Novel approaches to diabetes care: a population perspective.
OBJECTIVE
The purpose of this review is to outline the current state of diabetes in the United States and to explore novel, population-based approaches that involve the patient, provider and community, in the context of the health system, to improve diabetes care.


RESULTS
Currently, there is sub-optimal delivery of diabetes processes and outcomes in the United States. The US healthcare system remains rooted in acute and episodic care, resulting in consistently low-quality healthcare, and is not equipped to handle the diabetes epidemic. Evidence demonstrates that models of chronic care are needed in order for system changes to occur. Recent studies that have implemented such models are beginning to demonstrate improvements in both process measures and clinical outcomes following interventions which incorporate a comprehensive approach to chronic illness care.


CONCLUSIONS
Research over the past 5+ years demonstrates that a more comprehensive approach to diabetes care is needed. Only recently have studies been able to validate this concept, however. Applied research that strives to translate available knowledge and operationalize it in clinical and public health practice is needed in order for diabetes care to improve.
Piatt
Gretchen A
GA
University of Pittsburgh Diabetes Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. piattg@upmc.edu
Zgibor
Janice C
JC
D003695:Delivery of Health Care / Q000379:methods* / Q000592:standards / Q000639:trends*; D003920:Diabetes Mellitus / Q000628:therapy*; D004704:Endocrinology / Q000639:trends*; D006801:Humans; D016896:Treatment Outcome; D014481:United States