Announcement: Diabetes Program Manager (Grade 22) position

Good news on new job opportunities in the Bureau of Tobacco & Chronic Disease.  The Bureau of Tobacco and Chronic Disease has received approval to fill the Diabetes Program Manager (Grade 22) position.   The Diabetes Program Manager will work directly with our partners and other stakeholders on projects that build a strong statewide collaboration while achieving the goals of the diabetes program.  

Tim Vaske will be taking the lead on filling the position and will work with both internal and external partners on assessing candidates.  More detailed information can be found on www.azstatejobs.gov

We ecourage you to share this information with your community partners, networks, etc.

NIH study finds interventions to prevent type 2 diabetes give good return on investment

Programs to prevent or delay type 2 diabetes in high-risk adults would result in fewer people developing diabetes and lower health care costs over time, researchers conclude in a new study funded by the National Institutes of Health.

Prevention programs that apply interventions tested in the landmark Diabetes Prevention Program (DPP) clinical trial would also improve quality of life for people who would otherwise develop type 2 diabetes. The analysis of costs and outcomes in the DPP and its follow-up study is published in the April 2012 issue of Diabetes Care and online March 22 at http://diabetes.org/diabetescare.

The DPP showed that lifestyle changes (reduced fat and calories in the diet and increased physical activity) leading to modest weight loss reduced the rate of type 2 diabetes in high-risk adults by 58 percent, compared with placebo. Metformin reduced diabetes by 31 percent. These initial results were published in 2002. As researchers monitored participants for seven more years in the DPP Outcomes Study (DPPOS), they continued to see lower rates of diabetes in the lifestyle and metformin groups compared with placebo (www.nih.gov/news/health/oct2009/niddk-29.htm). Lifestyle changes were especially beneficial for people age 60 and older.

The economic analysis of the DPP/DPPOS found that metformin treatment led to a small savings in health care costs over 10 years, compared with placebo. (At present, metformin, an oral drug used to treat type 2 diabetes, is not approved by the Food and Drug Administration for diabetes prevention.) The lifestyle intervention as applied in the study was cost-effective, or justified by the benefits of diabetes prevention and improved health over 10 years, compared with placebo.

“Over 10 years, the lifestyle and metformin interventions resulted in health benefits and reduced the costs of inpatient and outpatient care and prescriptions, compared with placebo. From the perspective of the health care payer, these approaches make economic sense,” said the study’s lead author William H. Herman, M.D., M.P.H., a co-investigator of the DPP Research Group and director of the Michigan Center for Diabetes Translational Research, Ann Arbor.

The DPP enrolled 3,234 overweight or obese adults with blood sugar levels higher than normal but below the threshold for diabetes diagnosis. Participants were randomly assigned to a lifestyle intervention aimed at a 7 percent weight loss and 150 minutes per week of moderate intensity activity, metformin treatment, or placebo pills. The groups taking metformin or placebo pills also received standard lifestyle recommendations.

“We don’t often see new therapies that are more effective and at the same time less costly than usual care, as was the case with metformin in the DPP. And while the lifestyle intervention was cost-effective, we would see greater savings if the program were implemented in communities,” said Griffin P. Rodgers, M.D., director of the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). “This has already been demonstrated in other NIDDK-funded projects, including one in YMCAs, where a lifestyle-change program cost $300 per person per year in a group setting, compared to about $1,400 for one-on-one attention in the DPP.”

In the DPP, direct costs over 10 years per participant for the lifestyle and metformin interventions were higher than for placebo ($4,601 lifestyle, $2,300 metformin, and $769 placebo). The higher cost of the lifestyle intervention was due largely to the individualized training those participants received in a 16-session curriculum during the DPP and in group sessions during the DPPOS to reinforce behavior changes.

However, the costs of medical care received outside the DPP, for example hospitalizations and outpatient visits, were higher for the placebo group ($27,468) compared with lifestyle ($24,563) or metformin ($25,616). Over 10 years, the combined costs of the interventions and medical care outside the study were lowest for metformin ($27,915) and higher for lifestyle ($29,164) compared with placebo ($28,236). Throughout the study, quality of life as measured by mobility, level of pain, emotional outlook and other indicators was consistently better for the lifestyle group.

“The DPP demonstrated that the diabetes epidemic, with more than 1.9 million new cases per year in the United States, can be curtailed. We now show that these interventions also represent good value for the money,” said study chair David M. Nathan, M.D., director of the Diabetes Research Center at Massachusetts General Hospital, Boston.

In the United States, nearly 26 million people have diabetes, and up to 95 percent of them have type 2 diabetes. About 7 million people have type 2 diabetes but do not know it. In addition, about 79 million adults have prediabetes, with high blood sugar levels that are not yet in the diabetic range. Prediabetes substantially raises the risk for developing type 2 diabetes. Learn more about diabetes at http://diabetes.niddk.nih.gov and at www.YourDiabetesInfo.org.

The DPP is registered at ClinicalTrials.gov as NCT00004992 <http://www.clinicaltrials.gov/ct2/show/NCT00004992?term=NCT00004992&rank=1> and the DPPOS as NCT00038727 <http://www.clinicaltrials.gov/ct2/show/NCT00038727?term=NCT00038727&rank=1>. The studies were funded by the NIDDK; Eunice Kennedy Shriver National Institute of Child Health and Human Development; National Institute on Aging; National Eye Institute; National Heart, Lung, and Blood Institute; National Institute on Minority Health and Health Disparities; National Center for Research Resources; and the Office of Research on Women’s Health all part of NIH. Additional funding came from the Indian Health Service, the Centers for Disease Control and Prevention, the Department of Veterans Affairs, and the American Diabetes Association. Bristol-Myers Squibb and Parke-Davis provided funding and material support for the DPP. Lipha (Merck-Sanyo) provided medication, and LifeScan Inc. donated materials.

The NIDDK, a part of the NIH, conducts and supports research on diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition and obesity; and kidney, urologic and hematologic diseases. Spanning the full spectrum of medicine and afflicting people of all ages and ethnic groups, these diseases encompass some of the most common, severe and disabling conditions affecting Americans. For more information about the NIDDK and its programs, see www.niddk.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

Laura Oxley
Communication Director
Arizona Department of Health Services

As White Rice Intake Rises, So May Your Risk for Diabetes

FRIDAY, March 16 (HealthDay News) — People who eat white rice on a regular basis have a significantly increased risk of type 2 diabetes, a new international analysis contends.

Harvard School of Public Health researchers reviewed the findings of four previous studies conducted in the United States, Australia, China and Japan. None of the participants had diabetes at the start of the studies. Overall, the trials included more than 350,000 participants tracked anywhere from four to 22 years.

Researchers led by Qi Sun found a strong association between eating white rice and type 2 diabetes, and the link was stronger in women than in men, according to the study published online March 15 in the British Medical Journal.

The more white rice a person ate, the greater his or her risk for diabetes. For example, for each serving of white rice (assuming 158 grams/6 ounces per serving) there was a 10 percent increased risk of diabetes, the Harvard team estimated.

Compared to brown rice, the white variety has lower levels of nutrients such as fiber, magnesium and vitamins, the team noted. Intake of some of these nutrients are also associated with lowering a person’s risk of diabetes, the researchers said.

White rice — the main type of rice eaten worldwide — also scores high on the glycemic index (GI), a measure of how foods affect blood sugar levels. High GI diets are associated with an increased risk of type 2 diabetes, the research team said.

“These findings are very significant,” says registered dietitian Karen Congro, director of The Wellness for Life Program at The Brooklyn Hospital Center, in New York City. She agreed with the researchers that, “because it is a simple carbohydrate, white rice is also a high glycemic food and can be responsible for high spikes in blood sugar, even for people without diabetes.”

Another expert said lifestyle changes, including food choices, are key to warding off diabetes.

“In our developed societies, we are exercising less and eating more, causing the profound increases in obesity and diabetes that are associated with increased morbidity and mortality,” said Dr. Spyros Mezitis, an endocrinologist at Lenox Hill Hospital in New York City. “Our research should focus on how to eat less, consume foods of lower glycemic index and exercise more to prevent diabetes and obesity,” he said.

According to Congro, there are healthier alternatives to white rice.

“When you eat white rice often, you are missing an opportunity to have fiber in your diet,” she said. “You are also missing a variety of vitamins that are stripped away in the process of making white rice.”

Whole grains, including barley or quinoa, may be healthier options. “Buckwheat is [also] delicious and high in antioxidants, including Rutin, which is linked to improved circulation and prevention of blood vessel blockage due to LDL cholesterol,” Congro said. “There is a whole world of whole grains that people should consider exploring.”

The study found a link between white rice consumption and diabetes, but it did not prove that the food causes the blood-sugar disease.

More information:   The U.S. National Diabetes Education Program offers diabetes prevention tips External link.

(SOURCES: Karen Congro, RD, CDN, director, The Wellness for Life Program, The Brooklyn Hospital Center, New York City; Spyros Mezitis, M.D., endocrinologist, Lenox Hill Hospital, New York City; British Medical Journal, news release, March 15, 2012)

Copyright © 2012 HealthDay External link. All rights reserved.

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Announcing Kidney Early Evaluation Program (K.E.E.P.) Health Screening and request for volunteers on day of event

The Kidney Early Evaluation Program (K.E.E.P.) was developed by the National Kidney Foundation National Headquarters.  The purpose of KEEP is to identify and educate individuals at increased risk for kidney disease.

Volunteer Agreement

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KEEP flyer Glendale

New NIH Fact Sheet Explains Test For Diabetes, Prediabetes

A new fact sheet from the National Institutes of Health explains the A1C test, a widely used and important test to diagnose Type 2 diabetes and prediabetes, and to monitor blood glucose levels of people with Type 1 and Type 2 diabetes.

New NIH Fact Sheet Explains Test For Diabetes, Prediabetes