A large number of patients at Dallas County’s Parkland Hospital System have Type 2 Diabetes. Unlike Type 1, Type 2 Diabetes doesn’t require insulin injections – at least not right away – but it’s just as serious if it’s not managed properly.
To reduce that risk, Parkland launched a program called Diabetes INSIDE. In our consumer health series, Vital Signs, Dr. Luigi Meneghini, executive director of Parkland Hospital System’s Global Diabetes Program, talked about the new program and why Type 2 Diabetes is such a problem in Dallas County.
Highlights from Dr. Meneghini’s interview:
Why environment contributes to high rate of Type 2 Diabetes in Dallas County: We not only have access to food that is highly caloric and can drive weight and a lot of the inflammation that is attributed to diabetes, we have an environment that is sometimes difficult to be active in. For example, we use cars as oppose to walking. And we have a population that is particularly susceptible to Type 2 Diabetes. For example, African Americans, Hispanic/Latino populations are at increased risk as opposed to, for example, Caucasians, who tend to be at increased risk for Type 1 Diabetes compared to ethnic groups.
Why Parkland’s involved in quality improvement program for Type 2 Diabetes: Parkland’s dedicated a lot of money, effort and thought to diabetes because it represents one of the most common complications or diseases that affects the patient population in Dallas County. We’re looking not only at the hospital and the specialty clinic, but also the large primary network to see how we can optimize care for patients with diabetes, improve access and be more effective in terms of going out to the community as opposed of waiting for the patient to come to us.
Who qualifies for the program: Anybody with diabetes. We are going to focus on the highest risk patients. Parkland has 50,000 patients in their registry that are listed as having diabetes. About 25% of them are thought to have poor blood glucose control. So we’re already starting to narrow down the focus. And what we intend to do with this project is focus on individuals who have high A-one-C levels above nine percent – poor control – that can be associated with complications, and specifically understand what are the barriers to care that are driving these poor numbers and developing strategies to address those specifically.
What’s at stake for patients without the program: If patients remain with blood sugars elevated, there is the risk of eye damage, kidney damage, nerve damage. Diabetes is the leading cause of non-traumatic amputation in adults. Blindness in adults. Heart disease. So it has huge implications with regards to morbidity, to mortality, to health, to well-being and to quality of life.
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