Diabetes is the Fifth Deadliest Disease in the. U.S. and Its Prevalence is Increasing How Serious Is Diabetes? Impact of Diabetes. Is Also Staggering …
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The Growth of Diabetes and What to Do About It
Diabetes is the Fifth Deadliest Disease in the US and Its Prevalence is Increasing
1990 US Prevalence
of population
1999 69
49
Males Lifetime Risk if Born in 2000 Whites: African Americans: Hispanics: 33 27 40 45
Females 39 31 50 53
Sources: American Diabetes Association: Economic Costs of Diabetes in the US in 2002 Diabetes Care 2003;26:917-932 Venkat Narayan KM, Boyle JP, Thompson TJ, Sorensen SW, Williamson DF Lifetime risk of diabetes mellitus in the United States JAMA 2003;290:1884-1890 American Diabetes Association: Diabetes Statistics for African Americans Available at: wwwdiabetesorg/diabetes-statistics/african-americansjsp Accessed March 14, 2005 American Diabetes Association: Diabetes Statistics for Latinos Available at: wwwdiabetesorg/diabetes-statistics/latinosjsp Accessed March 14, 2005
How Serious Is Diabetes?
It predictably affects both lifespan and quality of life
Males Age at diagnosis: Lost of life years: Lost of quality-adjusted life years: 40 11 - 13 18- 20
Females 40 12 - 17 21 - 24
Source: Venkat Narayan KM, Boyle JP, Thompson TJ, Sorensen SW, Williamson DF Lifetime risk
of diabetes mellitus in the United States JAMA 2003;290:1884-1890
The Financial Impact of Diabetes Is Also Staggering
Total Health Care Costs in 2002: 865 Billion
Diabetes: 132B
Direct Expenditures: 92B 23B 25B 44B Related Other Diabetes Complications Medical Care Care
Indirect Expenditures: 40B Lost workdays Restricted activity days Mortality Permanent disability
Source: American Diabetes Association: Economic Costs of Diabetes in the US in 2002 Diabetes Care 2003;26:917-932
The Burden of Diabetes Is Greater for Minority Populations in the United States
Diabetes affects: 108 of African Americans
Diabetes in African Americans 27 million 114 over age 20
60 higher than in whites
106 of Hispanics
62 of Whites
Diabetes in Hispanics 20 million 82 over age 20
50 higher than in whites
Higher complication rates
2X as likely to suffer lower-limb amputations 2X as likely to suffer from diabetesrelated blindness
Higher complication rates
35 of diabetic Mexican Americans have eye complications Diabetic Mexican Americans are 5X more likely to suffe 
r from kidney failure
Sources: American Diabetes Association: Diabetes Statistics for African Americans Available at:
wwwdiabetesorg/diabetes-statistics/african-americansjsp Accessed March 14, 2005 American Diabetes Association: Diabetes Statistics for Latinos Available at: wwwdiabetesorg/diabetes-statistics/latinosjsp Accessed March 14, 2005 Mokdad AH, Ford ES, Bowman BA, et al Diabetes trends in the US: 1990-1998 Diabetes Care 2000;23:1278-1283
Considering the Risks, Its Remarkable How Many Diabetics Neglect Their Condition
Diabetics in 2002 18: Poor control of their blood sugar 37: No eye exam in past year 45: No foot exam in past year
Its obvious we have a large-scale health problem on our hands
Source: Saddine JB, Engelfau MM, Beckles GL, et al A diabetes report card for the United States: quality of care in the 1990s Ann Intern Med 2002;136:565-74
To Address the Challenge, We First Need Leadership from the Medical Community
Example: California Academy of Family Physicians CAFP
The over-arching strategy is directed at inducing organizational changes in physicians offices to better accommodate disease-management systems and streamline patient care to lead to improved efficiency and greater provider and patient satisfaction Eric Ramos, MD President, CAFP
Source: Personal Communication
California Academy of Family Physicians, 2005
CAFPs Diabetes Initiative
Lumetra UCSF Department of Family and Community Medicine
Expanded Clinical Education Traditional electronic platforms Expanded treatment guidelines Outcome measures Patient education self-management Public awareness Legislative linkages
CAFP
UCSF Collaborative Research Network
Comprehensive Practice Redesign Family involvement in care team Disease registries Group office visits Open access scheduling Electronic health records Leverage technology
Effectively addressing a complex disease requires a strategic plan that reforms daily care practices in the office, community, and home
Source: Personal Communication California Academy of Family Physicians, 2005
The Growth of Diabetes and What to Do About It
Release Date: 4/13/2005 wwwhealthpoliticscom
Where Healthcare Meets Policy
Source:azdhs.gov
