Diabetes mellitus is a significant health burden in the United States, affecting more than 20 million people and costing more than $100 billion annually. The prevalence of Type 2 diabetes (or T2DM as the medical clinicians refer to it) is growing rapidly; the CDC estimates that up to a third of Americans will have diabetes by the year 2050. The burden of Type 2 diabetes is particularly great among ethnic minority populations and those of lower socioeconomic status.
 
Here in the Central San Joaquin Valley of California, 3 out of the 5 counties (Fresno, Merced and Kern) have among the highest incidence and prevalence rates in the whole state, reaching as high as 9.4% of the population. And a 2016 study by the UCLA Center for Health Policy Research estimated the pre-diabetes rate in the Valley at 47% and as high as 68% among those aged 55-69 living in Fresno County.
 
Diabetes prevention care varies among populations
The evidence base for the prevention and care of Type 2 diabetes is one of the most well-established of any chronic illness. Clinical trials have shown the efficacy of cardiometabolic therapies in preventing mortality and morbidity in diabetes, and programs such as the Diabetes Prevention Program (DPP) have demonstrated that diabetes can be prevented in high-risk patients.
 
However, the overall quality of care for diabetes remains sub-optimal and significant disparities in diabetes care and prevention persist, especially in the Central Valley. Programs that can effectively translate high-quality, evidence-based diabetes prevention and treatment into widespread practice are desperately needed.
 
PACER grant coordinates care around diabetes
Here at the Deran Koligian Ambulatory Care Center on the Community Regional Medical Center campus, the primary care departments of Internal Medicine, Pediatrics and Family Medicine, along with Psychiatry, Nursing and Pharmacy, were recent recipients of something called the PACER grant. PACER stands for Professionals Accelerating Clinical and Educational Redesign and other national recipients of this grant include prestigious institutions such as the Mayo Clinic and University of Colorado. The goal of PACER is to catalyze meaningful change in preparing the primary care workforce through faculty and staff development that involves the requisite competencies to transform primary care training models and practices.
 
On their site visit to Community Regional and UCSF Fresno six months ago, the organizers of the grant wrote that, besides the different inter-professional redesign efforts we have initiated at the clinics, they recommended a unifying quality improvement (QI) project or topic. Hence, we started the diabetes QI initiative, since we agreed that it is a diagnosis that crosses all 6 departments at the Ambulatory Care Center.
 
Join us for diabetes lecture on Sept. 5
We believe a great way to jumpstart this effort is the upcoming Diabetes QI in Primary Care lecture series on Sept. 5, 2017 from 8:00-10:00 at the UCSF Fresno Auditorium and Room 137. All faculty, residents and students of the UCSF Fresno teaching program are invited as well as Community Medical Centers’ allied health professionals, administrators and clinical staff. Breakfast is provided in Room 137 courtesy of Community Regional.

Dr. Dominic Dizon