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Diabetes Prevention Initiative
In 2004, DMF funded two diabetes prevention pilots, one at Altru Health Systems in Grand Forks, ND and another at City-County Health in Valley City, ND, to address a growing concern regarding the incidence of diabetes in our region. The purpose of the pilots was to develop and implement a primary prevention program to reduce new cases of type 2 diabetes over the next five years. In 2005, Altru Health Systems received continuation funding for their diabetes prevention program, which included community diabetes screenings, pursuit of third-party payer coverage for group medical and nutritional visits, and lifestyle changes among program participants including weight loss, reduced blood pressure (BP)/fasting blood sugar rates, increased exercise and improved nutrition.
Progress:
- 93 participants to-date, 2 uninsured participants (10 participants have dropped out for various reasons).
- 30% of the two year participants have lost 5 lbs. over two years (5 year goal: 50%)
- 60% of the two year participants have BP of 130/80 or less (5 year goal: 80%)
- 42% of the one year participants have lost 5 lbs (5 year goal: 50%)
- 42% of the one year participants have BP of 130/80 or less (5 year goal: 80%)
- New weight loss strategies are being implemented: an intensive behavior change program will start in 2007 for those failing to meet weight goals, in addition to more meetings with the nutritionist, more involvement of primary care physician and possible referral to the bariatric program.
- New blood pressure strategies implemented: taking BPs at mid-point of session vs. at the beginning; patients monitor BP on their own and working with personal providers to more aggressively manage BP.
- At the two-year point, one patient became pregnant and again developed gestational diabetes and has dropped out of the program. In the second group, at 22 months, none of the patients has progressed to diabetes.
- Since July 2006, 1,446 community people have been screened; 84 were positive for diabetes (6%).
- 42 community presentations were made regarding diabetes; diabetes education also provided to family practice residents.
- Blue Cross Blue Shield (BCBS) North Dakota is providing reimbursement for patients to participate in group medical visits and receive one hour of medical nutrition therapy annually.
- A pilot weight management program funded by BCBS started in February 2007. This is an 18-month program for up to 25 people; BCBS is anticipated to provide $105,750 toward this
program.
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