Sunday, January 31, 2010

Diabetes Care Group, Jackson, Mississippi

This past week as I was lamenting that our political system does not seem to be able to work to address the serious problems facing our health system, I got a breath of fresh air: a look at something that was working.

Diabetes Care Group is a start up company that specializes in the management of diabetes, and is located in Jackson, Mississippi.** This group has a proven clinical model and a team that has shown remarkable control of patient Hemoglobin A1c levels, in addition to reducing cholesterol and controlling high blood pressure that are so commonly comorbid with obesity forming the bland sounding but deadly 'metabolic syndrome' that is exploding in our nation.

The statistics on type II diabetes (which typically onsets due to obesity and inactivity) in our nation are grim. A recent paper in Health Affairs shows that the costs of diabetes to US society were $153 Billion in medical costs and $65 Billion in reduced productivity in 2007. There are 16.5 Million persons with a diagnosis of type II diabetes, 1 Million with type 1 (which is hereditary and typically onsets in adolescence). Another 6.3 Million Americans have undiagnosed type II diabetes and are at extreme risk of suffering the complications of the disease (heart disease, stroke, retinopathy, renal failure, amputations of lower body extremities). And 57 Million Americans are said to have pre-diabetes--elevated glucose that will likely develop into type II diabetes if not mitigated.

The good news is that there are ways to manage pre-diabetes and diabetes. In addition to insulin and other pharmaceuticals, exercise, weight loss and a balanced diet can manage diabetes, sometimes without pharmaceutical intervention in the case of type II diabetes.

The Southern United States is the heart of the diabetes epidemic, so Jackson, Mississippi is a great place for Diabetes Care Group to be working. This is a start up with a head start in the form of a dedicated group of health care providers who have a proven track record of managing diabetes successfully. In fact, Dr. Marshall Bouldin has been involved along with his colleagues in a variety of diabetes control settings both in Jackson, but also in the Delta region of Mississippi, one of the poorest parts of the United States. They have shown the ability to reduce and maintain A1c levels and control the related risk factors among largely minority, low income and heavily uninsured (groups at higher risk) patient populations around Mississippi. In short, they have shown an ability to get results in places and among patients that would be expected to be harder than average to successfully treat. In fact, part of their success stems from learning to treat diabetes in resource challenged community environments, which forced them to figure out what works best to enlist patients' to become the key to managing their own disease.

Regardless of what does or doesn't happen with health reform, addressing type II diabetes is a tremendous challenge for the health of our nation. Diabetes Care Group is busy doing it.

**For full disclosure purposes, I was there at the Board meeting and open house of this organization because I am doing some consulting with them in the form of statistical/economic modeling of the treatment of diabetes.

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