1 / 27

DIABETES: THE TSUNAMI IN HEALTH CARE

DIABETES: THE TSUNAMI IN HEALTH CARE. Loretta Hothersall, PhD Family Nurse Practitioner Metabolic Leader. TSUNAMI.

byron
Download Presentation

DIABETES: THE TSUNAMI IN HEALTH CARE

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. DIABETES: THE TSUNAMI IN HEALTH CARE Loretta Hothersall, PhD Family Nurse Practitioner Metabolic Leader

  2. TSUNAMI • Defined as a very large sea wave or harbor wave caused by an earthquake under the sea. It can cause great destruction when it reaches land. The speed of a tsunami is 600m/hr and can travel a distance of over 2000 miles. • So WHY is diabetes compared to a tsunami?

  3. TSUNAMI The answer is the rapid increase in people being diagnosed with this chronic disease and burden placed upon our resources: Impact on society and our future resources Impact on an already burdened health care system Impact on the economical system Impact on the cost of research .

  4. Impact on Society 26 million Americans with DM 79 million with Pre-diabetes ~19 million new cases of diabetes

  5. SOCIETY • Every 17 mins someone is diagnosed with DM • ½ of the population 65 years and older will be diagnosed with DM this year

  6. SOCIETY • By the year 2050 1:3 adults will be diagnosed with DM • 1:3 Children born after the year 2000 will be diagnosed with DM

  7. SOCIETY • 19,000 children will be diagnosed this year with DM (~16,000 with T1DM and ~3,000 with T2DM). They join the ranks of 24,000 children already diagnosed with DM

  8. SOCIETY • GDM: Pregnancy rise 300,000 women per childbearing age • Increase in obesity in children: by 17.3% in ages 2-19 years. Highest in African-American boys, Hispanic Girls and White girls

  9. Society Current Ethnic Percentages • White 7.1% • Hispanic 11.8% • African-American 12.6% • Native American 16.1% • Asian American 25.8% (Asian Indian 17.4% and Asian 8.4%)

  10. Impact on Health Care • Management: 4000 practicing Endocrinologist 1:4700 patients with DM • Increased MD/NP role in management of DM at the primary care level

  11. Health Care • 2010 cost of DM treatment $174 billion. • 2013 $245 billion (41% cost increase).

  12. Health Care • 7th leading cause of death • CVD: 2-4 times higher (CVA) risk factor.

  13. Health Care • CVD: 2-4 times higher death rate. • Hypertension:67% of patients have elevated BP >140/>90 • Retinopathy: 655,000 cases and leading cause of blindness • Neuropathy: 60-70%

  14. Health Care • 44% new cases renal failure • >60% non traumatic LE amputations • 30million adults below basic general literacy level • 88% below the proficient health literacy level

  15. Health Care Maine • Rate DM 8.7% (higher in populations w/o exercise regimens 11.0%) • Rate Pre-DM 3.5% ( 2.6 times higher in people with elevated LP levels and 5 times higher with people with elevated BP). Higher in females 7.0% and males 6.6%

  16. Health Care Maine • Highest Counties: Aroostook and Penobscot 9.4-10.7%. Cumberland lowest 7.0-7.4% • CVD: 1:4 ( 25.6%)

  17. Health Care Maine • LE Amputation: 2.8 per 1000 and lower than national rate 3.5 per 1000 • ESRD: 108.3 per 100,000 and down from 2007 184.6 per 100,000 • Dental: People >45 years of age are 3 times more likely to have severe gum disease • Death adjusted rates: 65.8 per 100,000 down from 71.2 per 100,000

  18. Health Care Maine • Health Visits: Recent patient survey: Of those patients with diabetes, 90.4% reported 1 visit per year for their DM care • A1c: 2 in past 12 months 78% • Eye exam: (within the ADA recommended yearly exam)75.9% • Education: 60.7% patients with DM received education and training

  19. Health Care Maine • Daily Foot Checks: 61.2% of patients with DM perform daily foot evaluations • Foot Exams: 60.3% have their feet checked at every office visit

  20. Health Care Maine • So how is that being corrected? Quality control improvement (EMR) and insurance reimbursement.

  21. Health Care Maine • 65+ age group: • diagnosed with DM 17.8% • diagnosed Pre DM 11.7% • Hospitalizations: DKA: 3.9/10,000

  22. Health Care Maine Hospitalizations: • DKA: 3.9/10,000. • CVD: 40.8/10,000. • Infections: higher in males 2.8/10,000 • Clustered more in the northern and eastern areas of the state

  23. Health Care Maine Male vs Female: • Males 14.5/10,000 likely to be hospitalized • Female 9.9/10,000 likely to be hospitalized

  24. Health Care Maine Age Related Rates: • 34-64 years of age 2 times more likely • 65 + years of age 4 times more likely Loss in work days: • 1/3 of all work days (13.8 days/year), cost $ 3700-$8700

  25. Research • $137.3 million for the Division of Diabetes Translation (access to DM self-management education and support health programs) • $20million for the National Diabetes Prevention Program ( community life style changes through weight loss programs, meal planning and physical activity through insurance reimbursement and employer sponsored health benefits: cost $400 per participant)

  26. Research • Development of new treatment modalities: Medications: IncretinFactors (Glip-1 and DPP4). SGLT2 (Sodium-glucose co-transporter 2). Combination medication

  27. Research Insulin: inhaled, oral. Analogs: current therapy vs past therapy U200, U300, U500 Pumps: 530G with Enlite, Sensors. Bionic Pancreas

More Related