title: A novel endocrinology-based wellness program to reduce medication expenditures and improve glycemic outcomes.
abstract: OBJECTIVE
  The purpose of this study was to determine the difference in diabetes-related medication expenditures as a result of a 16-week lifestyle intervention program. Medical expenditures for patients with diabetes are twice as high compared to patients without this condition. Secondary objectives were changes in HbA1C, BMI, weight, body fat, and program satisfaction.
  
  
  METHODS
  The Wellness Life! Program includes educational sessions focused on nutrition, fitness, and behavioral therapy. Medication costs were based on Average Wholesale Prices, tabulated from the 2010 Red Book.
  
  
  RESULTS
  A total of 36 patients (49-80 years old) enrolled, of which 27 patients have diabetes mellitus (Type 2=26, Type 1=1). Mean 30-day anti-diabetic medication costs decreased by $142.92. Clinical mean parameters improved in both the overall group and the diabetic subgroup, respectively: HbA1C (%) -0.69, -0.82; weight (lbs) -16.94, -17.11; BMI -2.73, -2.88; and body fat (%) -1.71, -1.79. Participants were generally satisfied with the program.
  
  
  CONCLUSIONS
  Employing a multidisciplinary wellness program within an endocrinology practice can reduce anti-diabetic medication expenses; however, long term follow-up is needed to determine if medication reductions and improved clinical parameters persist.
authors.affiliation: Northeast Florida Endocrine & Diabetes Associates, Jacksonville, FL 32204, United States. john.evans12@comcast.net
authors.forename: J Gary
authors.initials: JG
authors.lastname: Evans
authors.forename: David R
authors.initials: DR
authors.lastname: Sutton
authors.forename: Lorraine H
authors.initials: LH
authors.lastname: Dajani
authors.forename: J Sample
authors.initials: JS
authors.lastname: Magee
authors.forename: Ricardo A
authors.initials: RA
authors.lastname: Silva
authors.forename: Miguel F
authors.initials: MF
authors.lastname: Roura
authors.forename: Khurram
authors.initials: K
authors.lastname: Wadud
authors.forename: John A
authors.initials: JA
authors.lastname: Purcell
authors.forename: Stefano
authors.initials: S
authors.lastname: Travaglini
authors.forename: Scott A
authors.initials: SA
authors.lastname: Segel
authors.forename: Senan
authors.initials: S
authors.lastname: Sultan
authors.forename: Melissa S
authors.initials: MS
authors.lastname: Roffman
authors.forename: Salwa S
authors.initials: SS
authors.lastname: Ayad
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Borja-Hart
authors.forename: Steven M
authors.initials: SM
authors.lastname: Smith
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000097:blood* / Q000191:economics* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D038321:Glycemic Index / Q000502:physiology*; D006293:Health Promotion / Q000191:economics* / Q000379:methods*; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D040242:Risk Reduction Behavior; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents