CCDTR Core Members and Staff participated in the 5K@ADA on Sunday, June 9, 2019. Through Novo Nordisk’s continued support of the American Diabetes Association, the 5K@ADA in San Francisco was free of charge to registered 79th Scientific Sessions attendees.
As a community activity that encourages healthy exercise and promotes diabetes awareness,1,214 people completed the 5K@ADA and helped set the pace for living a healthier lifestyle by running or walking in San Francisco.
Elbert Huang, MD, Core Member of the CCDTR, along with colleagues has published a new paper in Diabetes Care, entitled ‘Cost-Effectiveness of Shared Telemedicine Appointments in Young Adults With T1D: CoYoT1 Trial’.
Young adults (YAs) with type 1 diabetes (T1D) often struggle to achieve glycemic control and maintain routine clinic visits. This study aimed to evaluate the societal cost-effectiveness of the Colorado YAs with T1D (CoYoT1) Clinic, an innovative care model of shared medical appointments through home telehealth.
Within the trial, there were no significant differences found in 9-month quality-adjusted life; however, the control group had a larger decline from baseline in utility than the CoYoT1 group, indicating a quality of life (QoL) benefit of the intervention (difference in difference mean ± SD: 0.04 ± 0.09; P = 0.03). There was no significant difference in total costs. The CoYoT1 group had more study-related visits but fewer nonstudy office visits and hospitalizations. The CoYoT1 care model may help YAs with T1D maintain a higher QoL with no increase in costs.
Neda Laiteerapong, MD, MS, Associate Director of Clinical Outcomes for the Center for Chronic Disease Research and Policy, has published an editorial with Kasia Lipska, MD, MHS, in the New England Journal of Medicine concerning the lack of glycemic legacy effects in the Veterans Affairs Diabetes Trial (VADT). The VADT included 1791 military veterans who had received a diagnosis of type 2 diabetes a mean of 11.5 years earlier and who had been randomly assigned to intensive or standard glucose control for a median of 5.6 years. A major implication of the VADT follow-up study is that older patients with advanced diabetes should not expect long-term cardiovascular benefits from intensive glycemic control. Instead, interventions that clearly reduce cardiovascular risk — such as smoking cessation, blood-pressure control, statin therapy, use of antiplatelet agents, and the use of glucose-lowering agents with proven cardiovascular benefits in patients with established cardiovascular disease — should be prioritized.
The “Through Your Lens/ A Través de Su Lente” exhibit displayed photographs taken by Latinx community members in the Little Village neighborhood of Chicago and celebrated the journey of people living with diabetes in the community, on May 11th, 2019 at the OPEN Center for the Arts in Little Village.
Designing church-based programs to improve diabetes care among Mexican-Americans has the potential to have a broad impact and to decrease the health disparities. Dr. Arshiya Baig and her research team have led a project that is based in South Lawndale/Little Village, a Mexican-American neighborhood of Chicago. Little Village is a predominantly Mexican-American community that has a diabetes-related mortality rate higher than the national average and higher than the average across Chicago. Since the church has an important role in many Latino cultures and families, working with churches to address diabetes is one method of tailoring diabetes programs to this community. Many church-based programs have shown promise in improving health outcomes among minority communities, but data on church-based programs for Latino populations are scarce.
Picture Good Health is a bilingual church-based diabetes program. The program has eight weekly educational sessions that are held at one of the partner churches. The curriculum uses an innovative technique called “photovoice” where participants receive disposable digital cameras to document their lives with diabetes. These photos are then used in the class to guide a discussion on problem solving and provide training in self-empowerment.
Dr. Baig’s paper, ‘Using Photovoice to Promote Diabetes Self-Management in Latino Patients’, has been accepted for publication in Translational Behavioral Medicine. Photographs from the Photovoice project can be found here.
Chronic conditions, such as obesity, prediabetes, and type 2 diabetes, are leading public health problems significantly impacting individuals, families, and communities across the United States. Nationally, more than 30 million adults live with diabetes and another 84.1 million, or nearly 1 in 3, have prediabetes, a high-risk condition when blood glucose levels are higher than normal, but not high enough to be considered diabetes. Individuals with prediabetes are at high risk for diabetes, heart disease and stroke. These national statistics are reflected in the city of Chicago, which has an overall diabetes rate of 10.6% with significantly higher rates among African Americans, Latinx, and low-income populations. These communities are also at an increased risk for prediabetes and poor diabetes outcomes. Diabetes can be prevented or delayed through evidence-based lifestyle change programs that promote weight loss, eating healthy, and being more active. However, access to these programs is limited in Chicago, especially within high burden communities facing the greatest health disparities.
With support from the Centers for Disease Control and Prevention, under Cooperative Agreement CDC-RFA-DP18-1817, the Illinois Public Health Institute (IPHI) and the Chicago Department of Public Health (CDPH) are joining forces with nearly two dozen community partners to reduce racial and socioeconomic disparities around diabetes outcomes. This initiative, called the Chicago Collaboration to Advance Reach, Equity, and Systems (Chicago CARES) to Prevent Diabetes, is a multi-sector effort to expand access to, and increase participation in, the National Diabetes Prevention Program (National DPP.)
A key component of the National DPP is a structured, evidence-based, year-long lifestyle change program to prevent or delay onset of type 2 diabetes in adults with prediabetes or at risk of developing type 2 diabetes. The National DPP lifestyle change program is founded on the science of the Diabetes Prevention Program research study, and subsequent translation studies, which showed that making realistic behavior changes helped people with prediabetes lose 5% to 7% of their body weight and reduce their risk of developing type 2 diabetes by 58% (71% for people over 60 years old). The program is group-based, facilitated by a trained lifestyle coach, and uses a CDC-approved curriculum. The curriculum supports regular interaction between the lifestyle coach and participants; builds peer support; and focuses on behavior modification through healthy eating, increasing physical activity, and managing stress.
Since these healthy behaviors can be hard to maintain, especially within high economic hardship communities, the National DPP provides wrap-around guidance and social support through a trained lifestyle coach and a supportive peer group. Trained lifestyle coaches can be healthcare professionals, community health workers, lay health leaders, and other community members, and groups can be based in a variety of settings including health centers, workplaces, faith communities, and senior centers. By placing these programs in settings where people live, work, pray, and receive support, program participants are more likely to commit to the 12-month program.
IPHI and CDPH seek to provide financial support to develop a network of CDC-recognized organizations to deliver the lifestyle change program throughout Chicago. Over 24 months, IPHI and CDPH will provide start-up or expansion funding, along with technical assistance, to establish these programs. Through this 24-month “runway,” organizations will be able to get their diabetes programs off the ground with funds that cover program delivery costs, including staff time, marketing, and materials, as well as program support costs that mitigate common barriers to program participation. In addition, awarded organizations will become part of the Chicago CARES network, a hub of resources, support, and expertise to build successful and sustainable prevention models that will continue to serve Chicago’s communities in the future. Successful Chicago CARES applicants will serve high-burden populations living in Chicago, demonstrate strong program delivery capabilities, utilize innovative program support strategies, and work towards long-term sustainability in partnership with IPHI and CDPH over 24 months of funding.
The deadline for submissions is April 29, 2019.
To view the full RFP and the full application, visit the Illinois Public Health Institute website.
Leora Horwitz, MD, MHS, director of the Center for Healthcare Innovation & Delivery Science at the NYU Langone Medical Center will be giving the Center for Healthcare and Delivery Science & Innovation Special Lecture on Monday March 18, 2019, entitled ‘Transforming an Academic Medical Center to a Learning Health System’. The lecture will focus on the difference between an academic medical center and a true learning health system, as well as how healthcare delivery science can be incorporated into practice and operations.