NDEP Addresses Diabetes Care in Changing Environment

San Francisco—The National Diabetes Education Program (NDEP), a joint program of the National Institutes of Health and the Centers for Disease Control and Prevention (CDC), was launched in 1997. NDEP’s goal is to reduce the burden of diabetes and prediabetes by facilitating the adoption of proven approaches to prevent or delay the onset of diabetes and its complications. NDEP members had an opportunity to discuss diabetes care and NDEP’s role during a symposium at the ADA meeting.

Martha M. Funnell, MS, RN, CDE, chair, Diabetes HealthSense Task Group, opened the forum by addressing a NDEP strategy focused on behavioral change. “One of our strategies is to help support and facilitate behavior change on a clinical, individual, and community level. We know lifestyle is key for both preventing and managing diabetes,” she said.

What do we know about behavior? “As health professionals most of us view behavior as a problem,” said Ms. Funnell. “In reality, behavior is a symptom. We know in healthcare, when we address symptoms but we do not address the problem, then it does not seem to work.”

If healthcare professionals want to make an impact on behavior, they have to address diabetes-related distress, she explained, referencing data that found diabetes distress is more consistently linked to diabetes management and glycemic control than depression.

NDEP offers a compendium of resources on its Web site for healthcare professionals and patients. Diabetes HealthSense (www.yourdiabetesinfo.org/healthsense), for example, is a resource that has a series of dialogue tools that health professionals can use to talk with their patients about diabetes distress. Diabetes HealthSense has >200 resources directed specifically at behavior change and psychosocial aspects, according to Ms. Funnell.

Kevin A. Petersen, MD, MPH, FRCS, FAAFP, director of research, department of family medicine and community health, University of Minnesota, focused his presentation on NDEP resources directed at healthcare providers. As the healthcare environment continues to change, healthcare providers will need to transform their practices. NDEP developed a practice-centered Web site designed to help physicians, healthcare professionals, and healthcare administrators who want to change the system of healthcare delivery surrounding diabetes. While much of the content is diabetes specific, Dr. Petersen noted, “There are resources that apply across practices that really help provide more chronic disease support.” The Web site contains 8 sections:

     • Engage Leadership and Assess Your Practice
     • Provide Evidence-Based Care
     • Use Information Systems
     • Improve Practice Quality
     • Use Clinical Decision Support
     • Practice Team-Based Care
     • Enhance Patient-Centered Interactions
     • Improve Patient Care Coordination

For more information, visit www.yourdiabetesinfo.org/practicetransformation.

The work of NDEP would not be successful without partnerships, according to Linda M. Siminerio, RN, PhD, CDE, chair-elect, NDEP. She asked attendees to think about how they could partner with NDEP. “As the burden of diabetes grows, it comes alongside a reduction of resources,” she said.

NDEP engages with partners who live and work with diabetes in the trenches. For example, Dr. Siminerio said 2 partner groups worked with NDEP to help revise and expand “New Beginnings: A Discussion Guide for Living Well with Diabetes.” This online resource uses stories about black individuals with diabetes to help group leaders engage in discussions about the emotional impact of living with diabetes and to help people with diabetes identify family and social support needs and develop goal setting, positive coping, and problem-solving skills.

Judith E. Fradkin, MD, director, division of diabetes, endocrinology, and metabolic diseases, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and Ann L. Albright, PhD, RD, director, division of diabetes translation, CDC, concluded the symposium by providing an update on activities of NIDDK and the CDC and the implications for NDEP.

Dr. Albright gave a snapshot on what CDC partners do in the areas of research and translation of that research. She mentioned future plans for the SEARCH for Diabetes in Youth Study cohort. SEARCH is a multicenter, observational study developed to assess the prevalence, incidence, and trends of diabetes in youth <20 years of age based on age, sex, race/ethnicity, and diabetes type. Future plans for type 1 and type 2 diabetes in SEARCH include:

     • Determine the burden and clustering of diabetes-associated acute and chronic complications
     • Explore independent factors and pathways contributing to increased burden and clustering of
       complications
     • Determine independent risk factors/pathways associated with greater burden and clustering of
       complications, independent of other known risk factors

NDEP, along with its strategic partnerships, will continue to work toward reducing the burden of diabetes and prediabetes by creating strategies to delay the onset of the disease.—Eileen Koutnik-Fotopoulos