August 2015 Newsletter

The last 2 years have brought a transition and changes to DPAC. DPAC has a new charter, and previous required work groups have been replaced with an ad hoc work group structure. Jennifer Esdall, former DPAC Coordinator, is now the Diabetes Prevention Coordinator and I replaced Jennifer in fall 2014, after working for 9 years as a public health consultant with the Diabetes Program. Also in early 2015, the former Michigan Department of Community Health merged with the Department of Human Services to create the Michigan Department of Health and Human Services (MDHHS).

With the transition, what is being preserved from the over 20 years of DPAC's existence? We have listened to you through surveys: the biannual meetings, networking opportunities and quarterly newsletters are what you value the most. For these reasons, the DPAC Board and I will work hard to maintain and improve these aspects of DPAC. For example, the DPAC newsletter is now in the Constant Contact format, which we think will be more readable for you. We are very interested in your feedback on this change.

This is the first DPAC newsletter of 2015 and we expect to have two more newsletters before year's end, thereafter going to four quarterly newsletters. The newsletter will bring you information about both diabetes management and prevention as well as information about new resources, new members and upcoming events. In every newsletter we will feature a DPAC member who is doing significant and collaborative work in the diabetes arena. As always, we welcome input on newsletter content, distribution and format. In the past, many DPAC members have indicated they share the newsletter with their partners, staff or clients. Please continue to do this.

Please contact Anne Esdale at esdalea@michigan.gov or phone (517) 335-6936 with any questions.

DPAC Member Spotlight: Priority Health Leads Collaborative Attack on Diabetes

dpac member spotlight Priority Health is a community based health plan, with nearly 650,000 members, which is committed to improving the health and lives of the people they serve. Priority Health has been named the Essential Health Benefits benchmark for the state of Michigan for 2017. As part of their strategy to attack chronic disease, Priority Health has a focus on the prevention of type 2 diabetes. Through partnership with 8 Diabetes Prevention Recognized Programs (DPRPs), or those seeking recognition, Priority Health has enrolled 469 members in the Diabetes Prevention Program (DPP), at 16 locations across Michigan.

Kandi Jezak, RN, CCM, Senior Clinical Program Manager for Priority Health and a DPAC member reflects on successes and continued challenges of this program: "In addition to the collaborative partnerships we have established, Priority Health has tremendous internal management and leadership support for the Diabetes Prevention Program. One of our biggest challenges is the lack of knowledge people have about their diabetes risk."

To overcome this challenge, Priority Health is working to build the awareness of prediabetes and the DPP to their members, provider network and the greater community. "Our goal is to increase the awareness of prediabetes and the importance of lifestyle change that DPP supports, to our members and provider network. We are doing this through education, team work, and our ability to show quality outcomes." says Jezak. "Using our care management algorithms, we are reaching out to members that may be at risk to develop type 2 diabetes and offering DPP when it is available in their community. We have a multi-pronged approach through letters, social media, phone calls and physician engagement. This is helping to drive participation in DPP."

Priority health members participating in the DPP have achieved impressive outcomes, with 65% meeting the 5 - 7% weight loss goal, 43% exceeding 7% weight loss, and 72% meeting the exercise goal of 150 minutes a week.

Priority Health is continuing to build partnerships with DPRPs to deliver the DPP to its members. DPAC members and DPRPs interested in exploring this collaboration should contact Jezak at kandi.jezak@priorityhealth.com. As Jezak says, "Priority Health wants to work with partners to build the statewide DPP capacity and to make clinical and provider referrals more routine."

Diabetes Management Update: Persons with Diabetes Encouraged to Receive Diabetes Self-Management Education and Support at Four Critical Times

dsme logo Persons with diabetes are now encouraged to receive diabetes self-management education and support (DSME/S) at four critical times. It has long been recognized that persons with diabetes perform most of the care needed themselves and therefore require DSME/S. DSME/S refers to the information and skills people with diabetes need for proper self-care and the support they need to perform those skills and behaviors, such as healthy eating and taking medications.

A statement written by the American Diabetes Association (ADA), American Association of Diabetes Educators and the Academy of Nutrition and Dietetics was released at the ADA's 75th Annual Scientific Sessions on June 5th and highlights four critical times to assess, provide and adjust DSME/S:
  • At diagnosis
  • On a yearly basis
  • When changes in health affect self-management
  • When changes in care happen; for example, insurance changes that affect treatment or changes in the current medical team
The statement provides further guidance on the type of information and support patients might need at these important times. The statement also outlines the content to be taught, roles and action steps recommended for both the referring health care provider and for the diabetes educator.

"We know that diabetes education works," said Joan Bardsley, MBA, RN, CDE, FAADE, Assistant Vice-President of Medstar Health Research Institute and Immediate Past President of the American Association of Diabetes Educators. Research has shown that DSME/S helps to reduce A1C levels; reduces diabetes complications such as kidney disease and amputations; improves lifestyle behaviors, such as eating a more healthful diet and exercising more frequently; and decreases diabetes-related depression. DSME/S has also been shown to reduce hospital admissions and readmissions.

Bardsley continues: "But one of the major gaps we have seen is that there aren't a lot of providers who will routinely refer patients to diabetes educators. Either they don't know how to make these referrals, can't find an educator or don't understand how valuable diabetes education can be for people living with diabetes."

"Yes those referrals are critical," said Linda Siminerio, RN, PhD, CDE, Professor of Medicine at the University of Pittsburg and Chair of the National Diabetes Education Program. "Referrals influence patient behavior a great deal. When providers refer patients to diabetes education, we see an 83 percent participation rate, but without those referrals, participation is abysmally low. If patients believe their physician think diabetes education is important, they take it a lot more seriously. Patients trust their providers.

DPAC members are encouraged to talk with their patients about referrals to Michigan's 93 DSME/S programs at these four important times. A Certified Diabetes Educator will work with the patient to develop an individual education plan and goals. Medicare, Medicaid and state-regulated health insurance plans all reimburse for DSME.

Bardsley emphasized that education and support are needed throughout a person's lifetime, not just at diagnosis. "Diabetes is a chronic disease, and what a patient needs changes over time."

For more information about DSME/S and Michigan DSME/S programs, visit Michigan.gov/diabetes. The full ADA position statement and algorithm of care are at:

care.diabetesjournals.org/content/38/7/1372.full.pdf vegetables

Diabetes Prevention Update:
Michigan is First State to Launch Prevent Diabetes STAT

On May 8th, the Michigan Department of Health and Human Services (MDHHS) hosted the Prevent Diabetes STAT: Michigan meeting with over 80 invited attendees. This meeting was a result of a partnership with the American Medical Association (AMA) and National Association of Chronic Disease Directors (NACDD) to develop a state diabetes prevention plan and was the first such meeting to be held nationwide. Presenters included staff from the AMA, MDHHS, NACDD and state partners.

The goal of the meeting was to plan a course of action to scale statewide efforts to screen and test patients for prediabetes and to refer those with prediabetes to CDC recognized Diabetes Prevention Programs. An action plan will be available by the end of the year; look for updates at the November DPAC meeting. As part of this initiative, the AMA and CDC have developed a toolkit that is described in this newsletter under "New Resources."

Read more about the initiative at www.cdc.gov/media/releases/2015/p0311-diabetes-STAT.html

Diabetes Prevention Updates

There are currently 30 Diabetes Prevention Recognized Programs (DPRPs) in Michigan. New DPRPs included employers, YMCA's, hospital/health systems and local health departments. As of July 2015, there have been 1,252 eligible participants in the DPP, with 712 (56.9%) having a blood test or gestational diabetes mellitus (GDM). CDC is announcing the release of a national media campaign and TV advertising in January 2016 and a national DPP website redesign, with a consumer section, projected for this fall.

For more information about the Michigan Diabetes Prevention Network, visit www.midiabetesprevention.org

Promote Diabetes Media Campaign

A multi-media health awareness campaign was started on June 15th and includes radio spots, billboards, print ads, Facebook posts and digital custom targeted media. This campaign was developed and coordinated by the Diabetes Program of Michigan Department of Health and Human Services (MDHHS) with the MDHHS Communications Office and Brogan and Partners.

The intent of the campaign is to promote local Diabetes Self-Management Education and Diabetes Prevention Programs and increase referrals and enrollment in these programs by referring to www.michigan.gov/diabetes. The communities targeted for the campaign include Grand Rapids, Lansing, Muskegon, Saginaw and the counties of Lenawee, Macomb, Wayne and Oakland. DPAC members can hear the radio spot through the MDHHS YouTube channel: www.youtube.com/watch?v=3pK7bwPaKY4

Find the Michigan Department of Health and Human Services on Facebook

one in ten has diabetes Lower your risk of developing Type 2 diabetes by increasing physical activity and eating healthier. Take control of your health and learn how you can prevent diabetes and its complications at www.michigan.gov/diabetes.

Comparing MDHHS page views in the month of May before the campaign started to June after the campaign started, there were 4.67 times more page views in June than May. The Diabetes home page was also modified to provide users easier access to "diabetes prevention" and "diabetes management" content and programs.

DPAC members are encouraged to visit the newly re-designed MDHHS diabetes home page at www.michigan.gov/diabetes and refer their patients, clients and partners to this page. Also, please keep a lookout for the media in Michigan communities.

New Resources Prevent Diabetes STAT: Screen/Test/Act Today™

To help prevent type 2 diabetes, the Centers for Disease Control and Prevention (CDC) and the American Medical Association have created a toolkit that health care teams can use as a guide to screen, test and act today by referring patients to in-person or online diabetes prevention programs.

walking The CDC and AMA are calling on providers to:
  • Screen patients for prediabetes using the prediabetes screening test
  • (or the ADA Diabetes risk test)
  • Test patients for prediabetes using one of 3 blood tests
  • Act today to help prevent diabetes by referring patients with prediabetes to a diabetes prevention program
To see how a practice is implementing these guidelines and to access the tool kit, please visit www.ama-assn.org/sub/prevent-diabetes-stat/for-health-care-professionals.html

Health care providers can also visit www.stepsforward.org/modules/prevent-type-2-diabetes. This is a website where health care providers can access the toolkit, view modules and obtain more information around implementation of the toolkit.

GAME PLAN for Preventing Type 2 Diabetes: A Toolkit for Health Care Professionals and Teams

meeting The National Diabetes Education Program has updated its popular GAME PLAN toolkit to help health care professionals identify, counsel, and support patients at risk for type 2 diabetes. Visit: ndep.nih.gov/ to access this toolkit.

Welcome to New DPAC Members:

  • Bethany Burge, Area Agency on Aging 1-C
  • Zann Espree, OTD Global LLC
  • Larry White, Boehringer Ingelheim
Past DPAC meeting
View presentations from April 30th meeting, including:

* The Affordable Care Act and Healthy Michigan Plan: Implications for Diabetes Management and Prevention
* Prevent Diabetes STAT: Michigan
* Diabetes Needs of Michigan's Native American Population

Upcoming Events
Thursday, November 12th - 8:30 - 3:30: Full membership meeting and Michigan Capitol celebration of World Diabetes Day, Radisson Hotel, 111 N. Grand Avenue, Lansing, MI. 48933. Registration information will be on the DPAC website starting this October.

Free Diabetes PATH Classes
Thanks to a grant from the Michigan Health Endowment Fund, Area Agencies on Aging (AAAs) are now offering free classes around the state to help seniors with Type 2 diabetes manage their condition through Diabetes PATH classes. The classes are evidence-based and developed by the Stanford University Medical School. To find your local AAA, go to www.GreatAtAnyAgeMI.com and search by county. AAAs' websites have a link to their class schedules, or just call the AAA for assistance. Contact Mary M. Alban, M.A., M.S.W., Executive Director of the Area Agencies on Aging Association of Michigan, with any questions at (517) 886-1029