HEALTHY PEOPLE 2020 GROUP PRESENTATION

byJackie Crawley, Ryan Gorell, Francesca Gruszie,

Jessica Hawse, Melina Hernandez, Candace James, Heaven Keener

(Wagner1)

Introduction Diabetes Mellitus (DM) occurs when the

body cannot produce or respond to insulin, a hormone the body needs to absorb and use glucose as fuel for the body’s cells.

There are three common forms of diabetes: Type 1 Diabetes Type 2 Diabetes Gestational Diabetes (GD)

Status for the Nation

Diabetes Mellitus and it’s various types (I, II, GD) affect large numbers of Americans: 23.6 million people 1 in 4 Americans undiagnosed 57 million people with prediabetes

Americans are at higher risk for diabetes than any other population in the world due to sedentary lifestyles, obesity, diversity, and poor diets (overeating, diets high in fats, carbohydrates, sugars, preservatives)

Status for the Community Hampton Roads is a community located in

Southeastern Virginia Incidence of Diabetes Mellitus – 8.2%

Virginia incidence of Diabetes Mellitus – 8.7% Nationwide incidence of Diabetes Mellitus –

9.3% DM affects different ethnic and gender groups

Native Americans African-Americans Latinos Males

Healthy People 2020 Objectives

Objectives of HP2020 Reduce the annual number of new cases of diagnosed

diabetes in the population Reduce the death rate among persons with diabetes Reduce the rate of lower extremity amputations in

persons with diagnosed diabetes Improve glycemic control among persons with diabetes Improve lipid control among persons with diagnosed

diabetes Increase the proportion of persons with diagnosed

diabetes whose blood pressure is under control, who have an annual dental examination, foot examination, dilated eye examination

Healthy People 2020 Objectives cont.

Increase the proportion of adults with diabetes who have a glycosylated hemoglobin measurement at least twice a year and an annual urinary micro-albumin measurement

Increase the proportion of adults with diabetes who perform self-blood glucose-monitoring at least once daily

Increase the proportion of persons with diagnosed diabetes who receive formal diabetes education

Increase the proportion of persons with diabetes who condition has been diagnosed

Increase prevention behaviors in persons at high risk for diabetes with prediabetes, including increasing levels of physical activity, trying to lose weight, and reducing the amount of fat or calories in their diet

Local trends in Diabetes in the last 10 years

2000 2002 2004 2006 2008 20105456586062646668707274

Deaths Related to Diabetes

Deaths Related to Diabetes

National trends in the past 10 years

2004 2006 2008 2010 2012 20140123456789

New cases of diabetes for ages 18-84 (x1000 people)

New cases of dia-betes for ages 18-84 (x1000 people)

National trends in the last 10 years

Cases of death from diabetes in the last 10 years per 100,000 people Since 2002 to 2012, the number of deaths has decreased from 78.4 to 69.1 Target goal of Healthy people 2020 is to reduce new cases to 66. 1 People with A1C greater than 9: 2005-2008: 17.9 2009-2012: 21 Target goal of Healthy people 2020 is to reduce cases to 16.1

People with A1C less than 7: 2005-2008: 53% 2009-2012: 48.2% Target goal of Healthy people 2020 is to increase to 58.9%

Percent of people with diabetes who get formal education 2008: 56% Target goal of Healthy people 2020 is 62.5%

Exercise 2005-2008: 44.6% 2011-2012: 54.7% Target goal of Healthy People 2020 is to increase to 49.1%

What does it mean?

What does the local and national data mean?

Changes/improvements in: Exercise programs Nutrition consulting Regular medical evaluations Preventive education on DM

Area programs / organizations that target Diabetes Mellitus

American Diabetes Association (ADA)

Urban League of Hampton Roads, Inc.

The Health Systems of Hampton Roads

Young Men’s Christian Association of South Hampton Roads (YMCASHR)

Area programs / organizations that target Diabetes Mellitus cont.

The American Diabetes Association Mission: Finding a cure for DM

Nationally accredited organization

Active in the community Outreach programs Educational programs Research initiatives

Area programs / organizations that target Diabetes Mellitus cont.

Urban League of Hampton Roads, Inc.

Provide education and support services to target health issues that affect the minority communities.

This includes diabetes, heart disease, child obesity and cancer.

Area programs / organizations that target Diabetes Mellitus cont. The Health Systems of Hampton Roads

Sentara and Bon Secours are the two major health systems in the Hampton Roads area

Services offered for diabetes information Diabetes education Diabetic support groups Diabetic weight management Diabetic nutrition management.

The focus of these programs is to educate the public and be a resource for the public, and are generally free.

Area programs / organizations that target Diabetes Mellitus cont. Young Men’s Christian Association (YMCA)

of Hampton Roads Offers free diabetes prevention and education

programs Identifies and targets at risk population for

diabetes Provides adults and families information for

lifestyle changes Assigns a specific lifestyle coach Healthy eating and exercise programs are

incorporated

Successful programs in other communities

Stanford Diabetes Self-Management Program Diabetes management program

Dining with Diabetes Multi-state initiative through social-educative

events

Joslin Diabetes Center Independent, non-profit organization affiliated

with Harvard Medical School

Successful programs in other communities cont.

Stanford University School of Medicine created a diabetes management program. Originally created for Spanish speaking clients Randomized-control trials evaluated success and

effectiveness 4.5 day training program Enables the patient to become the teacher, reinforcing

information Program organized into 2.5 hour meetings, 3

times a week for six weeks in medium-sized groups Subjects include:

Techniques to cope with symptoms Exercise Healthy Diet Appropriate use of medication Working effectively with healthcare professional

Successful programs in other communities cont.

Dining with Diabetes A successful program utilized by multiple

states in the U.S. Utilizes social engagements to foster an

environment of learning and support Meals and food provided at events support the

learning of diabetic conscious eating Results in better understanding and

compliance with diet management; lowering of HA1C results and blood pressure

Successful programs in other communities cont.

The Joslin Diabetes Center A venture through Harvard Medical School in

Boston, MA Provides a significant amount of information

through online, self-paced educational classes: What is Diabetes? Managing blood glucose Effective monitoring Diabetic pills

Online education is beneficial for many patients who are active and may have busy schedules that don’t allow for face to face sessions

Current and new developments in Diabetes Mellitus

Monogenic Diabetes Research Genetic mutation that affects 1-5% of

diabetics Misdiagnosed in neonates and children as

Type 1 diabetes Unknown cause of genetic mutation Can have mild to moderate effects on insulin

production Specific testing for mutation should be

conducted to confirm diagnosis

Current and new developments in Diabetes Mellitus cont.

Smart Insulin Patch Current and historic DM protocol is for “finger

stick” blood glucose level testing at regular intervals and corrective or bolus insulin administration Often results in highs and lows of blood sugar

levels, which can be dangerous with over or under correction with insulin

“Smart” pumps and biopatches which monitor and sense changes in blood glucose levels and infuse specific amounts of insulin to maintain balanced levels

Conclusion Incidence of diabetes are on the overall

decline, but poor eating habits, diet, nutrition, obesity, and sedentary lifestyles are still a major problem in America. The convenience of technology and the desire for “fast” food service are hindering healthy habits and present barriers for DM management. There are initiatives and programs in place to help, but ultimately people need to want help in order to succeed.

References American Diabetes Association. (2015). About Us. Retrieved from

diabetes.org: http://www.diabetes.org/about-us/?loc=util-header_aboutus

American Diabetes Association. (2015, July 13). Pathway to Stop Diabetes Scientist Generates Smart Insulin Patch. Retrieved from diabetes.org: http://www.diabetes.org/research-and-practice/we-are-research-leaders/recent-advances/scientist-generates-smart-insulin-patch.html

American Diabetes Association. (2015, March 24). Research to Identify and Correctly Treat Rare Forms of Diabetes. Retrieved from diabetes.org: http://www.diabetes.org/research-and-practice/we-are-research-leaders/recent-advances/rare-forms-of-diabetes.html

CountyHealthRankings.org. (2015). Norfolk City. Retrieved from County Health Rankings: http://www.countyhealthrankings.org/app/virginia/2015/rankings/norfolk-city/county/outcomes/overall/snapshot

Joslin Diabetes Center. (2015). Welcome to Joslin's Online Learning Center. Retrieved from Joslin Diabetes Center: http://www.joslin.org/ape/default.asp

Joslin Diabetes Center. (n.d.). Living with Diabetes. Retrieved from Joslin Diabetes Center: http://www.joslin.org/diabetes_information.html

References cont. Office of Disease Prevention and Health Promotion. (2015, July). Diabetes. Retrieved from

Healthypeople.gov: http://www.healthypeople.gov/2020/topics-objectives/topic/diabetes

Stanford School of Medicine. (n.d.). Diabetes Self-Management Program. Retrieved from Stanford.edu: http://patienteducation.stanford.edu/programs/diabeteseng.html

Trust for America's Health. (2009, August 18). Examples of Successful Community-Based Public Health Interventions. Retrieved from healthyamericans.org: http://healthyamericans.org/assets/files/ExamplesbyState.pdf

Urban League of Hampton Roads, Inc. (2013). Health. Retrieved from ulhr.org: http://www.ulhr.org/health

Viginia Cooperative Extension. (n.d.). Steps to Delicious Dining with Diabetes. Retrieved from Viginia Cooperative Extension: http://offices.ext.vt.edu/bedford/programs/fcs/STDDD.html

Virginia Business Coalition on Health. (2008). Diabetes Resource Directory for Hampton Roads. Retrieved from myvbch.org: http://myvbch.org/wp-content/uploads/2012/09/VBCH-Diabetes-Resources-Directory-for-Hampton-Roads.pdf

Virginia Department of Health. (2011). Prevalence of Diabetes. Richmond: Virginia Department of Health. Retrieved from Virginia department of Health.

Young Men's Christian Association. (2015). Diabetes Prevention Program. Retrieved from ymcashr.org: http://www.ymcashr.org/programs/info/diabetes-prevention-program