Disease Management Update
Volume IV, No. 50
April 10, 2008

Dear Healthcare Intelligence Network Client,

Over 20 million Americans have diabetes, and an additional 77 million Americans are "pre-diabetics." Moreover, the prevalence of the disease has more than doubled since the 1980s and is expected to affect 39 million Americans by 2050. More and more organizations are seeing positive results in improving diabetes care coordination through the use of medical homes.

This week's Disease Management Update takes a look at a possible cure for Type 2 diabetes, as well as what the National Institute of Health and the University of Alabama Birmingham are doing to treat, prevent and potentially cure the disease.

Visit HIN's blog to watch our video on the impact of medical homes on diabetes outcomes.

Your colleague in the business of healthcare,
Laura M. Greene
Editor, Disease Management Update

If this is a forwarded copy of Disease Management Update and you like what you see, you can register to receive your own copy of this complimentary service. Sign up at:

Table of Contents

  1. Type 2 Diabetes May Be Caused by Intestinal Dysfunction
  2. Disease Management Q&A: Attracting Patients to Diabetes Medical Homes
  3. HealthSounds Podcast: Improving Outcomes for Diabetes Care
  4. UAB Designated NIH Diabetes Research and Training Center
  5. Survey of the Month: Personal Health Records for Consumers
  6. Changing Lifestyles with DM

1. Type 2 Diabetes May Be Caused by Intestinal Dysfunction

Growing evidence shows that surgery may effectively cure Type 2 diabetes — an approach that not only may change the way the disease is treated, but that introduces a new way of thinking about diabetes. A study from NewYork-Presbyterian Hospital/Weill Cornell Medical Center points to the small bowel as the possible site of critical mechanisms for the development of diabetes. The study's author, Dr. Francesco Rubino, presents scientific evidence on the mechanisms of diabetes control after surgery. Clinical studies have shown that procedures that simply restrict the stomach's size (i.e., gastric banding) improve diabetes only by inducing massive weight loss. By studying diabetes in animals, Dr. Rubino was the first to provide scientific evidence that gastrointestinal bypass operations involving rerouting the gastrointestinal tract (i.e., gastric bypass) can cause diabetes remission independently of any weight loss, and even in subjects that are not obese.

"By answering the question of how diabetes surgery works, we may be answering the question of how diabetes itself works," says Dr. Rubino, who is a professor in the Department of Surgery at Weill Cornell Medical College and chief of gastrointestinal metabolic surgery at NewYork-Presbyterian/Weill Cornell.

To learn more about this study, please visit:

2. Disease Management Q&A: Attracting Patients to Diabetes Medical Homes

Each week, a healthcare professional responds to a reader's query on an industry issue. This week's experts are Roberta Burgess, nurse case manager for Community Care Plan of Eastern North Carolina through Heritage Hospital in Tarboro, N.C., and Dr. James Barr, medical director for Partners in Care.

Question: What types of marketing messages do you find effective in attracting diabetics to the medical home model?

Response: (Roberta Burgess) Something that has been effective in ou area is the health fairs in the community because we have so many rural communities in North Carolina. Often when the churches or the hospitals have a health fair, they sponsor it through the church or it's a community event. Many times if it's a diabetic focus and they're talking about medical homes or conferences, they bring them to their community. That seems to work. It gets them more interested and helps them understand, “Okay, well, it's a little bit more here for me to grasp, and my doctor can’t help with these things.” When they focus, when they take the market and bring it to the community through what they're familiar with, that seems to be effective.

In addition, in just about every piece of information that we send out, even our printed information that comes from the state, the patient is referred to their medical home, not just for diabetes but for their care. Choose your medical home for this and this. Remember your medical home. You have a medical home. So they're hearing it more and more.

(Dr. James Barr) On the physician side, the certification by National Committee for Quality Assurance (NCQA) is something, just as any physician practice could market themselves from the standpoint of various competencies. But being NCQA certified as a patient-centered medical home is something that you could market, and not just to the diabetics. Any patient can benefit from a patient-centered medical home approach. Specifically with my practice, we're starting to educate the patients about the patient-centered medical home and what it means. You have to make sure that when you're marketing this it's not a gatekeeper concept. They're all prey to the terminology. You have to stay far away from the gatekeeper concept. The patient-centered medical home isn't there to stop them from getting care; it's to help them get care and arrange care.

For more information on diabetes medical homes, please visit:

We want to hear from you! Submit your question for Disease Management Q&A to info@hin.com.

3. HealthSounds Podcast: Improving Outcomes for Diabetes Care

In this week's disease management podcast, Partners in Care Medical Director Dr. James Barr and Roberta Burgess, nurse case manager for Community Care Plan of Eastern North Carolina through Heritage Hospital in Tarboro, N.C., provided the inside details on how they have implemented the medical home model to improve outcomes for diabetes care.

To listen to this complimentary HIN podcast, please visit:

4. UAB Designated NIH Diabetes Research and Training Center

The National Institutes of Health (NIH) has designated the University of Alabama at Birmingham (UAB) one of only six Diabetes Research and Training Centers (DRTC) in the country, putting UAB at the forefront in the development of new methods to treat, prevent and, ultimately, cure diabetes and its complications. The NIH award gives UAB $6.3 million over five years to grow its diabetes initiatives.

"The DRTC grant award will enable UAB to play a major role in advancing diabetes research and treatment," said principal investigator W. Timothy Garvey, M.D., professor and chair of the Department of Nutrition Sciences. "Our goals include working to decrease morbidity and mortality associated with diabetes, increasing quality of life for our diabetes patients, providing an outstanding environment for student training, and providing faculty career development in diabetes research."

To find out more about this grant, please visit:

5. Survey of the Month: Personal Health Records for Consumers

Complete our online survey on personal health records for consumers by April 30, and you'll get a free executive summary of the compiled results.

To participate in this survey and receive its results, please visit:

6. Changing Lifestyles with DM

Abandoning behaviors that are detrimental to one’s health is no simple feat. That's why numerous healthcare organizations are launching lifestyle management programs for individuals with life-threatening conditions such as diabetes, heart disease and obesity. This executive summary provides the general character of more than 60 such initiatives, including the differing approaches and techniques in identification, treatment and outcome assessment.

To download this complimentary white paper, please visit:
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