Program Update Summer 2008

Vol. 9, No. 2

Print version (PDF* 1.35MB)
 

A1C Levels in People with Diabetes Improve Over 10 Years

Americans are doing a better job of keeping their blood glucose under control according to a major study published in the January 2008 issue of Diabetes Care, a journal for health care professionals that is published by the American Diabetes Association. The study examined recent national trends in glycemic control among adults diagnosed with diabetes and indicated that blood glucose control significantly improved between 1999 and 2004.

Research Design and Methods

According to the journal article, data were examined from the National Health and Nutrition Examination Survey (NHANES), a nationally representative, population-based survey designed to collect information on the health and nutrition of the U.S. civilian non-institutionalized population. Results from NHANES studies are ongoing and released in two-year waves. The study focused on the 1999-2000, 2001-2002, and the 2003-2004 NHANES waves – to utilize and examine the most recent data and trends in glycemic control. Analysis was limited to adults aged 18 and older who reported previously being diagnosed with diabetes by a health care professional and who had received an A1C measurement. A1C is the principal method for monitoring glucose control. It is a standardized blood test that indicates the average blood glucose over the previous eight to 12 weeks. The A1C goal for most people with diabetes is below 7.

Conclusions

Researchers found that the average A1C levels were:

• 7.82 percent from 1999 through 2000,
• 7.47 percent from 2001 through 2002, and
• 7.18 percent from 2003 through 2004.

Overall, improvements were seen among people of all ages, body weights, educational backgrounds, and income levels. Hispanics/Latinos were the only exception, with a higher mean A1C from 2003 through 2004 than from 1999 through 2000.

The percentage of people with A1C levels below 7 percent rose from 36.9 percent to 56.8 percent from 1999 to 2004, while the proportion of people with A1C levels above 9 percent fell from 21 percent to 12.4 percent.

According to the authors of the article, several factors may explain the decrease in A1C levels in recent years:

• Clinical guidelines for diabetes care were strengthened with lower A1C goals following publication of the Diabetes Complications and Control Trial and the United Kingdom Prospective Diabetes Study results.
• Health care plans implemented multifaceted disease management programs targeted to health care professionals and people with diabetes to improve care and reduce A1C levels.
• National public health awareness campaigns like the National Diabetes Education Program were developed to emphasize improving glycemic and cardiovascular risk factor control among people with diabetes and their families.
• Reporting and measuring of diabetes care in health plans has improved.
• Diabetes drugs like metformin were developed to help people with diabetes manage their A1C levels.
• Diabetes education and/or fewer medication side effects helped people with diabetes adhere to therapy.
• Medicare increased coverage for diabetes-related supplies during this period.

The findings of this study are encouraging for the long-term outcomes of people with diabetes. However, many individuals are still not meeting their optimal control targets and A1C levels, and rates are particularly high in some demographic groups. Therefore, additional efforts are necessary to ensure continued improvement in A1C levels of people with diabetes in the future, and NDEP will remain committed to promoting effective team care and self-management among people with diabetes through its campaigns, messages, and resources.

A Message from Our Chair: Partnerships to Help People with Diabetes

As I come to the close of my tenure as chair of the National Diabetes Education Program (NDEP) or, as I prefer, the National Diabetes Education Partnership, I wanted to offer a few reflections on some of NDEP’s accomplishments and challenges:

• NDEP’s accomplishments are too numerous to review fully here. Clearly from the inception of NDEP through our first decade, we worked together to increase awareness of the seriousness of diabetes among the general public and we have seen this awareness increase from 8 percent in 1997 to 89 percent in 2006. Factors contributing to this success include our programs and materials, strong media outreach and public service campaigns, a commitment to reach the entire team of health care professionals, and an unwavering focus on reaching the diverse audiences affected by diabetes with culturally appropriate messages and materials.
• NDEP has committed in its current strategic plan to identify and share more information about how to make lifestyle changes. Our current effort to identify and share lifestyle change tools for people with diabetes, those at risk, and their health care team is a critically important step as we build on our achievement in diabetes awareness and work to turn awareness into changes in health outcomes.
• One example of the educational challenges that we will encounter in the future is the measure of glucose. Having worked hard to define and establish A1C as the measure of glucose control, plans are now underway to introduce the additional measure of estimated average glucose (eAG). eAG offers new opportunities to help our patients better understand the dimensions of glycemic control, but also poses new educational challenges for both patients and their health care professionals.
• NDEP will also seek a greater understanding of the implications of the results of the Action to Control Cardiovascular Risk in Diabetes trial (ACCORD), Action in Diabetes and Vascular Disease trial (ADVANCE), and Veteran Affairs Diabetes trial (VADT) for patient care. In these studies, attempts to achieve near normal A1C levels were not associated with decreased cardiovascular risk compared to more usual care. Moreover, in the ACCORD trial, intensive blood glucose control (A1C goal of less than 6 percent) in patients with longstanding diabetes and known cardiovascular disease (CVD ) or with multiple CVD risk factors was associated with increased mortality compared to currently recommended therapy. NDEP must emphasize that these results should not be interpreted to decrease the importance of glycemic control. Most patients should continue to strive to achieve an A1C goal of less than 7 percent; however, glycemic targets should be individualized as appropriate based on life expectancy, advanced complications, hypoglycemia, comorbidities, etc. As previously shown in the DCCT, Kumamoto, and UKPDS studies, the ADV ANCE trial showed that intensive blood glucose control lowered the risk of new or worsening microvascular complications, particularly kidney disease.
• Another challenge is the clear need for NDEP to make primary diabetes prevention work. As the obesity problem grows in our nation, so will the prevalence of type 2 diabetes. As we see more instances of diagnosed type 2 diabetes in teens and people in their 20s, we can only imagine the impact of diabetes complications occurring at an earlier age. A key goal of the NDEP partnership, bringing life to the lessons of the Diabetes Prevention Program, is a challenge for which we must find solutions.

Let me conclude with some additional thoughts. First, patients are responsible for the vast majority of their diabetes care or, as my friend Marti Funnell characterizes it, a patient is 98 percent responsible for his or her health outcomes. Our patients know that diabetes is serious, and they are looking to NDEP to translate the most recent research findings, to explain eAG, and to help them understand their health care goals. The actions required—adhering to lifestyle measures and medication regimens, and performing self blood glucose monitoring, etc.—remain the responsibility of the individual. However, according to the findings of NDEP’s 2006 “Survey of Public Attitudes, Knowledge, and Practices Related to Diabetes,” the health care team needs to do more to empower patients and to provide them with assistance in their efforts to make this all work. That is one reason I am excited about NDEP’s new strategic plan and its partnership commitment to find and share “how to” information and tools.

What about people at risk? NDEP also has a responsibility to identify and share practical action steps to help this group understand their risk for type 2 diabetes and make lifestyle changes to reduce it.

Finally, I am reminded of the extraordinary role that each of you play in our NDEP partnership. The leadership of Ann Albright, Judy Fradkin, and their respective teams at CDC and NIH has been critical to our success. Charlie Clark, NDEP’s first chair, built this extraordinary partnership. Jim Gavin, immediate past chair, helped move NDEP from program and product development to action. Fran Kaufman, NDEP chair-elect, will be charged with bringing our commitment to behavior change and primary prevention to life.

However, the majority of the responsibility for the success of the NDEP partnership comes from you—our partners:

• Steering Committee members, work group chairs, work group members;
• State Diabetes Prevention and Control Program leaders and staff;
• Individual efforts such as those who have verified translations, helped field test NDEP materials such as tip sheets and brochures, pilot tested the Power to Prevent: A Family Lifestyle Approach to Diabetes Prevention curriculum and the Road to Health/El camino hacia la buena salud toolkit, and volunteers who have written articles on our behalf for School Nurse News and National Association of School Nurses Newsletter;
• Experts now carefully writing NDEP’s Team Care: Comprehensive Lifetime Management for Diabetes, Guiding Principles for Diabetes Care, and other NDEP publications and websites;
• Staff and volunteers at partner organizations who ensure that NDEP’s campaigns, messages, and materials appear in their newsletters, journals, and on their websites so we can reach all diabetes communities; and
• Numerous individuals who have served in many other roles.

Those associated with the National Diabetes Education Partnership should take pride in its accomplishments. I feel privileged to have been engaged, in some role, since the program’s inception in 1997. As I transition into my role as immediate past chair in October, I pledge my continued support and participation in the NDEP partnership effort to change the way diabetes is treated.

Lawrence Blonde, M.D., F.A.C.P., F.A.C.E.
Chair, National Diabetes Education Program

Diabetes Toll Reaches Devastating $174 Billion in 2008

In January 2008, the American Diabetes Association (ADA) announced that the rising economic costs associated with diabetes have reached unprecedented levels. Diabetes now costs Americans $174 billion annually—a 32-percent increase since 2002, according to an ADA-commissioned study. Considering that an additional 6 million more people are believed to be undiagnosed, the study estimates that the actual cost of diabetes may greatly exceed $174 billion. During a congressional briefing on Capitol Hill, members of ADA, leaders from the Congressional Diabetes Caucus, and diabetes experts discussed the economic impact of this new study data.

The study revealed that the direct medical expenditures of care for people with diabetes are estimated to be $116 billion, with a disproportionate percentage of the costs resulting from treatment and hospitalization of people with diabetes-related complications. The findings also suggest that one out of every five health care dollars is spent caring for someone with diagnosed diabetes.

“The findings re-affirm that diabetes is a public health crisis and its implications are painful and far reaching,” said Ann Albright, Ph.D., R.D., President, Health Care and Education, ADA and member of NDEP’s Executive Committee. “This underscores the importance of early diagnosis and treatment. Diabetes becomes much more costly in financial and human terms when the disease is not properly treated.”

The study also revealed the economic impact of indirect costs. When accounting for reduced productivity of both those in the labor force and unpaid workers, unemployment from disease-related disability, and increased absenteeism, indirect costs were estimated to be $58 billion.

NDEP encourages you to include this updated data in presentations and materials when promoting diabetes control and prevention. These figures show the tremendous cost of diabetes in the United States and underscore the importance of continued diabetes education in all of our communities. To learn more about the cost of diabetes in your state, check out ADA’s Diabetes Cost Calculator at www.diabetes.org/cost. To find out how much diabetes is costing your company, visit NDEP’s DiabetesAtWork website at www.DiabetesAtWork.org

NDEP Leadership News

NDEP is pleased to announce that Jeffrey B. Caballero, M.P.H., executive director of the Association of Asian Pacific Community Health Organizations (AAPCHO) has volunteered to begin a second three-year term as chair of NDEP’s Operations Committee (OC). The OC allows NDEP work group chairs to come together to address cross-cutting issues and plan ways to integrate program messages into work group activities. In the past, Mr. Caballero has served as chair of the Asian American and Pacific Islander Work Group. He also represents AAPCHO on the NDEP Steering Committee.

NDEP is also proud to announce the appointment of new work group leadership for the Older Adult Work Group (OAWG). Linda Haas, Ph.C., R.N., C.D.E., who recently completed a term as OAWG vice chair, represents the Department of Veterans Affairs Puget Sound HCS, Seattle Division, and is the new work group chair. Sandra Burke, Ph.D, R.N., A.N.P., C.D.E. represents the American Association of Diabetes Educators and is the new vice chair. The OAWG is responsible for a variety of NDEP materials, including the It’s Not Too Late to Prevent Diabetes. Take Your First Step Today. tip sheet and The Power to Control Diabetes Is in Your Hands brochures and community outreach materials.

Promote, Promote, Promote

Inquiring Minds Want to Know…About Diabetes
After findings from market research proved that many of its readers had been diagnosed with diabetes, the National Inquirer ran NDEP’s“Superhero” and “Important Numbers” print public service announcements in three issues in November and December of 2007. For three consecutive weeks, these placements reached more than 3.3 million people with NDEP’s messages of comprehensive diabetes management.

2007 National Diabetes Fact Sheet

Number of Americans with Diabetes Continues to Increase

Nearly 24 million Americans—almost 8 percent of the population—are now living with diabetes, according to the 2007 National Diabetes Fact Sheet, which was released in late June. The 24 million Americans include nearly 6 million people who are undiagnosed. An additional 57 million Americans aged 20 and older have pre-diabetes, a condition that increases a person’s risk of developing type 2 diabetes, heart disease, and stroke. The fact sheet also indicates that the prevalence of diabetes in ethnic minority populations continues to rise, heightening concerns about health disparities among these populations. Compared to non-Hispanic whites, diabetes continues to be more prevalent among African Americans, Hispanics/Latinos, American Indians, Alaska Natives, Asian Americans, and Pacific Islanders.

The new fact sheet includes an updated section on treating diabetes for health care professionals and diabetes educators, which emphasizes that people with diabetes can lower their risk for developing serious complications by controlling blood glucose, blood pressure, and blood lipids. Self-management education or training is highlighted as a key step in improving health outcomes and quality of life for people with diabetes. This section indicates that many people with type 2 diabetes can control their blood glucose by following a healthy meal plan and physical activity program, losing excess weight, and taking medications if necessary. Some people may need insulin for controlling their blood glucose. Many people with diabetes also need to take medications to control their cholesterol and blood pressure.

Another addition to the new fact sheet includes prevalence rates for pre-diabetes by race. For example, among adults aged 20 and older, more than 21 percent of African Americans, more than 25 percent of non-Hispanic whites, and more than 26 percent of Mexican Americans have pre-diabetes. Regarding diagnosed diabetes, the fact sheet also includes a new number for the prevalence of diabetes among Asian Americans aged 20 or older—nearly 8 percent. Additionally, among adults, diabetes increased in both men and women and in all age groups. However, diabetes still disproportionately affects the elderly. In 2007, almost 25 percent of the population aged 60 years and older had diabetes.

Diabetes is a serious, common, and costly, yet controllable and preventable disease. NDEP has free resources on diabetes control and prevention for people with diabetes and their families, those at risk, and health care professionals. Materials are available in 15 Asian and Pacific Islander languages and Spanish. To download or order free materials, visit NDEP’s website, www.YourDiabetesInfo.org, or call 1-888-693-NDEP (6337). Together, we can change the way diabetes is treated.

To download the 2007 National Diabetes Fact Sheet, visit www.diabetes.niddk.nih.gov/dm/pubs/statistics.

A Job Well Done

• The American Pharmacists Association Foundation recently selected NDEP as the recipient of its 2008 Pinnacle Award in the category of Voluntary Health Agencies, Non-profit Organizations, Associations, Government Agencies, and Public/Private Partnerships for its role in assisting patients and their caregivers in achieving better outcomes from their medications. NDEP was honored with the Pinnacle Award during a June ceremony at the Embassy of Italy in Washington, D.C. Accepting the award was NDEP’s chair, Lawrence Blonde, M.D., F.A.C.P., F.A.C.E. Also in attendance were local NDEP work group leadership and Francine Kaufman, M.D. and Judith Fradkin, M.D., both members of NDEP’s Executive Committee.
• Several NDEP materials received recognition from the 2008 National Institutes of Health’s (NIH) Plain Language Awards. Consejos para ayudar a una persona con diabetes (Tips for Helping a Person with Diabetes) and 4 Steps to Control Your Diabetes. For Life. received Silver Awards. Also, It’s Not Too Late to Prevent Diabetes. Take Your First Step Today. received a Bronze Award. NIH’s Plain Language Awards recognize the use of simple, easy-to-read language in government-authored documents. NDEP’s feature article, “Preventing Type 2 Diabetes When You’re On-the-Go” has earned an Honors Award from the 21st Annual International Mercury Excellence Awards. This feature article was selected among 970 entries submitted from 23 countries. To download the feature article, visit NDEP’s “Campaign Tools” webpage at www.YourDiabetesInfo.org/campaigns/tools.htm.
• David Marrero, Ph.D., a member of NDEP’s Evaluation Work Group and Health Care Professional Work Group, is the recipient of the American Diabetes Association’s 2008 Outstanding Educator in Diabetes Award. This award is presented to an individual who demonstrates significant contributions to the understanding of diabetes education, has spent many years of effort in the field, and has benefited recipients of education. Dr. Marrero is recognized for assisting in the design of the Diabetes Prevention Program and the Translating Research into Action for Diabetes study. His research interests include strategies for promoting diabetes prevention, care settings, improving diabetes care practices used by primary care providers, and the use of technology to facilitate care and education.
• NDEP-NIH Director Joanne Gallivan, M.S., R.D., is the 2008 recipient of the American Dietetic Association’s Excellence in Community Dietetics Award after being nominated by the organization’s Diabetes Care and Education Dietetic Practice Group. The American Dietetic Association has over 65,000 members, and each year only one recipient in the category of Community Dietetics is chosen. This award is presented to registered dietitians or dietetic technicians who have demonstrated innovation, creativity, leadership, and significant contributions to the advancement of practice and leadership achievements in nutrition-related organizations. Ms. Gallivan will receive this award during a session entitled, “The Diabetes Pandemic: The Role of the Dietitian,” at the organization’s 2008 Food & Nutrition Conference & Expo on October 27 at 3 p.m. in Chicago.
• As reported in a previous issue of NDEP Update, John Riley, other students, and school personnel from Davenport High School in Oklahoma adapted NDEP’s Move It! And Reduce Your Risk of Diabetes School Kit to start a diabetes prevention program in their school. John was instrumental in partnering with community organizations, helping to build a walking/running track, starting a Move It! Exercise Club, and hosting a Pre-Diabetes Extravaganza in his community. NDEP is pleased to report that John is a 2008 recipient of the Gates Millennium Scholarship (GMS), developed by the Bill and Melinda Gates Foundation. Out of 13,000 applications nationwide, 1,000 scholarships were awarded, and only 150 scholarships were awarded to American Indian and Alaska Native students. GMS funds will cover John’s college education at the institution of his choice at the bachelors, masters, and doctoral levels as long as he remains in an education-related field. This fall, John will attend Oklahoma City University where he plans to double major in journalism and English. Congratulations to all from NDEP!

Spreading the Word

NDEP Partners at Work

Because our partners play such a key role in our mission to promote, promote, promote – they also play a key role in our ability to measure how we’re doing. That’s why the NDEP Partner Activities Survey, sent every spring and fall via email, is so important. NDEP would like to thank all the partners who participated in the spring 2008 edition of the survey. Here are just a few of the ways that our partners are working to change the way diabetes is treated. Feel free to contact the partners below for more information on modeling these programs and initiatives.

Work Group Members

• Nia Aitaoto, M.P.H. of NDEP’s Asian American & Pacific Islander Work Group used NDEP materials to promote diabetes awareness, control, and prevention messages during the Hokulea voyage, a five-month tour that sailed from Hawaii to Palau, and reached thousands of Hawaiian school children through educational programs to expand the vision of global kinship and encourage cultural heritage and stewardship.
• Martha Funnell, M.S., R.N., C.D.E. of NDEP’s Health Care Professional Work Group promoted the BetterDiabetesCare website as a resource for health care professionals during a conference attended by 100 primary care physicians and registered nurses. She also promoted the BetterDiabetesCare website in the Michigan Organization of Diabetes Educators’ newsletter.
• Gladys Gary-Vaughn, Ph.D. of NDEP’s African American/African Ancestry Work Group distributed the More than 50 Ways to Prevent Type 2 Diabetes tip sheet to staff at the U.S. Department of Agriculture.
• JoAnn Gurenlian, R.D.H., Ph.D. of NDEP’s Pharmacy, Podiatry, Optometry& Dentistry Work Group co-presented during two national dental meetings and highlighted NDEP prevention and control messages and materials.
• Marilee Kadar of NDEP’s Older Adult Work Group designed a full-page public service advertisement in Lions Club International’s magazine, The Lion, to promote diabetes awareness and NDEP’s free resources for older adults.
• Kelly Moore, M.D. of NDEP’s American Indian & Alaska Native Work Group gave a presentation highlighting NDEP’s Move It! And Reduce Your Risk of Diabetes School Kit during the Diabetes Mellitus Interagency Coordinating Council and American Diabetes Association’s Scientific Sessions.
• Janet Silverstein, M.D. of NDEP’s Diabetes in Children & Adolescents Work Group partnered with the American Diabetes Association to conduct workshops for school nurses and other health care professionals in Orlando, Fla. and New York City to promote NDEP’s Helping the Student with Diabetes Succeed: A Guide for School Personnel.
• Pamella Thomas, M.D., M.P.H. of NDEP’s Business Health Strategies Work Group partnered with the Dekalb County Health Department to conduct a DiabetesAtWork workshop with 32 corporations representing more than 30,000 employees.
• Virginia Valadez of NDEP’s Hispanic/Latino Work Group partnered with promotoras to promote NDEP materials during health fairs, school events, and community presentations. Also, NDEP’s online Recipe and Meal Planner Guide was promoted in local restaurants and recipes like arroz con pollo (rice with chicken) were added to their menus. Customers who tried NDEP’s recipes were given a free copy of the Meal Planner.

Diabetes Prevention and Control Programs (DPCPs)

• The Alabama DPCP updated their website to include an audio/video component to showcase NDEP’s Movimiento por su vida and Step by Step: Moving Toward Prevention of Type 2 Diabetes CD/DVD s.
• The Delaware DPCP ran more than 3,000 television public service advertisements (PSAs) on local stations in English and Spanish from January through June 2007 promoting NDEP’s free resources.
• The Illinois DPCP aired NDEP television PSAs on local stations and reached approximately 1 million viewers.
• The Kentucky DPCP collaborated with other Department of Public Health chronic disease programs to develop a 16-page insert targeting youth at risk for diabetes. The insert included NDEP’s Tips for Teens: Lower Your Risk for Type 2 Diabetes tip sheet and was published in a local newspaper.
• The Maine DPCP promoted NDEP’s prevention and control messages during Legislative Wellness Day at the capital. During the event, NDEP materials provided a focal point for one-on-one discussions with legislators on the importance of diabetes control and prevention.
• The Texas DPCP partnered with the American Association of Clinical Endocrinologists to present a continuing education event for more than 100 health care professionals. Attendees received an NDEP materials order form and a toolkit containing NDEP resources.
• The Virginia DPCP partnered with the Virginia Pharmacy Association to distribute NDEP’s materials for pharmacists during their statewide meeting. As a result of this partnership, pharmacies continue to request additional NDEP resources.
• The Washington DPCP partnered with the Eastern Washington Diabetes Network to coordinate diabetes awareness weeks, staff a local television station’s call-in lines, and assist with diabetes screenings at local pharmacies. During this promotion, more than 600 NDEP PSAs were aired. Additionally, the Spokane NBC affiliate, KHQ-TV , linked to NDEP’s website and experienced an increase of more than 4,000 site visitors to their website.

National Outreach Organizations

• The Black Women’s Health Imperative adapted NDEP’s Power to Prevent: A Family Lifestyle Approach to Diabetes Prevention curriculum to meet the unique diabetes education needs of African American women. NDEP’s Small Steps. Big Rewards. Your GAME PLAN to Prevent Type 2 Diabetes physical activity tracker and fat and calorie counter were included as part of the curriculum.
• The National Alliance for Hispanic Health promoted NDEP through their toll-free helpline, “Su Familia,” to bilingual callers with questions about diabetes prevention and control and through conferences, meetings, and health fairs.
• The National Association of School Nurses (NASN) adapted NDEP’s Helping the Student with Diabetes Succeed: A Guide for School Personnel to meet the needs of practicing school nurses in two NASN grant affiliate sites.
• The National Latina Health Network developed and distributed an online banner promoting NDEP via a Hispanic news listserv. The banner was highlighted on the website for one year in the Calendar of Events and Health sections.
• The National Medical Association (NMA) reprinted and disseminated NDEP materials to six coalitions in Atlanta, Houston, Indianapolis, Los Angeles, Pine Bluff, and Washington, D.C. during NMA’s regional meetings.
• Papa Ola Lokahi forged partnerships with the Pacific Region Tobacco Coalition, the Cancer Council of the Pacific Islands, and the Maternal Child Health Program to promote NDEP campaigns, messages, and materials.

Partner Spotlight

American Association of Indian Physicians Promotes NDEP’s Campaigns and Resources in Annual Newsletter

NDEP applauds the American Association of Indian Physicians (AAIP) for promoting its campaigns, messages, and materials in the winter 2008 issue of Legacy, their annual member newsletter. Here are some of the ways AAIP mentioned NDEP in their newsletter:

• A letter commending NDEP’s Move It! And Reduce Your Risk of Diabetes School Kit was included from a Move It! coordinator at the Menominee Tribal School in Neopit, Wis.
• Two diabetes education programs—“Dance Away Diabetes” and “Working Together for Balance”—were recognized by AAIP as Outstanding Model Diabetes Programs based on criteria such as the program’s use and dissemination of NDEP’s materials.
• A transcript from the October 2007 National Institutes of Health podcast featuring Francine Kaufman, M.D., chair-elect of NDEP and head of the Center for Diabetes, Endocrinology, and Metabolism at Children’s Hospital Los Angeles, regarding type 2 diabetes and children was included. During the podcast, NDEP was mentioned as a resource.
• A feature article entitled, “The Good News About Pre-Diabetes” promoted NDEP’s Small Steps. Big Rewards. Prevent Type 2 Diabetes. campaign and messages. In addition, NDEP’s Your GAME PLAN to Prevent Type 2 Diabetes: Information for Patients was highlighted as an essential, effective tool for helping people with diabetes make small lifestyle changes to prevent or delay the onset of type 2 diabetes.
• NDEP’s The Power to Control Diabetes Is in Your Hands Community Outreach Kit for older adults and Your GAME PLAN to Prevent Type 2 Diabetes: Health Care Provider Toolkit were highlighted as NDEP resources that will be updated and re-launched in 2008.
• AAIP members were encouraged to use NDEP’s new billboard campaign to personalize their own diabetes prevention efforts in their communities. The billboards are based on NDEP’s prevention messages for American Indians and Alaska Natives and can be customized by adding local contact information, logos, and images.

American Dietetic Association Teleseminar Promotes NDEP to Food & Nutrition Professionals

In April 2008, NDEP partnered with the American Dietetic Association for an hour-long teleseminar for food and nutrition professionals who do not specialize in diabetes but often see patients who have the disease. Topics of the teleseminar included a discussion of the diabetes epidemic in the United States, current treatment recommendations, and NDEP’s vast array of free resources available to people with diabetes, those at risk, and health care professionals. During the teleseminar, NDEP chair Lawrence Blonde, M.D., F.A.C.P., F.A.C.E. and NDEP-NIH Director Joanne Gallivan, M.S., R.D. presented to nearly 600 food and nutrition professionals at 17 sites across the country.

Dr. Blonde discussed the scope of the current diabetes problem, challenges to achieving recommended goals, the latest recommendations for achieving target therapeutic goals, current and new medications to help people with diabetes reach their target goals, and the importance of early diagnosis and aggressive treatment strategies.

Ms. Gallivan highlighted NDEP’s free resources available to health care professionals, people with diabetes, and those at risk for the disease through the Control Your Diabetes. For Life. and Small Steps. Big Rewards. Prevent Type 2 Diabetes. campaigns and resources. To provide examples of how NDEP adapts materials and resources for various audiences, Ms. Gallivan highlighted NDEP’s in-language materials for Asian Americans, Pacific Islanders, and Hispanics/Latinos and ethnic-specific resources for African Americans, American Indians, and Alaska Natives. She also promoted NDEP’s tip sheets for women who have had gestational diabetes and older adults.

As the teleseminar concluded, participants were reminded that early diagnosis, diabetes education, and a solid team care approach can significantly improve outcomes for people with diabetes – and that NDEP has free diabetes resources needed to assist food and nutrition professionals in this process.

New and Noteworthy

Plans to Redesign NDEP Website Underway

NDEP is currently revising its website, www.YourDiabetesInfo.org. We’re optimizing, updating, improving, and simplifying our features and webpages to make the site user-friendly and easy-to-navigate. Here’s a sneak peak of some of the new features we’re working on:

• New Partners Section on the Homepage will help you quickly find diabetes education resources and information about NDEP.
• Printer-Friendly Webpages will make printing a breeze.
• New Search Categories such as publication title and audience will give you more ways to find the information you need.

Stay tuned for more information regarding NDEP’s updated website in News & Notes, our monthly e-newsletter.

Diabetes and Depression Continuing Education Opportunity Available on DiabetesAtWork Website

Recent studies show that people with diabetes have a higher risk of developing depression. In fact, adults who are depressed are 37 percent more likely to develop type 2 diabetes. Depression can impact a person’s ability to perform tasks, communicate, and think clearly – attributes that a person needs to operate in the workplace. Currently, only 30 percent of people diagnosed with both depression and diabetes receive adequate treatment, which can alleviate debilitating symptoms in most individuals.

Employers can play a key role in assisting their employees with seeking appropriate help. To address this issue, NDEP’s DiabetesAtWork website now features continuing education materials for health care professionals and health educators on recognizing and dealing with diabetes and depression in the workplace. Valuable Continuing Education (CE) credits can be earned for reviewing these new webpages. To learn more about diabetes and depression and to earn CE credits, visit www.DiabetesAtWork.org/DiabetesResources/DiabetesandDepression.cfm.

CE/CME Credits Available from NDEP’s BetterDiabetesCare Website

The BetterDiabetesCare website focuses on how to improve the way diabetes care is delivered, rather than on the clinical care itself. Since 2006, Continuing Education (CE) and Continuing Medical Education (CME) credits from the Indiana University School of Medicine have been available through the BetterDiabetesCare website for health care professionals who tackle this challenge. BetterDiabetesCare emphasizes the need for changes to systems of care and ways to implement them and is a practical resource to help health care professionals make a difference in the way diabetes is prevented and treated. Steps, models, guidelines, resources, and tools for making and evaluating effective systems changes are provided on the site.

To obtain CE/CME credit, health care professionals choose a topic of interest, set their own objectives, and complete a project as they use the website’s tools and materials to assess their current situation, determine priorities for system changes, plan strategies to implement changes, take action, and evaluate results. CE credits are awarded for reflective learning, a self-directed process that occurs in response to key issues or problems that arise in health care practice. For a nominal fee of $10, users of the website will receive a certificate documenting up to 10 Category 1 CE/CME credits per project.

NDEP encourages you to tell your partners, local community health organizations, professional associations, and every health care professional you know about this opportunity! To start your CE/CME program today, visit www.BetterDiabetesCare.nih.gov/CE.htm.

NDEP Publications New and Updated

To order these publications and other NDEP materials, call 1-888-693-NDEP (6337) or visit the NDEP website, www.YourDiabetesInfo.org.

NDEP on the Road

Upcoming NDEP exhibits in 2008 are listed below:

American Academy of Family Physicians
September 17 –21
San Diego

American Academy of Pediatrics
October 11 –14
Boston

American Dietetic Association
October 25 –28
Chicago

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