Prevention of Type 2 Diabetes and Stemming the Tide

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K. David McCowen, MD, FACP, Medical Director, Diabetes
Endocrine Consultants Northwest for Franciscan Medical Group. Talking about diabetes prevention best practices.

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Prevention of Type 2 Diabetes and Stemming the Tide

  1. 1. K. David McCowen, MD, FACPMedical Director, DiabetesEndocrine Consultants NorthwestFranciscan Medical GroupPrevention of T2DMStemming the Tide
  2. 2. • T2DM: 93% of all DM• Rapid expansion of disease incidence• Always preceded by Impaired GlucoseTolerance (IGT) 790.21• FBS = 100 – 125 mg/dl• HgbA1c – 5.7 or 6.0 to 6.5 %2 | Creating Healthier Communities | Best practices for managing high-risk clinical populations
  3. 3. Diabetes Prevention Program (DPP)• Treated IGT patients: Life Style Changes vs Metformin (Met)vs no intervention. Now we have 10 year data.• Delay development of DM: LSC = 11%; Met = 3%.• Reduction of DM incidence: LSC = 20%; Met = 8%.• Above compared to the no intervention arm.• Reduced microvascular, neuropathic, and CV complications.• Quality Adjusted Life Years (QALY): cost $8800 LSC;$29,900 Met.• Survival up 0.5 years LSC; 0.2 years Met.3 | Creating Healthier Communities | Best practices for managing high-risk clinical populations
  4. 4. DPP continued• THE COST EFECTIVNESS IMPROVED WHEN THEINTERVENTIONS WERE IMPLEMENTED INROUTINE CLINICAL PRACTICE• Last month FMG implemented a robust DM treatmentpathway.• We included the therapy of IGT as equally (andprobably more) important than the DM1 and DM2pathways.4 | Creating Healthier Communities | Best practices for managing high-risk clinical populations
  5. 5. 5 | Creating Healthier Communities | Best practices for managing high-risk clinical populations
  6. 6. 6 | Creating Healthier Communities | Best practices for managing high-risk clinical populationsIdentify
  7. 7. Assessment & Diagnosis
  8. 8. Treatment
  9. 9. THANK YOU
  10. 10. THANK YOU

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