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Medicare Wellness Visits and Diabetes Management and Prevention

By Dr. Phyllis Pennington

The Medicare “Annual Wellness Visit” is available to Medicare recipients 65 year and older, once every 365 days.

Annual Wellness Visit is not a physical exam. It is a conversation between patient and provider to discuss health history and concerns patient has regarding their health. It can be used to review medications, immunizations, existing health problems, and potential future problems and how to prevent them.

The Wellness Visit is performed by a provider (physician or advanced practice provider) to review medical history, medications, healthcare team and immunization schedule. Other components of the Annual Wellness Visit are a Health Risk Assessment, a Wellness Schedule, Advance Directives and a Personal Health Record. The provider can also discuss managing chronic conditions like diabetes or assess the patient’s risk.

Diabetes Quick Facts

What is Diabetes: People with diabetes either don’t make insulin or their body’s cells are resistant to insulin. This leads to high levels of sugar (glucose) accumulating and circulating in the blood. This is also called high blood sugar.

Definition of Diabetes: Having a blood glucose level of 126 milligrams per deciliter (mg/dL) or more while fasting (not eating anything for 8 hours).

Where does sugar (glucose) come from: The body uses food for energy at the cellular level. When a person eats or drinks, food is broken down into simple sugars called “Glucose”

Where does the sugar go: Glucose is transported through blood stream into the cells of the body where it is used by the cells for energy.

Role of hormone insulin: The amount of glucose in the bloodstream is regulated by a hormone called insulin which is released in small amounts from the pancreas. When blood sugar rises, the pancreas releases more insulin to push the glucose into the cells. The body prevents blood glucose levels from getting too low by signaling person to eat and also releases glucose stored in the liver.

Diabetes Statistics

30.3 million have diabetes (23.1 million diagnosed, 7.2 million (23.8%) are undiagnosed which is 1 in 4 people

84.1 million adults (over 18) have prediabetes (34% of US population) which is 1 in 3 people

23.1 million are 65 years or older (over 25% of all prediabetics are over 65 yrs old)

Chronically high blood sugar accelerates an inflammatory process that damages blood vessels.

Having diabetes increases the risk of small vessel damage which can cause vision loss, kidney damageD and nerve damage. Heart attacks and strokes come from large vessel damage from too much sugar in the bloodstream. The Pancreas is the organ that makes insulin that moves glucose (sugar out of the blood stream into the cells which need it for energy)

To prevent these complications, patient and provider must work together to manage the patient’s blood glucose as well as other damaging conditions such as high blood pressure and high cholesterol

The Annual Wellness Visit can give you and your provider a complete picture of your health and what you need to do to be healthier. The more you know about your health, the more likely you are to be your own advocate.