A Surveillance System for Diabetes Primary Prevention

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A Surveillance System forDiabetes Primary
Prevention
Gary He, PhD Diabetes Primary Prevention
Initiative Surveillance Focus Area 2009 CDC/DDT
Diabetes Conference April 21-24, 2009 Long Beach,
CA
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Diabetes Primary Prevention InitiativeSurveillanc
e Focus Area

• Participants and Partners
• Centers for Disease Control and Prevention (CDC)
• States California, Massachusetts, Minnesota
• Partners Research Triangle International (RTI),
  Intervention Focus Area, CDC Division of
  Nutrition and Physical Activity, Behavioral Risk
  Factor Surveillance System (BRFSS)

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Goal

• Recommend a surveillance system to monitor
  populations with prediabetes or at risk for
  diabetes
• State/territory-based
• Replicable by most state/territory diabetes
  programs
• Address all ages
• Incorporate multiple settings

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Objectives

• Determine a framework
• Identify and prioritize potential indicators
• Determine methods
• Pilot selected indicators and tools

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Challenges

• State/territory-based Surveillance Systems are
  limited
• Diabetes registry (lab-based)
• Health interview survey (self-reported)
• Prediabetes Awareness is lacking
• Prevalence of prediabetes 29
• Prevalence of self-reported prediabetes is about
  4-5
• Collaborative surveillance efforts just started
• Chronic disease surveillance
• Healthy community programs

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Activities and Productsfrom the Surveillance
Focus Area

• Recommended a Diabetes Prevention Module in CDC
  BRFSS
• Have you ever been told by a doctor or other
  health professional that you have prediabetes or
  borderline diabetes?
• Have you had a test for high blood sugar or
  diabetes within the past three years?
• More than 33 states are implementing in 2008

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Activities and Productsfrom California

• In partnership with a state public health agency,
  a health care organization, private industry, and
  the DPPI Intervention FA, piloted a worksite
  diabetes screening and lifestyle intervention.
• Report on abnormal glucose risk assessment
• Report on disparities in prediabetes
• Report on worksite diabetes screening and
  prevention
• Online diabetes risk assessment tool

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Activities and Productsfrom Massachusetts

• In partnership with chronic disease programs and
  stakeholders, developed and implemented a
  community survey to
• Inventory community policies and programs related
  to health
• Identify gaps in resources at the local level
• Report on community survey
• Report on BRFSS screening algorithm
• Report on BRFSS prediabetes module data

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Activities and Productsfrom Minnesota

• Developed and tested 21 BRFSS measures to
  determine feasibility and usability
• Inventory of prediabetes, diabetes, and chronic
  disease prevention measures for telephone surveys
• Peer reviewed publication on review of
  gestational diabetes data
• Primary prevention surveillance report using the
  BRFSS

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Lessons Learned

• Consistent definition of primary prevention
• Bring other partners on board
• Nutrition and Physical Activity
• Overweight and Obesity
• Reproductive Health
• Heart disease
• Stroke
• Cancer programs
• BRFSS

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Gaps

• Gestational diabetes
• Diabetes in children and adolescents
• Differences between diabetes and prediabetes
• Use of other data sources
• Claims data
• EMR
• Hospital discharge
• Lab data
• Birth certificate

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Contact Information

• California
• gary.he_at_cdph.ca.gov
• Massachusetts
• brianne.beagan_at_state.ma.us
• Minnesota
• jay.desai_at_health.state.mn.us
• nagi.salem_at_state.mn.us

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Thank You!