IHS Confused Whether Indian Diabetes Funding Faces Another Sequestration

Indian Country Today Media Network: 1/16/14

For the second year in a row, Indian Health Service (IHS) leadership is confused how federal sequestration will impact its budget, leading to questions of responsibility and competency from Native-focused health officials.

The latest confusion centers on how the Special Diabetes Program for Indians (SDPI), a program created in 1997 by Congress for the prevention and treatment of diabetes in American Indian and Alaska Natives, will be affected under the new federal budget deal. The December congressional arrangement alleviates sequestration on many so-called discretionary Indian-focused programs, but it leaves cuts in place for some mandatory programs.

SDPI last year was classified as mandatory under White House Office of Management and Budget (OMB) rules, so the program received a 2 percent cut, translating to $3 million. That reduction was able to be absorbed by IHS through an internal reshuffling of funds, according to agency officials last year. Read More

New poll finds diabetes top health concern for Latino families

HSPH News: January 21, 2014

Princeton, N.J. – A new NPR/Robert Wood Johnson Foundation/Harvard School of Public Health poll was released today on the views of Latinos in America about their health and health care, communities, financial situation, and discrimination in their lives. The poll found that Latinos see diabetes as the biggest health problem for their own families.

Nearly one in five (19%) Latinos said diabetes is the biggest health problem facing their families. The next most cited problem, cancer, is mentioned by just one in twenty Latinos (5%). Diabetes was the biggest health problem reported by both immigrant (16%) and non-immigrant Latinos (22%). Read More

NIH, industry and non-profits join forces to speed validation of disease targets

NIH: February 4, 2014

The National Institutes of Health, 10 biopharmaceutical companies and several nonprofit organizations today launched an unprecedented partnership to transform the current model for identifying and validating the most promising biological targets of disease for new diagnostics and drug development.

The Accelerating Medicines Partnership (AMP) aims to distinguish biological targets of disease most likely to respond to new therapies and characterize biological indicators of disease, known as biomarkers. Through the Foundation for the NIH (FNIH), AMP partners will invest more than $230 million over five years in the first projects, which focus on Alzheimer’s disease, type 2 diabetes, and the autoimmune disorders rheumatoid arthritis and systemic lupus erythematosus (lupus). Read More

Reasons for participation and non-participation in a diabetes prevention trial among women with prior gestational diabetes mellitus (GDM)

BMC Medical Research Methodology: 24 January 2014

Background

Gestational diabetes mellitus (GDM) is a risk factor for the development of type 2 diabetes. Lifestyle intervention can prevent progression to type 2 diabetes in high risk populations. We designed a randomised controlled trial (RCT) to evaluate the effectiveness of an established lifestyle intervention compared to standard care for delaying diabetes onset in European women with recent GDM. Recruitment into the RCT was more challenging than anticipated with only 89 of 410 (22%) women agreeing to participate. This paper identifies factors that could enhance participation of the target population in future interventions. Read more

Considerations in the design of randomized trials to screen for type 2 diabetes

Clin Trials: January 23, 2014

Background Randomized controlled trials (RCTs) are the most robust and valid approach to evaluate screening for diseases. Many in the diabetes research community have advocated sole reliance on RCTs for designing diabetes screening policies. However, the challenges of conducting RCTs of screening for type 2 diabetes may have been underappreciated.

Behavioral and technological interventions targeting glycemic control in a racially/ethnically diverse population: a randomized controlled trial

BMC Public Health: 23 January 2014

Background

Diabetes self-care by patients has been shown to assist in the reduction of disease severity and associated medical costs. We compared the effectiveness of two different diabetes self-care interventions on glycemic control in a racially/ethnically diverse population. We also explored whether reductions in glycated hemoglobin (HbA1c) will be more marked in minority persons.

Methods

We conducted an open-label randomized controlled trial of 376 patients with type 2 diabetes aged ≥18 years and whose last measured HbA1c was ≥7.5% (≥58 mmol/mol). Participants were randomized to: 1) a Chronic Disease Self-Management Program (CDSMP; n = 101); 2) a diabetes self-care software on a personal digital assistant (PDA; n = 81); 3) a combination of interventions (CDSMP + PDA; n = 99); or 4) usual care (control; n = 95). Enrollment occurred January 2009-June 2011 at seven regional clinics of a university-affiliated multi-specialty group practice. The primary outcome was change in HbA1c from randomization to 12 months. Data were analyzed using a multilevel statistical model. Read more

Practice Facilitation to Improve Diabetes Care in Primary Care: A Report From the EPIC Randomized Clinical Trial

PURPOSE We investigated 3 approaches for implementing the Chronic Care Model to improve diabetes care: (1) practice facilitation over 6 months using a reflective adaptive process (RAP) approach; (2) practice facilitation for up to 18 months using a continuous quality improvement (CQI) approach; and (3) providing self-directed (SD) practices with model information and resources, without facilitation.