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Bruce Nelson, MA, Community Services, Glendale Adventist Medical Center, 1509 Wison Terrace, Glendale, CA 91206, 818-409-8008, nelsonbr@gamcpo.ah.org, Robert Nicoloff, MD, Diabetes Treatment Center, Glendale Adventist Medical Center, 1509 Wilson Terrace, Glendale, CA 91206, Lee S. Berk, DrPH, MPH, FACSM, Department of Health Promotion & Education and Department of Pathology and Human Anatomy, School of Public Health and School of Medicine, Loma Linda University, Nichol Hall Room 1511, Loma Linda, CA 92350, and Edward Fujimoto, DrPH, MPH, Health Promotion and Education, Loma Linda University, School of Public Health, Loma Linda, CA 92354.
Diabetes mellitus is a disease characterized by high levels of blood glucose resulting from defects in insulin production and/or action. An estimated 17 million people (6.2%) in the United States have diabetes mellitus. Among U.S. adults, diagnosed diabetes increased 49% from 1990 to 2000. The total annual economic cost of diabetes in 1997 was estimated to be $98 billion including $44 billion in direct health care and treatment costs and $54 billion for indirect costs attributed to disability and premature mortality. The CDC has concluded that population-based and selective screening programs in community settings have uniformly demonstrated low yield and poor follow-up. However, 5.9 million people have not been diagnosed, and the number is increasing. In response to this national epidemic, Glendale Adventist Medical Center (GAMC) has developed a screening strategy that allows for pre-selection of high-risk subjects in target populations. A proven survey tool was pilot tested with an Armenian population during an Armenian cable television program. Viewers were provided with a scoring value for their response to each survey question. After guided self-scoring, viewers with totals above a specific threshold were invited to a diabetes-screening event at GAMC. Twenty-four attendees were determined to be candidates for the glucose tolerance test. The screening survey resulted in pre-selection of high-risk candidates with 75% accuracy for identifying previously undiagnosed diabetics. Benefits of this health care strategy include a positive benefit to cost ratio, identification of high-risk undiagnosed individuals, and population specific screening with respect to culture, language, and geographic area.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.