What can you expect from an Ohio-based event called a "Global Diabetes Summit?"
Well, think hundreds of international leaders from the diabetes world, top government initiatives focusing on D-prevention, and novel ideas like using the YMCA and reality TV to help change lifestyles in order to prevent type 2 diabetes. Not to mention the latest and greatest in diabetes technology, pharmacology and how the experts are all working more closely than ever in tackling this condition throughout the world.
I was excited to attend the Global Diabetes Summit held Nov. 14-17, bringing nearly 500 people together at the Wexner Medical Center at Ohio State University in Columbus, Ohio. This was the second event of its kind on U.S. soil in the past five years. The university held its first on-site summit in 2007, convening about 650 people, and that had its origins from a dozen years earlier, after a smaller summit in Africa as part of its work with the International Diabetes Federation (IDF). That first overseas event was what led to the idea of this international conference.
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This event is not to be confused with the giant annual World Diabetes Congress run by IDF, which brought together 15,000 people from 172 countries in Dubai December 2011. That event is huge and has a bigger focus on government policy-makers across the world, but it's now not the only global conference on the block.
The theme of the Ohio Global Summit this year was New Horizons in Diabetes: Genetics to Personalized Health Care.
Dr. Kwame Osei, a medical professor who's director of the Diabetes Research Center and the OSU Wexner Medical Center's Division of Endocrinology, Diabetes and Metabolism, has chaired the summits and did a fabulous job bringing an impressive roster of brilliant mindpower to the table. Given the event's name there of course was a global focus, but I was very impressed with how they tied it all together and brought the subjects home to wherever one might be living. We are a global D-Community, after all.
The multi-track meeting covered topics ranging from the newest in medicine and glucose sensing technology to teens and obesity to how type 2 diabetes is growing and being dealt with in specific populations across the globe. Not surprisingly, the summit took on a type 2 focus... but there were some great broader messages and overlaps for the type 1 diabetes world.
"We are in the right place at the right time, and we seem to be more ready as a global community to address these issues. This is not abstract thinking anymore, we are doing it and we have a strategy for combating diabetes. This year, we have the evidence and people can see what can be done, " Dr. Osei says.
Lots of good stuff was covered! But for the sake of brevity, the U.S.-based community efforts to "confront the type 2 diabetes pandemic," all supported in some way by the Centers for Disease Control (CDC), came out on the top of my radar:
Lifestyle Intervention That Works
Right now, about 1 in 10 Americans are living with diabetes, says Dr. Ann Albright who leads the CDC's Division of Diabetes Translation. But only 7% of people living with pre-diabetes know it, and so if the trajectory of new diagnoses doesn't change, the number of PWDs will jump to one in three by 2050.
"That is not sustainable," Albright told summit attendees. "If we think prevention is difficult now, we ain't seen nothing yet if we don't get it together."
With the numbers rising, Albright said it's "all hands on deck" to do what we can to provide more lifestyle intervention programs to fight type 2 diabetes.
She highlighted the National Diabetes Prevention Program (DPP), a widespread national trial program, supporting "lifestyle intervention" efforts through hundreds of organizations around the country.
This initiative is an important milestone in national prevention efforts and a focus of the Affordable Care Act passed in 2010 and upheld by the Supreme Court earlier this year. That legislation authorized the federal agency to lead this national diabetes intervention program.
The CDC helps to organize and fund this program, but they don't own it. The CDC just provides the organizational infrastructure: training to increase work force, assuring quality, delivering the program to people in the community, and marketing the program, Albright says. "This belongs to the U.S. and the world, to you."
So far, the DPP has served or is serving 9,000 people and is being run by more than 1,000 lifestyle coaches across the U.S. Early data suggests weight loss achievement is about 4.9 percent of initial body weight, and that rises to 5.1 percent among programs that have been running the longest. Retention is best after participants get through the first four sessions, she said.
"We need to connect people with programs they can use, and we need to have the biggest impact on people we can," Albright said.
The Y to the D
First to step up to join the DPP in offering one of these community-based intervention programs in the U.S. was the YMCA, which has teamed up with the National Institute of Diabetes and Digestive Kidney Diseases (NIDDK) to create a nationwide lifestyle intervention program focused on type 2 prevention.
The Y is offering its staff and resources to help more than 200 organizations create and run local programs at car dealerships, churches, and community centers. How cool is that? Need help with your health? Just stop by a local car dealership or community center!
Results show that the program is helping people to achieve "meaningful" weight loss and cut their risk of developing type 2 diabetes, and overall, to achieve healthier lifestyles. In the roughly two years since it's been going on, more than 4,000 people have enrolled and are participating in programs scattered across 50+ cities in 30 states. People go through weekly classroom sessions for about 16 weeks with a lifestyle coach and they get support from a small group of peers as they learn how to eat healthier, be more physically active and make other health behavioral changes.
And the coolest part? Insurers and employers are paying the tab. United Health Group (which owns United Health Care) was the first, and now four other insurers have signed on, making this a third-party "pay for performance" model and not a CDC grant endeavor. The Y gets reimbursed by insurers and employers who enroll in a year-long D-prevention course. If people meet their target goals of 5% to 7% weight loss, the Y gets more payments. It can cost $275-$325 when using a trained Y-staffer, and $550 per person when a certified diabetes educator is used.
"Our CDC Vision is a world free of the devastation of diabetes," Albright said. "And really, I'm going to draw a Blue Circle around this because the DPP is in lock step with the IDF and we're all about unifying on this message."
Diabetes Prevention, Reality TV Style
Also as part of the DPP, United Health Group and Comcast are piloting a reality TV program called "Project Not Me" this year, which we introduced after the Joslin Innovation event at the end of September. This study examines the use of video on demand to deliver national DPP interventions targeting type 2 prevention.
The 16-episide series uses a reality TV format that follows six adults who are at high risk for developing type 2 and go through the DPP community efforts. Each video features a health and wellness coach leading a class of participants to lose weight, eat healthier and change their lifestyle habits. Viewers are also given assignments to track their health each week in between episodes, and the goal is to lose 5-7% in body weight.
People using the TV programming also get access to a virtual scale to monitor their own health, and report that data. And data from the show: the six people in the videos lose an average 8.1% of their body weight during the full 16 weeks of the program.
Within just a month of the study launched in two test markets in Philadelphia, PA, and Knoxville, TN, more than 300 people signed up for the on demand episodes featuring six people with pre-diabetes learning to eat healthier, get more exercise and make changes in their lifestyles.
Data on the reality TV initiative is being finalized and should be published in the coming months, according to Albright, who says that there's significant evidence "that this program is working." The program is also expected to move into more markets soon.
The rest of the summit's prime time was also very fascinating, but mirrored some of the common threads: type 2 diabetes is spreading worldwide and we can do something about it through the use of new medicines being developed; community-based initiatives like what the CDC is doing; and just more connections between government, corporations, innovators, researchers, health care providers, third-party payers and patients.
Dr. Osei says his group is working to support the IDF's upcoming 2013 World Diabetes Congress to be held in Melbourne, Australia, Dec. 2-6 of next year. The focus will be on creating a strategic plan that can be distributed and implemented worldwide. All of this will be in place before his group reconvenes for their own third third Global Diabetes Summit in 2017.
Wow - another five years from now? That seems like a long ways off, but Dr. Osei says: "If you do these too soon, you won't see a drastic change so you need to (wait) so that you can benefit more. There will be new innovations, new creativity and ways of thinking... really, who knows where we will be five years from now?"
Who knows, indeed? But I for one am encouraged about where these programs seem to be headed.