Abstract
Direct spending on diabetes, already exceeding $118 billion, is forecast to reach $336 billion in 2034, driven by newly diagnosed cases secondary to an aging, increasingly sedentary, obese population and the advent of comorbidities, particularly cardiovascular complications affecting more than one-third of persons with diabetes. Traditional, directive, and fragmented approaches to patient management based on acute intervention and specialty care has been unable to stem the impending tsunami of diabetes-related complications and costs. Health care reform and the growing shortage of primary care physicians will only exacerbate the situation. Consumer-centric health care, enabled by digital media and technology, is integral to engagement, self-management, behavior change, and outcomes. It is time for the health care establishment to consider the "other" 360 days per year when a patient is not being seen by a physician.