November 16, 2010

When we know what works to prevent and manage diabetes, how can we make sure that information gets into the hands of as many people as possible?
That was a question that Dr. Albright posed during the event.

Dr. Albright highlighted the National Diabetes Prevention Program (NDPP) as an effective intervention to prevent diabetes for the 60 million Americans with pre-diabetes. Based on a National Institutes of Health program, NDPP focuses on encouraging lifestyle changes related to diet and physical activity, which have shown to reduce the risk for diabetes by 58% for those at highest risk. The program, which is being implemented across the country through a partnership between the CDC and the Y, involves 16 one-hour sessions with monthly follow-ups for a year. NYHealth is supporting replication of the model with Ys in 10 regions across New York State. Private payers are also supporting the program. UnitedHealth Group, which is funding six sites across the country, covers the cost of the program for its beneficiaries, and additional insurers have expressed interest in doing the same.

For the millions of Americans who already have diabetes, Dr. Albright emphasized the important role that health care professionals play in helping patients to manage their diabetes effectively. She encouraged providers to embrace their role as citizens in the community: ensuring access to healthy foods and safe places to walk and play, and spreading effective prevention programs will play a big part in curbing the epidemic.

There are a number of opportunities for health care professionals and community-based organizations to work together to prevent and manage diabetes.Areas for collaboration include screening those at high risk; monitoring glucose; facilitating structured lifestyle programs, and advocating for better reimbursement.

“Diabetes is a 24/7 gig,” Dr. Albright noted, so people who have diabetes need to develop the skills and experience to manage their disease effectively. Otherwise, “it’s like getting a new iPad without the owner’s manual, and being expected to know how to use it.” Dr. Albright pointed out that there are effective and promising models to help manage diabetes, many of them focused on using the entire health care team—an especially timely approach given the shortage of primary care physicians. Existing models use nurses and pharmacists to provide medication management for patients. Other programs, pair community health workers and health care professionals to provide self-management support to patients.

Dr. Albright’s take-away message was that using a dual approach of improving community-based prevention services and ensuring high-quality clinical care and self-management is vital to curbing the diabetes epidemic and to reducing the toll it takes on our physical and financial health.

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