1061-P: Use of Nutrition and Behavioral Therapy for Obesity among Medicare Beneficiaries with Incident Diabetes, 2002-2016

• Published in: Diabetes (New York, N.Y.) Vol. 70; no. Supplement_1
• Main Authors: ANDES, LINDA J., SIEGEL, KAREN R., WILLIAMS, ALEXIS, IMPERATORE, GIUSEPPINA, ROLKA, DEBORAH B.
• Format: Journal Article
• Language: English
• Published: New York American Diabetes Association 01.06.2021
• Subjects: Behavior modification; Body weight loss; Counseling; Diabetes; Diabetes mellitus; Diagnosis; Medicare; Nutrition; Nutrition therapy; Obesity; Weight control
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/db21-1061-P

Nutrition and weight loss/maintenance are important for managing blood glucose and preventing complications among individuals with diabetes (DM), and counseling for these behaviors can be particularly effective in those with newly diagnosed DM. To encourage their use in older adults - who may lack other support and thus rely on health care provider counseling- Medicare covers three types of counseling: 1. Medical nutrition therapy (MNT); 2. DM self-management training (DSMT); and 3. Intensive behavioral therapy for obesity (IBTO). We used Medicare claims data to estimate use of these three types of counseling among beneficiaries with incident DM. We included individuals with at least a) 1 inpatient claim with a DM diagnosis code in the index year or preceding 2 years, or b) 1 outpatient DM claim and 1 inpatient or outpatient claim in the 2 years following the first claim. An incident case must have an initial two year “clean period” with zero DM diagnosis codes. Therefore, participants must be at least 67 years of age to be included in the study. Use of counseling was defined as having any claims with the appropriate procedure codes in the 365 days after the first claim date with a DM diagnosis code. Among 8.6 million beneficiaries with incident DM, MNT use increased from 1.2% in 2002 to 2.8% in 2006 and then decreased to 2.4% in 2016. In contrast, DSMT use decreased from a high of 5.9% in 2002 to 3.1% in 2016. IBTO coverage began in 2011 and by 2016, IBTO use increased to 0.8%. MNT, DSMT and IBTO are under-utilized among Medicare beneficiaries with incident DM, and there is much room for improvement. Increasing health care provider and patient awareness of these Medicare benefits may help to increase the likelihood of referrals to such counseling and subsequently its use. Disclosure L. J. Andes: None. K. R. Siegel: None. A. Williams: None. G. Imperatore: None. D. B. Rolka: None.