Joslin Diabetes Center Affiliated Programs Highlights October 27, 2008

Welcome  Medical Directors  Center Administrators  Dubai Attendees  Invited Guests

Disease Burden of Diabetes Over 24 million Americans have diabetes 17.5 million diagnosed Cost of Diabetes $174 billion annually (direct and indirect) 32% increase over 2002 Affiliates Challenge in the United States Information from Diabetes Care, March 2008

The Quiet March of the Diabetes Epidemic “Although six of the seven persons, all head of families…living in three adjoining houses…on a peaceful, elm-lined street….in a country town in New England…succumbed to diabetes….no one spoke of an epidemic. Consider the measure which would have been adopted to discover the source of the outbreak to prevent a recurrence….if these deaths had occurred from scarlet fever, typhoid fever or tuberculosis…..Because the disease was diabetes, and because the deaths occurred over a considerable interval of time, the fatalities passed unnoticed”. - Elliott Joslin, 1921

Affiliated Programs - 22 nd Year – 2007 Highlights  20 Contracts  30 Sites  170,000 patient visits in 2007  30,000 new patients visits in 2007  11% increase over 2006  13 states  2 International sites  77 Physicians  21 Nurse Practitioners  111 Educators  2 New Partners for Diabetes Specialty Program at Long-Term Care and Skilled Nursing Facilities (with SUNY & The Hospital of Central Connecticut Affiliate Partners)

2008 Affiliate Domestic Expansion Focus  Network Growth with our existing Affiliate partners  2008 Presentations & Contracts in Negotiation:  Illinois  California  Texas  Florida  Ohio  New Jersey

December 31, Domestic Contracts 4 International Contracts 32 Domestic Sites 6 International Sites 2 SNF Diabetes Specialty Programs INTERNATIONAL SITES Bathurst, NB, Canada Manama, Bahrain Dubai, UAE Chennai, India Network of Centers-Projected December Joslin Diabetes Center Affiliated Programs Single site Multiple sites Upgrade to multiple sites Upgrade to additional sites Contracts in negotiation

2008 Affiliate Domestic Expansion Focus  Skilled Nursing Homes and Long Term Care  Growth of partnerships between our Affiliates and SNF & LTC prospective partners  Metro Marketing Campaign  Comprehensive Materials being finalized for targeted campaign to decisionmakers in Major Metropolitan Markets (20 Cities)  Targeted series of cover letters and informational papers discussing Joslin benefits and services  Consulting Services  Increased requests for Joslin Boston to conduct consulting engagements for existing ADA recognized programs throughout the U.S. -Consulting engagements provide a vehicle for introduction of Joslin team-based approach to prospective Affiliate partners

2008 Affiliate International Projects  Hamed Farooqi, MD, former Medical Director of the Joslin Affiliate in Florida, relocated to Dubai to become Medical Director of the new Joslin Diabetes Center affiliate at the Dubai Health Authority  Agreement has been signed with Agada Health Services in Chennai, India, to begin the process of establishing a Joslin affiliate  Agreement with Partners Harvard Medical International for project in Libya to evaluate current state of care for patients with diabetes

JARS (Joslin Affiliates Reporting System) Mean Results Sites Participating  $~9 million annual net revenue per FTE endocrinologist  8% incremental annual net revenue  $3,000+ per patient  40% increase in patient population  53% increase in incremental patient population

ADA Poster Abstract Demonstration JARS (Joslin Affiliates Reporting System) ROI

2007 Joslin Diabetes Center Clinical Performance Summary

Power of the Brand

The Right Time for Joslin A Testimonial from the CEO of Frisbee Memorial Hospital - NH

Joslin 50 Year Medalists