1. HEALTHY PEOPLE 2020: DIABETES By Jazzy, Abby, and Caley

2. Healthy People Objectives D-1 Reduce the annual number of new cases of diagnosed diabetes in the population D-14 Increase the proportion of persons diagnosed with diabetes who receive formal diabetes education D-15 Increase the proportion of persons with diabetes whose condition has been diagnosed D-16 Increase prevention behaviors in persons at high risk for diabetes with prediabetes 1

3. What is diabetes? When you eat, your body turns food into sugars, or glucose. At that point, your pancreas is supposed to release insulin. Insulin serves as a “key” to open your cells, to allow the glucose to enter -- and allow you to use the glucose for energy. But with diabetes, this system does not work. Type 1 Type 2 2

4. Who has it? Why do we care? DM affects an estimated 23.6 million people in the United States Is the 7th leading cause of death increase risk of heart disease by 2 to 4 times Lowers life expectancy by up to 15 years Leading cause of kidney failure, lower limb amputations, adult onset blindness Lowers life expectancy by up to 15 years.

5. Are you at risk? Who should be tested? Anyone over 45 should consider getting tested for diabetes. People younger than 45 should get tested who are overweight or obese and have one or more following risk factors ● Modifiable ● Non-Modifiable ● Socially Determined

6. Does Diabetes target Populations Differently? Socially determinant of diabetes Migrant workers Reservations Geographical correlation

7. http://www.cdc.gov/diabetes/atlas/obes ityrisk/atlas.html

8. Local Goal: Reduce the annual number of new cases of diagnosed diabetes in the population -CDC states age-adjusted incidence rate in every 1000 individuals in whatcom county is currently 7.1% - For the years of 2004-2012 (the most current/accurate data) it suggests that our rates of diabetes have gone down slightly from age-adjusted incidence rate of 8.3 in 2004 to 7.1 in 2012

9. How to Diagnose Diabetes

10. Costs/Diagnosis Insurance interfaith/unity care can charge Medicaid insurance for diabetes ed. Some insurance companies will cover costs for life coach and Peacehealth services depending on provider Diagnosing New Cases endocrinologists diagnose cases of diabetes (in bellingham we have 2 endocrinologists)

11. Whatcom County Prevention Organizations Local Organizations that have Diabetes Programs: Peacehealth Nutrition and Diabetes clinic Washington State University - Food Sense Program Diabetes Prevention Coordinator (Life Coach) Beth Schramer - Pre-diabetes Program Online information through Washington DOH and CDC Public Diabetes Information Meeting the first wed of each month - Peacehealth

12. Washington

13. Diagnosing New Cases 8% of the state’s population 4,600 youth with diabetes CDC estimates about 172,000 people are undiagnosed Diabetes Tests Worksheet→ Prediabetes interventions $120,000 annually on DPP

14. Prevention 1 in 3 Washington residents have prediabetes 25 diabetes prevention programs Diabetes Prevention and Control Program Diabetes Connection Worksite Wellness Healthcare Partners Data and Publications Diabetes Epidemic and Action Report

15. Education 60 diabetes education programs approved by Medicaid for reimbursement WADE self-learning focus Stop Diabetes Initiative Evergreen Health inpatient diabetes care Diabetes and endocrinology services Diabetes Education and Nutrition Services

16. Costs Diabetes in Washington led to direct medical expenditures of $3.75 billion in 2012 Increase to $5.39 billion (in 2012) 10 years from now The annual diabetes-attributable cost per person with type 1 or type 2 diabetes in Washington was $8,527

17. National Level

18. Diagnosing Nationally ○ 17.9 million diagnosed…5.7 million are undiagnosed ○ undiagnosed cases are extremely dangerous ○ diagnostic testing vs. screening ○ HP2020 ↓

19. Prevention NIDDK- National Institute of Diabetes and Digestive and Kidney Disease Intramural vs. extramural Diabetes Prevention Program (DPP) national controlled clinical trial lifestyle changes show real result

20. Prevention is Easier Than Management -goal of community health workers -prevention of diabetes has three facets -increase physical activity -losing body weight -reducing caloric intake

21. Prevention Through Education National Diabetes Prevention Program (NDPP): an evidence based behavioral change program → Find a program in your area National Diabetes Education Program (NDEP): Works with partners to reduce burden of disease by adopting of proven approaches → BRFSS

22. Change is not easy…. but it’s better when it’s fun Recipes Grocery shopping tips and meal planning Alternative Exercises Salsa CD in spanish Prevention pamphlets in all languages Work specific programs

23. Thank you for listening! ANY QUESTIONS