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JOUR-5-1

Diabetes Prevention Program (DPP)

Problem:

Alarming statistics about prevalence of Diabetes Mellitus, Prediabetes and Metabolic Syndrome along with their associated problems of Hypertension, Obesity, and multiorgan failure

Goals:

Identification of Patients at risk of developing DM. A1C Hgb >5.8, BMI >26, Hypertension, Glucose level >99.

Prevention of Diabetes, decreasing the number of newly diagnosed diabetes in the county.

Increasing the number of patients seen for prevention of diabetes.

Objective:

Besides the above goals, follow of those parameters mentioned above will be entered into a database and on a yearly basis a report about the improvement of values will be published.

Gaps:

Identification of patients at risk of developing diabetes mellitus is challenging.

Access to healthcare is lower in population at higher risk of developing DM.

The underdiagnosing of diabetes is an important public health problem.

In order to prevent diabetes mellitus and decrease gaps, all emergency rooms, hospitals, health centers and clinics will refer all patients with one of the above laboratory data or vital sign abnormality to a participating clinic in the DPP. To increase DPP participation by clinics, all clinics of the county will be invited and aggressively recommended to participate in the DPP. Those clinics that participate will see a 0.5% reimbursement increase. This represent an incentive for clinics to participate.

Public announcements will be placed in different media inviting the public to attend to their healthcare center to be checked. Health fairs will be organized semiannually, measurements of the above-mentioned parameters will be performed and those patients at risk will be referred to those participating clinics.

As the logic models shows, once patients have been referred to the DPP participating clinics, teaching about nutrition, physical activity, use of medication and supplements will be given and patients are going to be presented with 10 questions quizzes about the material taught.

We believe that, when patients understand the reason behind a program, the adherence to that program is better.

No ethical issues or concerns are identified. It is considered actually unethical not to conduct this program and be passive about the increasing prevalence of diabetes.