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ARRA Investments in Improving Diabetes Outcomes

Public Health Burden
Diabetes affects nearly 24 million people in the U.S.  People with the disease have to check their blood glucose (sugar) levels several times a day, administer insulin or other diabetes medications, and may need to take other medications to reduce their risk for complications such as heart disease.  This regimen places a heavy burden on patients and their families, and few people achieve the recommended treatment targets that can reduce their risk for diabetes complications and improve their long-term health outcomes.

Medical Therapy
ARRA-funded grants are exploring medical therapies for improving diabetes outcomes:
  • A study will investigate the effectiveness of immediate versus delayed use of the diabetes drug metformin to treat people with newly-diagnosed type 2 diabetes.  The scientists will use electronic health records of over 40,000 people to examine health outcomes of people who were treated with immediate initiation of metformin versus delayed initiation of the drug.  The findings can inform future strategies for treating people with newly-diagnosed type 2 diabetes.1
Behavioral Approaches
Because good control of diabetes requires strict self-management, behavioral research on ways to help people with diabetes manage their disease can improve health outcomes.  In addition, type 2 diabetes places a disproportionate burden on minority groups, including African Americans, Hispanic Americans, American Indians, and Asian/Pacific Islanders.  Research is also ongoing to identify behavioral strategies to reduce health disparities and improve health outcomes.  Several ARRA funded-grants are supporting behavioral research to improve diabetes outcomes:
  • A study examining factors that may predict why some people with diabetes fail to utilize referred health services that are covered under their insurance plans (e.g., standard lab tests, visits to specialists).  Identifying such predictors may enable healthcare delivery systems to modify their programs so that people utilize referred services and improve health outcomes.2
  • A study to determine if a mindfulness meditation-based intervention could improve health of overweight or obese adults with type 2 diabetes.  Because stress can contribute to high blood glucose levels and poor eating habits, the approach may lead to improved health outcomes.3
  • A study will examine factors and resources used by older Latino patients with low literacy and type 2 diabetes who are able to achieve good control of their type 2 diabetes.  This knowledge can inform new strategies to help people with low literacy and poor diabetes control glucose levels and improve their health.4
  • A study will develop and deliver a community-based intervention using a media campaign, community engagement, and individual self-management training by “diabetes block captains” in a poor, African American community.  The strategy will empower the captains to conduct household screenings for type 2 diabetes and to engage their neighbors in activities that promote diabetes self-management toward improving health outcomes.5
  • A study will compare a nurse-managed intervention to standard care with respect to improving health outcomes in people who have heart failure and diabetes.6
  • Research will examine whether diet and exercise, either each alone or in combination, can reduce abdominal fat levels and decrease risk for heart disease in people with type 2 diabetes who are overweight or obese.7

  1. 1RC1DK086585-01 -- Effectiveness of immediate vs. delayed use of metformin in new-onset T2 diabetes -- Selby, Joe (CA)
  2. 1RC1DK086178-01 -- Failure to utilize diabetes health services following a referral -- Karter, Andrew (CA)
  3. 1R21DK084330-01 -- A mindfulness-based approach to the treatment of obesity and diabetes -- Miller, Carla (OH)
  4. 1R21NR011309-01 -- Literacy-compensatory strategies and resources of older Latinos with diabetes -- Cordasco, Kristina (CA)
  5. 1RC1MD004946-01 -- North Lawndale diabetes community action project -- Whitman, Steven (contact); West, Joseph (IL)
  6. 1R21NR011204-01 -- Improving self management and outcomes in heart failure patients with diabetes -- Dunbar, Sandra (GA)
  7. 1R01HL086026-01A2 -- Diet and exercise in type 2 diabetes -- Stewart, Kerry (MD)

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