United States

Access & coverage

Medicare/Medicaid + commercial

Fragmented: employer, Medicare, Medicaid, ACA, uninsured residual

Treatment

• Metformin / newer agents (SGLT2, GLP-1) where funded
• Insulin pathways; dialysis / transplant for ESRD
• Complication screening (eyes, feet, kidneys)

Prevention

• Obesity / diabetes screening in primary care
• CKD screening in diabetes and hypertension
• School / workplace nutrition environments (weak but present)

Lifestyle

• Calorie balance, diet quality, walking / resistance training
• Glucose and BP self-management education
• Sodium and protein guidance in CKD

What stands out here

Same broad metabolic / renal toolkit as peers — differences are coverage rules, wait times, prices, and follow-through.