(1)What do you think? Should companies incentivize preventive screenings for their employees?1. Yes. Preventive screenings are an important part of staying healthy, and should be as affordable and accessible as possible. (60%, 3 Votes)
2. No. The Affordable Care Act’s workplace wellness incentive program tied to preventive screenings could increase the likelihood of over diagnosis. I think workplace wellness programs should incentivize. (20%, 1 Votes)
3. Unsure. Workplace wellness programs are beneficial – both those tied to preventive screenings and those that incentivize healthy choices; however, there is not enough data about the costs and outcomes. (20%, 1 Votes)

A survey done by Walgreens suggests confusion among 31.5 million enrolled in Medicare Part D plans, and finds up to 50 percent are unaware of certain cost-saving opportunities. More than one-third of Medicare Part D beneficiaries surveyed (37 percent) have everyday fears about their prescription drug costs and 1 in 5 say they’ve had to make sacrifices, such as delaying filling a prescription or skipping doses, to help manage medication costs.(2,3)

Perhaps we can share this information with our senior patients and help them understand the system.

(5) In other breaking news, Type 1 diabetes and heart disease have been found to be linked by an inflammatory protein.(6) Therapeutic agents that block the protein calprotectin could potentially reverse or slow the progression of atherosclerosis in people with type 1 diabetes. Researchers have known that diabetes can lead to atherosclerosis. This study shows that this outcome is associated with increased circulating levels of inflammatory white blood cells (WBCs), which contribute to the build-up of plaque in blood vessels. In this animal study, the investigators found that normalizing the blood glucose diminished this pathway, leading to an overall decrease in inflammation. They also determined the relevance of these findings in humans, by analyzing date from 290 patients with diabetes that had been followed for 18 years. Those who had developed coronary artery disease had significantly higher levels of calprotectin, compared with patients who had not developed coronary artery disease. The results of the study highlight the importance of controlling blood levels to limit the production of inflammatory cells that drive atherosclerosis. The results also advocate innovative therapeutic strategies, such as inhibiting the production of calprotectin or preventing its binding to the RAGE receptor.(7)

Enjoy the newsletter! World MS Day, Melanoma Monday, the new report White Out!, Nutrition, the oral-systemic link, and other items of interest are covered!

2. Centers for Medicare and Medicaid Services, “2013 Medicare Part D Landscape,” September 19, 2012; Accessed May 8, 2013.
7. Prabhakara R. Nagareddy, Andrew J. Murphy, Roslynn A. Stirzaker, Yunying Hu, Shiquing Yu, Rachel G. Miller, Bhama Ramkhelawon, Emilie Distel, Marit Westerterp, Li-Shin Huang, Ann Marie Schmidt, Trevor J. Orchard, Edward A. Fisher, Alan R. Tall, Ira J. Goldberg. Hyperglycemia Promotes Myelopoiesis and Impairs the Resolution of Atherosclerosis. Cell Metabolism - 7 May 2013 (Vol. 17, Issue 5, pp. 695-708).


Maria Perno Goldie, RDH, MS

To read previous RDH eVillage FOCUS introductions by Maria Perno Goldie, go to introductions.

To read more about the oral-systemic lnk, click here.