Diabetes Eradication? The New Chronic Condition Care Playbook and How GLP-1s Are Changing the Game

What if type 2 diabetes could nearly be eliminated? This isn’t even a thought experiment; it’s increasingly becoming a reality. A recent study found that Tirzepatide lowered the risk of developing diabetes by 94% in adults with obesity and prediabetes. That’s not just treatment — it’s prevention at a level we’ve never seen before.GLP-1 medications are transforming how we think about chronic disease management and, more importantly, prevention. These aren’t just “weight-loss medications” — and I would argue that calling them such understates the actual impact of GLP-1s. Ongoing research has found them to be effective in the prevention or treatment of diabetes, heart attacks and strokes, kidney disease, liver disease, sleep apnea, and more.So, what does this mean for employers? It means a complete overhaul of how we view chronic condition prevention and management. These medications (with the right approach) can reduce the cost of chronic disease before it escalates to improve employee wellbeing and reduce healthcare costs. We know that they have a powerful impact on chronic diseases, but right now they’re very expensive. At some point in the future, the savings will far exceed the costs of these medications. The question is — what do we do until then, and how can we prepare for this new reality?

The expanding impact of GLP-1s on chronic conditions

The rise of GLP-1s has been meteoric, and it’s far from over. Recently, the FDA approved GLP-1s as a treatment for cardiovascular disease, and there are additional indications expected to be added in the future. Research has found that GLP-1s impact many different chronic conditions.

• Diabetes & metabolic health: GLP-1s have been a treatment for type 2 diabetes for years, but recent research has shown that Tirzepatide reduces the development of type 2 diabetes risk by 94%, revolutionizing prediabetes and diabetes care.
• Cardiovascular health: GLP-1s reduce heart attack and stroke risk by 20%, helping to address one of the leading causes of death and disability in the United States.
• Liver disease: Patients using GLP-1s cut their risk of developing liver disease in half, reducing the likelihood of cirrhosis and liver cancer.
• Kidney disease: GLP-1s lower the risk of major kidney disease events by 24%, a disease that affects nearly 15% of the adult U.S. population.
• Sleep apnea: Tirzepatide reduces sleep apnea events of patients with obstructive sleep apnea (OSA) by as much as two- thirds (66%). OSA is the most common sleep-related breathing disorder, affecting up to 50% of men and 25% of women in the United States. Many patients find the current standard treatment of a CPAP machine really cumbersome, so this opens the door for an alternative treatment option.
• Brain health: GLP-1s have been found to reduce the risk of addiction, seizures, and neurocognitive disorders — including Alzheimer’s and dementia.

With chronic conditions accounting for 90% of U.S. healthcare spend, employers list chronic disease as one of their top healthcare costs. Investing in chronic disease prevention can have a direct impact on cost — such as improved health outcomes or reduced high-cost claims, or an indirect impact — such as employee engagement and workplace productivity. With the expanding indications of GLP-1s, more and more employers will be folding them into their chronic condition prevention arsenal.

The wrench: How stigma exacerbates the cost of chronic conditions

A recent Harvard national poll found that three-fourths (76%) of U.S. employees with a chronic condition — such as diabetes, hypertension, heart disease, or asthma — need to manage their chronic disease during work hours. Yet the stigma behind having a chronic condition has a powerful impact, as most (60%) employees with a chronic condition do not inform their employer. Additionally, 49% of employees feel unable to take necessary breaks at work, and 36% have delayed medical care to avoid disrupting their work.

All-in-all, this presents a difficult challenge for employers. Their chronic condition prevention and management strategy must address clinical outcomes and company culture. Addressing chronic disease stigma allows employees to access the care that they need—ultimately bringing down healthcare costs and improving employee engagement.

The caveat: Why medications alone aren’t enough

GLP-1s have been called a “game changer” for obesity and chronic conditions — and they’re definitely one of the most powerful tools in the toolbox. But they’re not an end-all-be-all solution. Without the right support, they not only fall short of their potential but can backfire — setting people up for adverse events.

Right now, the weight loss conversation is being vastly oversimplified. Obesity isn’t a number on the scale — it’s extremely complex, with multiple factors and nuances around cause and care. While medications help, long-term success depends on addressing the full picture: metabolic health, behavior change, nutrition, stress management, and more.

Without the right support, employers face:

• A band aid approach that doesn’t address the root cause — addressing behavior is critical for sustainable clinical outcomes and quality of life improvements that can lead to bigger gains in employee engagement and productivity.
• High discontinuation rates — research has found that more than 30% of people taking GLP-1s discontinue use after one month, and 58% discontinue before losing a clinically meaningful amount of weight.
• A short-term fix, with long-term costs — inadequate support risks a revolving door of employees going on and off these medications, jeopardizing future health outcomes and leading to increased healthcare costs.

GLP-1s aren’t meant to be a standalone solution — they’re just one piece of the puzzle. As the FDA states, weight-loss medications are to be used adjunct to diet and physical activity counseling — and we would add a good behavioral skills program. A more comprehensive approach to obesity and chronic condition care integrates multiple strategies, including nutrition counseling, lifestyle support, and obesity expert care. Programs that focus on the whole human being (and not the scale) will have the greatest long-term impact — improving healthcare costs and employees’ lives.

Looking ahead: The future of chronic condition management

The good news for chronic condition management is that the supply and demand for GLP-1s isn’t slowing down. Even without employer coverage, these medications are still easily accessible. The bad news is, while there’s no shortage of prescribers, there is a shortage of GLP-1 support and care.

The real opportunity lies in shaping sustainable GLP-1 support beyond the prescription. Instead of reacting, forward-thinking organizations are building a strategy that addresses their short and long-term needs with the following:

• Prevention as a priority — Addressing obesity earlier reduces the need for high-cost interventions down the line.
• Comprehensive solutions — Integrating GLP-1s with a proven behavior-change program helps ensure long-term success.
• Personalized, expert-led care — Employees need more than a prescription; they need support that helps them navigate treatment and weight loss successfully.
• Addressing the stigma of chronic conditions — Employers who foster a culture of support and flexibility — where employees feel safe managing their health — will see better engagement, improved well-being, and reduced long-term claims.

GLP-1s are redefining chronic disease management, but medication alone isn’t enough. The real “game-changer” is a comprehensive strategy — one that empowers employees to improve their health and helps organizations reduce long-term costs.

Photo: AlexandraFlorian, Getty Images

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