New Emory Partnership Announced to Educate and Improve Access to Care for Atlanta-area Minorities with Diabetes

AADE, Emory University and Johnson & Johnson Diabetes Institute Partner to Educate and Improve Access to Care for Atlanta-area Minorities with Diabetes


/PRNewswire/ -- The American Association of Diabetes Educators (AADE) today announced the launch of an Atlanta-based program aimed at improving self-management of diabetes among minority populations. In partnership with Emory University's Latino Diabetes Education Program and the Johnson & Johnson Diabetes Institute, the program aims to advance diabetes education in Hispanic and African American populations and to improve clinical and behavioral outcomes. The announcement was made at the Association's annual meeting.

The program will be offered in the Chamblee neighborhood, which is served by the North DeKalb Health Clinic. The clinic is part of the satellite neighborhood network of clinics of Grady Health System in the Metro Atlanta area. Emory's Latino Diabetes Education Program is already serving the Latino community in this area, and will partner with Grady and AADE to implement this minority-specific model.

The "Increasing Access to Diabetes Self-Management Education as a Means of Decreasing Health Disparities in Minority Populations" project aims to:

-- Ensure high quality and culturally appropriate services for people
with diabetes by involving different members of the disease management
team including: physicians, educators, health promoters/community
health workers and other health care professionals.
-- Teach the basics of diabetes self management to populations often
lacking in education and community-focused support.
-- Build upon local program capacity to achieve desired clinical and
behavioral outcomes.

Individuals from minority communities that participate in this program will receive support and tools that will empower them to:

-- Improve their health and clinical outcomes.
-- Change behaviors, set goals and gain problem solving and healthy
coping skills.
-- Learn how to navigate the health care system to increase adherence to
evidence-based guidelines and reduce high-cost emergency department
utilization.

"This program is unique in that it promotes a team approach to diabetes care. Each member of the team -- physician, diabetes educator and community health worker -- supports and builds upon one another's work," said AADE President Marcia Draheim, RN, CDE. "Success will be measured by many factors including clinical improvements, behavioral outcomes, participation and patient satisfaction with the program."

Emory University School of Medicine and Grady Health System have been serving Latinos with diabetes through the Emory Latino Diabetes Education Program. "The program started over three years ago and has reached more than 750 Latinos with diabetes and their families," said Amparo Gonzalez, RN, CDE, director of the program. "This grant offers the opportunity to apply the successes and experiences that the Emory Latino Diabetes Education has had had with Latino community to the African American community."

The program is sponsored through a grant from the Johnson & Johnson Diabetes Institute.

Facts about Diabetes in Minority Populations

Diabetes disproportionately affects minority individuals, who comprise a significant segment of the U.S. population. For example, according to the U.S. Census Bureau, Latinos represent the United States' largest minority group making up 14.8% of the population or 43 million people.

According to the Centers for Disease Control and Prevention:
-- Non-Hispanic whites: 14.9 million, or 9.8% of all non-Hispanic whites
aged 20 years or older, have diabetes.
-- Non-Hispanic blacks: 3.7 million, or 14.7% of all non-Hispanic blacks
aged 20 years or older, have diabetes.

Moreover, health disparities are increasing in the U.S. Individuals in African American and Hispanic neighborhoods, in particular, face many barriers to achieving successful self-management of their diabetes. These barriers are attributable to structural factors (e.g., lack of sidewalks or access to food stores with affordable produce) as well as the cultural, socio-economic, and literacy characteristics of the people living there.

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Savannah City Leaders Launch Medicare Diabetes Screening Project

/PRNewswire/ -- Senator Lester Jackson III (D - 2nd District), Diane Weems, MD, Chief Medical Officer of the Coastal Health District, Charles Powell, Executive Director, Community Cardiovascular Council, and Loretha Jenkins, Program Coordinator, Coastal Area Agency on Aging, gathered today to urge all Savannah area seniors to learn more about their personal risk for diabetes. Together, they launched the Medicare Diabetes Screening Project (MDSP) in Savannah before a crowd gathered at the W. W. Law Senior Center. On a national level, the MDSP is co-chaired by the American Diabetes Association, the Health Care Leadership Council, and Novo Nordisk, and is supported by more than 20 organizations representing the interests of seniors and health care providers.

"When diabetes is undiagnosed and untreated, it can be devastating, and new government statistics show that our senior citizens are especially vulnerable," said Sen. Jackson. "That's why I am proud to announce the start of the Medicare Diabetes Screening Project in Savannah."

According to a study in the February 2009 issue of Diabetes Care, 32% of adults ages 65 and older have diabetes. What's more, almost half (46%) of those seniors with diabetes don't know they have it - they have not been diagnosed. In addition to those with diabetes, another 40% of adults ages 65 and older have pre-diabetes, putting them at very high risk of developing diabetes and heart disease, and it is likely that most of them are unaware of their status. When these statistics are applied to Chatham County, it is estimated that approximately 4,600 seniors ages 65 and older have undiagnosed diabetes, and an additional 12,500 seniors ages 65 and older have pre-diabetes.

"These statistics show why it is crucial that we create awareness of the benefits that Medicare offers for diabetes screening, and motivate our seniors to ask their health care providers about being tested for diabetes," said Loretha Jenkins of the Coastal Area Agency on Aging.

"Since 2005, Medicare has offered benefits for diabetes screening, but usage of these benefits has been minimal," said Charles Powell, Executive Director of the Community Cardiovascular Council, "and usage rates for Chatham County are particularly worrisome."

Nationally, the rate of usage was 9.6% for all of 2006 (the most recent Medicare data available at www.cms.hhs.gov). Usage rates in Georgia were substantially lower, at 6.8%; the rate for Chatham County, at 4.0%, was significantly lower still.

For people who are ages 65 and older and have one risk factor for diabetes, Medicare offers a free diabetes-screening test in a health care provider's office, with no deductible and no co-pay. If seniors are found to have pre-diabetes, they are eligible for another free screening in six months.

To encourage use of these benefits, the Medicare Diabetes Screening Project was conceived and launched in 2007 in Columbus, Georgia. City and community leaders in Columbus developed a model for public awareness and outreach, and that model is being adapted for implementation here in Savannah.

"Savannah elected officials and other leaders from the community immediately saw the need for the Project," said Chatham County Health Department Administrator Dr. Diane Weems, "and we have quickly developed ideas and networks for reaching out to seniors and their health care providers with messages of what Medicare offers for diabetes screening. This type of collaboration represents the best of Savannah."

The MDSP will reach out to Savannah-area primary care providers, to complement public awareness activities and directly inform them and their staff members about the MDSP and the screening benefits that Medicare offers their patients.

Also planned are a series of educational seminars at local senior centers and other community locations, to be coordinated and implemented by the Coastal Area Agency on Aging.

The most currently-available estimates from the Centers for Disease Control and Prevention (CDC) show that the prevalence of diabetes is 25% higher in the state of Georgia as compared to the national average (10% versus 8%, respectively). The CDC also estimates that 10.7% of all adults ages 20 and older in Chatham County have diabetes.

The Medicare Diabetes Screening Project in Savannah is a community-based effort to reach and motivate seniors who have undiagnosed diabetes or pre-diabetes, and encourage them to see their doctors or other health care providers, and take advantage of the free diabetes screening benefits offered by Medicare. To learn more, visit www.screenfordiabetes.org.

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One in Five Augustans With Type 2 Diabetes Mistakenly Believe That Being Obese or Overweight Can Positively Impact Their Disease

/PRNewswire/ -- Taking Control of Your Diabetes (TCOYD) announced findings today from a recent survey conducted by national research firm Yankelovich that found that more than one in five Augustans with type 2 diabetes mistakenly think that excess weight has a positive effect on the disease. In fact, research shows that being overweight often contributes to the development of diabetes, complicates proper management of the disease and can lead to other serious conditions, including blindness, kidney damage and cardiovascular disease.

Survey findings also revealed that the recession is taking a negative toll on how Augustans manage their diabetes. One in four have reduced their level of diabetes care to save money, either by limiting treatment supplies, skipping doctor visits or taking medications less often, which can all lead to significant long-term health risks.

"These findings underscore the need for more education on the importance of proper diabetes management, including the impact of weight, in Augusta and the variety of options available to them," said Dr. Steven Edelman, physician, author and founder of TCOYD.

The survey, which assessed the behaviors and attitudes of Augustans with type 2 diabetes, was commissioned by TCOYD, a not-for-profit 501(c)3 diabetes education organization that offers programs to inform, motivate and empower participants to take control of their diabetes. TCOYD is also holding a diabetes education conference that will help Augustans with diabetes and their loved ones learn how to better manage the disease. The conference and health fair, taking place on Feb. 28, 2009 from 10 a.m. to 4 p.m. at the Augusta Marriott, will feature national and local medical experts in diabetes care discussing the latest developments in the treatment of diabetes, the complications of the disease, psychological barriers to controlling diabetes and nutritional issues.

The survey also found that many Augusta residents with type 2 diabetes struggle with managing their weight because of a lack of knowledge of their disease and available treatment options, as well as local challenges specific to Augusta. Survey results include:

* Seventy-nine percent of survey respondents describe themselves as
overweight, and 81 percent say that their doctor has told them to lose
weight to better manage their disease
* Seventy-one percent are aware that there are diabetes medications that
cause weight gain, but almost half are currently taking these
medications. A startling 77 percent are unaware that there are diabetes
medications that can help people lose weight



"These survey findings show that many Augusta residents with type 2 diabetes are unclear on how to manage their disease and do not have the educational and economic resources to make healthy choices," said Dr. Charles Shaefer, Clinical Assistant Professor of Medicine at the Medical College of Georgia. "It is vital that Augustans receive the necessary information and resources to take care of their health and prevent serious related conditions."

Both diabetes and obesity are growing national epidemics, affecting millions in the United States and worldwide. Recognizing the impact of these and other chronic diseases on the American healthcare system, the new Obama administration is making them a primary health focus. These diseases also have a significant impact in Richmond County, where more than 10 percent of the population has diabetes and more than 30 percent are obese. With so many Augusta residents affected by these diseases, it is vital to understand the best way to manage them.

Pre-registration for the conference is recommended and is $15 per person. On-site registration begins Feb. 28, 2009 at 9 a.m., and costs $20. Financial assistance is available by calling TCOYD. To register or get more information, call (800) 998-2693 or visit http://www.tcoyd.org/.

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New CDC Study Finds Community Physical Activity Programs Are Money Well Spent

Community-based physical activity interventions designed to promote more active lifestyles among adults are cost-effective in reducing heart disease, stroke, colorectal and breast cancers, and type 2 diabetes, according to a study by the Centers for Disease Control and Prevention, with support from the Robert Wood Johnson Foundation.

Using a rigorous economic model developed to assess the cost-effectiveness of community-based physical activity interventions, the study found these interventions to be cost-effective; reducing new cases of many chronic diseases and improving quality of life.

Researchers found that community-based physical activity programs appeared to reduce new cases of disease by: 5-15 cases per 100,000 people for colon cancer; 15-58 cases per 100,000 for breast cancer; 59-207 cases per 100,000 for type 2 diabetes; and 140-476 cases per 100,000 for heart disease.

Community-based physical activity interventions broadly fall under the following strategies:

-- Community campaigns such as mass communication efforts (TV/radio,
newspapers, billboards, advertisements).
-- Social support networks such as exercise groups to encourage behavior
change.
-- Tailored behavior change to encourage people to set physical activity
goals and monitor their individual progress.
-- Enhanced access to services that support active lifestyles such as
fitness centers, bike paths and walking trails.


"Our study found that public health strategies that promote physical activity are cost effective, and compared with other well-accepted prevention strategies, such as treatment for high cholesterol or motor vehicle air bags, offer good value for the money spent," said Larissa Roux, M.D., Ph.D., lead author of the study.

The study, "Cost Effectiveness of Community-Based Physical Activity Intervention," is being published in the online version of the American Journal of Preventive Medicine.

"This study supports the value and effectiveness of the physical activity interventions that were studied," said William Dietz, M.D., Ph.D., director of CDC's Division of Nutrition, Physical Activity and Obesity. "This study also shows the importance of the new physical activity guidelines put forth last month by the U.S. Department of Health and Human Services."

The HHS guidelines recommend:
-- Two and a half hours each week of moderate-intensity aerobic activity,
such as brisk walking or,
-- An hour and 15 minutes each week of vigorous-intensity aerobic
activity such as jogging or running.


In addition, all adults should include muscle strengthening activities that work all the major muscle groups on two or more days per week.

CDC's Division of Nutrition, Physical Activity and Obesity funds programs in 23 states designed to prevent obesity and promote healthy lifestyle habits such as physical activity.

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Columbus Medicare Diabetes Screening Project Cited as Model for State by Lt. Governor Casey Cagle

PRNewswire/ -- Lt. Governor Casey Cagle today applauded the design and implementation of the Medicare Diabetes Screening Project (MDSP) in Columbus, citing it as a model for other cities in Georgia and around the country. He made his remarks at the Columbus Summit, a meeting hosted by the Columbus Research Foundation and the Columbus Medicare Diabetes Screening Project, designed to enlist other Georgia cities to adopt the innovative outreach effort in Columbus that has created a model for promoting diabetes screening for adults aged 65 and older.

"There is no greater health challenge in Georgia than the fight against diabetes," said Lt. Gov. Cagle. "The Columbus Medicare Diabetes Screening Project has developed an effective and powerful model for encouraging senior citizens to get screened and to work with their health care providers to prevent or better manage their diabetes. This model should be adopted by other Georgia cities to help our seniors win the fight against diabetes."

Since July 2007, leaders of the Columbus MDSP have conducted a variety of activities to increase awareness of the benefits Medicare offers to adults age 65 and older for free screening for diabetes. These leaders shared their strategies and accomplishments today with their counterparts from Albany, Augusta, Gainesville, Macon and Savannah, who had been invited to participate in this statewide launch of the MDSP.

Medicare beneficiaries at risk for diabetes are eligible for free, annual diabetes screenings from their health care provider. Although as many as 60% of Medicare beneficiaries are at risk for diabetes and should be screened, less than 10% of beneficiaries nationally used the free diabetes screening benefit in 2006, according to the most recently available data. In Georgia, just 6.8% of beneficiaries were screened in 2006.

The MDSP in Columbus has engaged citizens through a variety of awareness-raising and informational activities, including an event at the Columbus Civic Center, distribution of information in church newsletters, displays at shopping centers and health fairs, risk assessments at local fire stations, and advertisements on television and radio.

"A diverse group of public and private city leaders came together, worked hard, and delivered the message of free Medicare diabetes screening to the senior citizens of Columbus and health care providers," said Columbus Mayor Jim Wetherington, as he welcomed the assembled crowd. "Our work in Columbus can serve as a model for how you might implement the Project in your communities."

The Mayor was followed by Dr. William Rowley, the Chief Operating Officer and a Senior Futurist at the Institute for Alternative Futures, who made a compelling case for the potentially devastating impact of diabetes on America and Georgia in the coming decades, and why we need programs such as the Medicare Diabetes Screening Project to help stem the relentless tide of this disease.

Steven Leichter, MD, FACP, FACE, Medical Director of the Columbus Research Foundation, then explained the details of the benefits Medicare offers for diabetes screening, and why their use is vital to helping identify older adults with undiagnosed diabetes or pre-diabetes. "It's critical that we get more of our seniors to use their free Medicare screening benefits," said Dr. Leichter, "so that we can help find those who have diabetes or pre-diabetes but don't know it. Screening and diagnosis is the essential first step to prevent diabetes for those at risk or to better manage diabetes for those who may already have the disease."

After watching a new video about the Columbus MDSP, participants at the Columbus Summit witnessed a lively panel discussion that included the perspectives of four local Columbus leaders who have worked with MDSP: Renee Adamson, Region 3 President, Georgia Pharmacy Association; the Rev. Dr. Johnny Flakes, 4th Street Missionary Baptist Church; Mike Gaymon, President, Columbus Chamber of Commerce; and Jeff Meyer, Chief of the Columbus Department of Fire and Emergency Services.

Later in the forum the assembled community leaders from Albany, Augusta, Gainesville, Macon and Savannah joined with their counterparts from Columbus in small group work sessions, where they asked questions, brainstormed ideas for activities, and planned how they might implement the MDSP in their communities. At the end of the day, Lt. Governor Cagle gave the charge to participants to take what they had learned and work to promote diabetes screening for Medicare-aged residents of their own cities.

The Medicare Diabetes Screening Project in Columbus is a community-based effort to reach and motivate the estimated 12,000 seniors who have undiagnosed diabetes or pre-diabetes to see their doctors and take advantage of the free diabetes screening benefits offered by Medicare. Locally in Columbus, efforts have been led by the Columbus Research Foundation. On a national basis, the MDSP is co-chaired by the American Diabetes Association, the Healthcare Leadership Council, and Novo Nordisk Inc., and includes more than 20 organizations representing patients, health care providers, older adults, businesses and government. It is the first and only program designed to increase awareness and promote use of the largely unused, free screening benefits that Medicare offers for diabetes and pre-diabetes. Information is available at www.screenfordiabetes.org.

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New Cases of Diagnosed Diabetes on the Rise

The rate of new cases of diagnosed diabetes rose by more than 90 percent among adults over the last 10 years, according to a study by the Centers for Disease Control and Prevention (CDC).

The data, published in CDC′s Morbidity and Mortality Weekly Report, show that in the past decade, the incidence (new cases) of diagnosed diabetes has increased from 4.8 per 1,000 people during 1995-1997 to 9.1 per 1,000 in 2005-2007 in 33 states.

“This dramatic increase in the number of people with diabetes highlights the increasing burden of diabetes across the country,” says lead author Karen Kirtland, Ph.D., a data analyst with CDC′s Division of Diabetes Translation. “This study demonstrates that we must continue to promote effective diabetes prevention efforts that include lifestyle interventions for people at risk for diabetes. Changes such as weight loss combined with moderate physical activity are important steps that individuals can take to reduce their risk for developing diabetes.”

The study used data from CDC′s Behavioral Risk Factor Surveillance System, and provides incidence rates of diabetes for 43 states and two U.S. territories. Only 33 states had data for both time periods, but 43 states collected data in 2005-2007.

State-specific, age-adjusted estimates of new cases of diabetes ranged from 5 per 1,000 people in Minnesota to 12.7 per 1,000 in West Virginia. The number of news cases was highest in Puerto Rico at 12.8 per 1,000. States with the highest age-adjusted incidence were predominately Southern states: Alabama, Florida, Georgia, Kentucky, Louisiana, South Carolina, Tennessee, Texas and West Virginia.

“This report documents the geographic distribution of new cases of diabetes and is consistent with previous studies showing an increase in new diabetes cases,” said Kirkland. “We must step up efforts to prevent and control diabetes, particularly in the Southern U.S. region where we see higher rates of diabetes, obesity and physical inactivity.”

CDC, through its Division of Diabetes Translation, funds diabetes prevention and control programs in all 50 states, including the District of Columbia, and seven U.S. territories and island jurisdictions. The National Diabetes Education Program, co-sponsored by CDC and the National Institutes of Health, provides diabetes education to improve treatment for people with diabetes, promote early diagnosis and prevent or delay the onset of diabetes.

For more information about diabetes, visit www.cdc.gov/diabetes. The MMWR report is available at www.cdc.gov/mmwr.

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UGA Kinesiology Researcher Receives $1.7 Million NIH Grant to Explore Use of Electric Stimulation of Muscles as Tool Against Diabetes

University of Georgia researchers who have developed a treatment that improves blood sugar levels in paraplegics, reducing their risk of becoming diabetic, are now asking if the same method can help treat or even reverse the condition in paraplegics who already have diabetes.

Kevin McCully, a professor in the College of Education’s department of kinesiology, is principal investigator of the study which has received a $1.7 million grant from the National Institutes of Health to follow up on a discovery that may offer a solution to people with paralysis who developed diabetes as a result of their injury.

“We’re pretty excited about this. It’s an important health problem.” said McCully, director of the Exercise Vascular Biology Laboratory in the Ramsey Center.

The hopeful results were an unexpected discovery made by McCully and the late UGA Distinguished Research professor Gary Dudley. The scientists initially used electrical stimulation as a way of exercising leg muscles that their subjects could no longer flex, or even feel, believing that strength training can help people with complete paralysis—those who are completely unable to move their legs—improve their cardiovascular health.

“What we found was yes indeed, we could resistance train them,” said McCully. “Their muscle size increased and their blood flow improved.”

But while monitoring the subjects’ oral tolerance to glucose, using a simple test that can show whether a person is likely to develop diabetes, the researchers made an exciting discovery. They found that the strength training dramatically improved glucose sensitivity, greatly reducing the study participants’ chance of getting diabetes.

Improvements in medical care have made it possible for paraplegics to live much longer than they would have in the past. However, living longer lives means they also must wrestle with common health problems other populations often face.

Diabetes, the sixth leading cause of death in the United States, is related to the pancreas, an organ near the stomach that produces a hormone called insulin. In people with diabetes, the pancreas doesn’t produce enough insulin or their bodies aren’t able to use the insulin properly, which can lead to serious complications such as kidney failure, heart disease and blindness.

“People who are paralyzed are three to four times more likely to become diabetic,” said McCully. “So it’s an important health problem, and our continuation is to follow up on that.”

The high-tech treatment is surprisingly simple. By attaching electrodes to paraplegics’ thighs from small battery-operated current generators and sending a mild electric current into the legs, the nerve endings are stimulated, generating force and expending energy the same way a muscle would contract in a non-paralyzed person.

The upcoming study is part of a nearly decade-long collaborative effort between UGA and the Shepherd Spinal Center in Atlanta. College of Education faculty members Lesley White, an associate professor in kinesiology, and Stephen Olejnik, a professor of educational psychology, are co-investigators.

Dudley forged an alliance between UGA and the Shepherd Center in the late 1990s, where he himself was taken for rehabilitation following a catastrophic car accident in 2002. A year later, he was back in the classroom, defying predictions that he would live in a nursing home the rest of his life. Dudley worked at NASA and the University of Ohio before joining the UGA faculty in 1993, where he was named a Distinguished Research Professor and awarded the prestigious Creative Research Medal. He passed away in 2006 following a long battle with cancer.

McCully, who studies effects of aging and disease on muscle metabolism and functional capacity, was named a Fellow of the American Academy of Kinesiology and Physical Education in 2007. He joined the UGA faculty in 1999 from the Medical College of Pennsylvania and Hahnemann University. He received his Ph.D. in physiology from the University of Michigan.

By Catharin Shepard