Forging new partnerships  pg. 3

We just launched the National Kidney Disease Education Program, which in its pilot phase is targeting four cities – Atlanta, Ga., Baltimore, Md., Cleveland, Ohio, and Jackson, Miss. – which have a disproportionately high level of end-stage kidney disease, mostly among African Americans. If we can get the information out about the importance of measuring protein in the urine and using ACE inhibitors where indicated, for example, we can really make an impact.

The use of information technology also can be very important. One really needs to look at chronic diseases through a different management model, one that focuses on flagging reminders, making sure people are monitored. This increases cost in the short run, but it can make a huge difference in the long run in terms of reduced hospitalization.

Lens: What about prevention?

A 3-year-old boy before, and several weeks after becoming one of the first patients to receive insulin in 1922.
Photos courtesy of Eli Lilly and Company Archives
Preventing disease is a high priority, and much of our research is aimed at understanding how better to prevent chronic and costly diseases such as diabetes. If we don’t do this, we’re really in for trouble simply because the health care system is not going to be able to sustain itself, faced with a diabetes epidemic and its attendant complications – amputations, blindness, kidney failure and cardiovascular mortality.

Our Diabetes Prevention Program (DPP) showed clearly that type 2 diabetes can be prevented or at least delayed in the majority population as well as all ethnic and minority groups, including African Americans, Hispanic Americans, American Indians and Asian American/Pacific Islanders who are at highly disproportionate risk. We are now building on the DPP results to develop cost-effective ways to prevent type 2 diabetes in adults and in adolescents, who increasingly are developing the disease.

With regard to obesity, we need research that will address ways to interfere with inappropriate cues and signals that lead to overeating. Behavioral efforts have been successful. That is the powerful message of the DPP. We’re not talking about running a marathon here. We’re saying that, for a group of individuals we can identify who are at particularly high risk, a targeted effort aimed at early lifestyle changes would be effective.

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