Initiative Ratchets Up Diabetes Tracking in Pa.


Efforts are underway in Pennsylvania to set up physician tracking systems, self-management programs, and centers to help patients better manage diabetes.

“In Pennsylvania, there's a significant lack of knowledge regarding diabetes health,” said Dr. Andrew Behnke, an endocrinologist and a member of the Pennsylvania Medical Society. While the society isn't specifically involved in this initiative, “we're supportive of any effort to educate physicians and patients and help patients achieve their health goals.”

The University of Pittsburgh Diabetes Institute (UPDI) will be spearheading these efforts in partnership with communities throughout western Pennsylvania with an $8 million grant from the Department of Defense.

“Diabetes has emerged as one of the most serious health problems in Pennsylvania, particularly in rural areas,” Rep. John Murtha (D-Pa.) said in announcing the initiative. Eight percent of Pennsylvanians (1.1 million people [720,500 diagnosed and 379,500 undiagnosed]) have diabetes, according to data from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System. Diabetes accounts for about $7.7 billion in total health care costs every year in Pennsylvania and 11,500 deaths in the state each year. It is also the leading cause of new blindness, end-stage renal disease, and nontraumatic amputations in the state.

The expectation is the programs will serve as models that can be replicated throughout the United States and applied to the military, Rep. Murtha said.

A similar initiative is already underway in New York City, where clinical laboratories are sending the results of all hemoglobin A1c tests to the city's health department, with a goal of providing information to physicians on their patients with diabetes—and informing those patients whose results indicate poor glycemic control.

Some of the DOD funds will build upon the UPMC's efforts to track diabetes information. Diabetes tracking systems and programs will be offered through Memorial Medical Center, Uniontown Hospital, Highlands Hospital, and Indiana (Pa.) Regional Medical Center. Specifically, the programs will be monitoring hemoglobin A1c tests, blood pressure, cholesterol levels, and foot and eye exams, said Linda Siminerio, Ph.D., director of the UPDI. Project leaders hope to use the data to coordinate intervention programs, where they would work with doctors to get patients better care.

As part of the tracking initiative, Delphi Health Systems Inc. will partner with UPDI and the community hospitals by providing diabetes management software to be used at the point of care.

The ultimate goal is to create a registry to monitor and support the needs of people affected by diabetes.

The project has been working with leaders of hospitals in outlying communities that have their own physician practices, Dr. Siminerio said in an interview. “We've been asking those leaders who have done needs assessments in their communities what their physicians are interested in—what they feel would improve the quality of care in diabetes patients.”

In another partnership, the Diabetes Institute and the Conemaugh Health System's Memorial Medical Center will be establishing a Diabetes Wellness Center at Memorial's downtown campus in Johnstown. The Center is planning a comprehensive approach to screen for the prevention of diabetes complications such as retinopathy, nephropathy, neuropathy, cardiovascular disease, and lower-extremity arterial disease.

“We are excited about the establishment of the diabetes clinic and the positive impact this overall program will have on people with diabetes and people at risk of getting diabetes,” said Scott Becker, chief executive officer of the Conemaugh Health System. “With the right education, management, and care, people can lessen the effects of this potentially devastating disease and in many cases prevent it from happening in the first place.”

Experts estimate that 1.5 million new cases are diagnosed each year in the United States. Recent statistics from the CDC indicate that the incidence of diabetes has risen more than 14% in the last 2 years.

Nationally, diabetes is the fifth leading cause of death, according to the American Diabetes Association. One out of every 10 health care dollars is spent on diabetes and its complications.

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