The Hawai'i chapter of the American Diabetes Association is trying to make companies and their employees more aware of diabetes prevention and care, which can end up reducing healthcare costs for businesses.

"The one person using the most healthcare dollars is the diabetic," said Majken Mechling, the group's executive director. "Everyone knows somebody who has diabetes — or is going to have diabetes."

The costs for the association's Winning At Work program will never exceed $1,000, which primarily covers the services for a certified diabetes educator who comes to each business. It also includes the cost for materials like diabetes-related signs and diabetes risk tests.

Summerlin Life & Health Insurance Co. was the first Hawai'i business to sign up for the program, and account manager Debbie Silva-Lucas wants to see more companies spreading the word about diabetes detection and management.

The program is confidential, and employees with diabetes are never identified to their bosses, Mechling said, following federal privacy guidelines.

But Silva-Lucas is happy to talk to anybody about her type 1 diabetes.

"It's very personal to me because I live it," she said. "I try to make people aware that you can control it."

The Hawai'i Business Health Council, at the same time, is promoting a separate program called Diabetes Life Coaching, which costs an average of $2,500 per year per diabetic employee in addition to the employees' normal healthcare costs.

But in the first two years of the program in Hawai'i in 2006 and 2007, businesses typically saved more than $5,000 per year per diabetic employee, said Gary Allen, executive director of the Hawai'i Business Health Council.

"Those are actual dollar savings," Allen said. "We look at the cost of hospital stays and the resources consumed. The employer has to pay for those resources consumed."

Diabetes Life Coaching was created 10 years ago in North Carolina, and Mainland companies that have been involved for years have seen savings as much as $8,000 per year per diabetic employee, Allen said.

"Over time," he said, "you will reach those difficult patients who consume an extensive amount of resources."

So far, six Hawai'i companies are enrolled, representing 100 diabetic employees, whose identities are also confidential, Allen said.

"Because of the success, more companies now want in," Allen said. "For a CEO, I say, 'I'm going to make your employees healthier and I'm going to save you money.' What employer wouldn't want that?"

At AIG Hawai'i, Diabetes Life Coaching is just one part of a company culture increasingly focusing on employee health.

"We want to promote a healthier lifestyle," said Robin Campaniano, AIG Hawai'i's president and chief executive officer, who was diagnosed with type 2 diabetes two years ago.

The company organized a "Pedometer Challenge" that involved 55 teams of three people who compared their results each week.

"We had give-aways and gift certificates, and it got very competitive," Campaniano said. "Everybody who wanted a pedometer got one, and it got very intense. It was a lot of fun, and a lot of people are still wearing their pedometers, so we know it has some longevity."

AIG also conducted health risk assessments and health screenings; organized a prescription drug program so employees can have their medications mailed directly to them, rather than visiting a pharmacy; held brown-bag sessions on stress; brought in dieticians to talk about nutrition; hosted Weight Watchers meetings; and is constantly encouraging employees to walk before and after work.

But one of the hardest adjustments has been trying to change the food at the periodic AIG Hawai'i office potlucks, Campaniano said.

"There have been attempts — not totally successful — to bring in more healthy food," he said. "You've got to start someplace. A lot of people now realize it starts with moderation. You don't have to go cold turkey on the katsu. You can just cut it into smaller slices."

At Summerlin, Silva-Lucas is happy to talk up her eight-week experience with Winning At Work to her clients and suggest they get involved, too.

"We've been the guinea pigs for the program," she said. "But it's something I live with every day."