San Bernardino Diabetes Collaborative

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San Bernardino Diabetes Collaborative

• Roger Chene MPH, RD
• Area Health Promotion Specialist
• California Diabetes Program

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Diabetes is...

• Serious - Chronic condition, there is currently
  no cure. More children now diagnosed with Type 2
  diabetes.
• Common There are now almost 24 million people
  in the U.S. with diabetes.
• Preventable - modest changes in lifestyle can
  prevent diabetes and complications
• Controllable - take charge of your diabetes
• Source National Diabetes Fact Sheet, Centers for
  Disease Control and Prevention, 2005

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Longterm Complications of Diabetes

• Kidney Disease/ Nephropathy damage to blood
  vessels in the kidneys causing kidney failure
• Eye Disease/ Retinopathy damage to vessels in
  back of the eye leading to blindness
• Heart and Blood Vessels causes narrowing of the
  arteries and increases the risk of a heart attack
  or stroke
• Nerve Disease/ Neuropathy nerve damage
  throughout the body. Causes numbness, pain, and
  weakness in the hands, arms, feet, and legs

Sources AADE, CDC and NIDDK
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Source AADE
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Why Focus on Diabetes?

• Diabetes is Costly
• Cost of Diabetes in the United States (2007)
• Total (direct and indirect) 174 billion
• Direct medical costs 116 billion
• Indirect costs (disability, work loss, premature
  death) 58 billion
• Average annual health care costs for a person
  with diabetes 13,243
• Average annual health care costs for a person
  without diabetes 2,560
• California estimates total healthcare and related
  costs of diabetes to be 24.5 billion is spent
  annually in the state
• Source National Diabetes Fact Sheet, Centers for
  Disease Control and Prevention, 2005 2007)

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Why focus on diabetes?

• Diabetes is increasing at epidemic proportions
• It is currently estimated that approximately 23.6
  million persons in the U.S. have diabetes.
• 17.9 million diagnosed
• 5.7 million undiagnosed
• Approximately 7.8 of the total population has
  diabetes
• 1.6 million new cases in people 20 years and
  older in 2007.
• These numbers are up from 18.2 million and 6.3
  total prevalence in 2002 and 20.8 million and
  7.0 in 2005

2005 CDC Diabetes Fact Sheet
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Diabetes in California

• In California, approximately 2.7 million people
  had diabetes in 2007
• This means that nearly 1 out of 10 Californians
  has diabetes, of these 660,000 adults have
  undiagnosed diabetes
• From 1998-2007 the prevalence of diagnosed
  diabetes rose from 5.5 to 7.6, representing a 28
  percent increase in one decade
• In 2007, about 7.9 million adults (29) in CA had
  prediabetes
• (CDC National Diabetes Fact Sheet and
  BRFSS 2007)

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Why focus on diabetes?

• Diabetes disproportionately affects communities
  of color contributing to increased health
  disparities
• African Americans
• Hispanics
• American Indians/Alaskan Natives
• Asian/Pacific Islanders

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Diabetes in California

• Prevalence of diabetes varies by ethnicity (Ages
  18 and over)
• American Indians 9.9
• African Americans 9.3
• Latinos 7.5
• Asians 6.4
• Whites 5.6
• (UCLA Center for Health Policy Research Dec
  2005)

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Diabetes in San Bernardino County

• Nearly 8.0 total prevalence of diabetes
  countywide
• Over 92,000 total individuals
• Latinos 9.1
• Age 46-64 12.0
• Age 65 - 24.0

2005 California Diabetes Program Prevalence
Report
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Why Focus on Diabetes?

• Type 2 diabetes is preventable
• Evidence from multiple studies, including the
  Diabetes Prevention Program (DPP), has shown that
  the onset of type 2 diabetes can be prevented or
  delayed among adults with prediabetes
• The DPP found that lifestyle interventions of
  weight loss and physical activity were more
  effective at preventing diabetes than Metformin

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Prediabetes Prevalence

• 57 million adults age 20 older were estimated
  to have prediabetes in 2007
• 25.9 of persons age 20 older
• 35.4 of persons age 60 older

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Social Determinants of Health and Diabetes

• gt245,000 Adults with diabetes have MediCal over
  250,000 are uninsured
• DM Prevalence is higher among those with a family
  income lt100 of the federal poverty level (9.6)
• DM Prevalence is higher among those with lt9th
  grade education (13.7) compared to those with a
  college degree or higher (4.7)

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How do we manage diabetes?

• In addition persons with diabetes can manage
  their disease through
• Healthy Eating Individualized meal plan
• Regular Physical Activity
• Taking medications as prescribed
• Receiving appropriate medical care health
  education
• Community resources and support

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How do we combat the impact diabetes in our
communities?

• Increase access to healthcare services
• Promote quality in management of diabetes
• Reduce the prevalence of smoking and hypertension
  among persons with diabetes
• Reduce the prevalence of overweight and obesity
  among persons with and at risk for diabetes
• Promote environments that encourage healthy
  lifestyle choices

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Need for Collaboration

• The diabetes and obesity epidemics are exploding
• We can do many things to prevent and control
  diabetes
• Health care entities and communities need to work
  together in a coordinated manner to prevent and
  control diabetes
• Partnerships are essential to achieve desired
  results
• It is critical that we work in a more coordinated
  and organized manner to achieve necessary results

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• Questions?

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Contact

• Roger Chene MPH, RD
• Area Health Promotion Specialist
• Greater Los Angeles Region
• Phone [phone]
• Email rogerchene_at_yahoo.com
• Visit www.caldiabetes.org to find staff in your
  local area