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Team-Based Approach Improves Diabetes Care

Feb 12, 2008

The results of the study over three years confirms that optimal diabetes care requires a team effort.

Due to the success of the first three years of the American College of Physicians (ACP) and the American College of Physicians Foundation (ACPF) Diabetes Initiative, the program has received additional funding from Novo Nordisk Inc. to continue the initiative for an additional two years through December 2009.


“The results of the first three years of our efforts confirm that optimal diabetes care requires a team effort,” says Vincenza Snow, MD, FACP, director of clinical programs and quality of care at ACP.

Launched in 2005 and funded by an unrestricted educational grant from Novo Nordisk, as part of its Changing Diabetes(sm) initiative, the ACP and ACPF Diabetes Initiative offers educational tools and practice-based, team-oriented training for physicians, patients, and health care teams.

The goals of the initiative include increasing awareness of the gap between current practice and acceptable standards of diabetes care among internists; increasing internists’ awareness of what constitutes high quality, evidence-based diabetes care; and providing educational tools to improve diabetes treatment.

To date, 60 team participants from 19 physician practices caring for a total of 1,300 patients have participated in ACP’s “Closing the Gap” module for diabetes, a program that seeks to close the gap between clinical evidence and best practices and the care actually provided in a physician’s office. The practice-based, team-oriented program trains teams – usually an internist, a nurse, and a staff assistant – to improve the quality of care for patients with chronic diseases.

This team-based approach has resulted in statistically significant improvements in many clinical measures such as a nearly 50 percent improvement in the average number of days between patient office visits for diabetes (from 115 days to 58), a 40 percent increase in annual urine albumin testing, a 62 percent increase in annual dilated eye exams (29 percent to 47), and a 100 percent increase in influenza vaccinations (26 percent to 52). Other important improvements were seen in patients’ lipids levels such as lower total cholesterol and LDL cholesterol.

“The Diabetes Initiative on Closing the Gap has proven it is changing diabetes at its most critical stages: the interface between patient and the care delivery team. By assessing the risk for complications or identifying complications earlier, these complications can be checked and treated appropriately, potentially reducing the long-term consequences of diabetes,” said Alan Moses, MD, chief medical officer worldwide for Novo Nordisk A/S.

Last year, ACP and ACPF produced three educational tools for practicing internists, other health care professionals on clinical practice teams, and their patients:

  • “Living With Diabetes: An Everyday Guide for You and Your Family” – a self-management guide designed for patient education and empowerment.
  • “The ACP Diabetes Care Guide” -for use by physicians and multi-disciplinary teams providing care to patients with diabetes.
  • The Diabetes Portal (http://diabetes.acponline.org ( http://diabetes.acponline.org/ )) – a free Web-based resource for physicians and patients that provides tools, resources, and research supporting diabetes care.


DID YOU KNOW: According to the American Heart Association, 75 percent of people who suffer from diabetes will die from some type of heart or blood vessel disease: Heart disease is still the nation’s leading cause of death. The U.S. has seen a drop in mortality rates by 25.8 percent from 1999-2005, below the American Heart Health Association (AHA) expectations, but the obesity epidemic that began over a century ago is working to change all that. AHA president Daniel Jones even “anticipates a new wave of cardiovascular disease deaths” to result from the substantial increase in diabetes. There are studies that suggest people are choosing to eat healthier, quit smoking, and get better health care, but a healthy heart in today’s high-pace society demands more. Studies now suggest that along with high blood pressure, smoking, diabetes, high cholesterol, and family history, work stress and gender are acknowledged as factors in the onset and aggressive nature of heart disease.