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Diabetes

Diabetes currently afflicts 29 million people in the U.S.—about 9% of the population—and that proportion is expected to increase to 30% by 2050.

Diabetes can cause devastating impacts, including heart disease, stroke, and blindness. In 2010, diabetes was the seventh-leading cause of death in the U.S., and in 2012, its estimated costs were $245 billion.

CHR has been a leader in diabetes research for more than 25 years. In 1989, we helped Kaiser Permanente develop one of the country’s most comprehensive registries of patients with diabetes. We developed the registry so that the health care system could identify its diabetes patients to ensure that they received blood sugar testing and foot exams. However, it also proved very useful for research on diabetes and its complications, making it possible to conduct studies that help clinicians to better serve patients and to help patients better manage their disease.

CHR recently took the lead role in building a massive new dataset of patients with diabetes. The three-year project, called SUPREME-DM (Surveillance, Prevention, and Management of Diabetes Mellitus), created a national infrastructure that will enable many years of comparative effectiveness research on diabetes prevention and treatment. The SUPREME-DM DataLink comprises about 1.3 million adult members with diabetes as well as patients at high risk for developing type 2 diabetes in the membership of each of 11 participating health systems.

Featured Studies

Comparing Two Gestational Diabetes Screening Methods: A Pragmatic Outpatient Randomized Clinical Trial

This five-year project is testing two different ways of screening women for diabetes in pregnancy (gestational diabetes). The study involves more than 17,500 pregnant women and their babies in a large, diverse health maintenance organization. Our goal is to determine how diagnosis and treatment of gestational diabetes, based on the two different screening strategies, affect complications for both mother and baby.

Teresa Hillier, MD

Principal Investigator

Funder: National Institute of Child Health and Human Development

Dissemination of CVD Risk Factor Treatment Among Diabetic Patients in FQHCs

Adults with diabetes who take aspirin, statins, and ACE inhibitors can dramatically reduce their risk of cardiovascular events. Kaiser Permanente has committed to putting members with diabetes on this drug regimen, using the electronic medical record to identify the right patients and remind providers to start these patients on the medications. We sought to implement the same protocol for patients at 11 community health centers (CHCs) in Oregon. Our goal was to assess whether KP’s program could be successfully disseminated in those settings, and whether it can affect the percentage of eligible patients who are prescribed and refill the target medications. We demonstrated that this intervention to improve delivery of guideline-concordant care could be adapted for and implemented in CHCs, and that doing so significantly improved care quality in CHCs.

Gregory Nichols, PhD

Principal Investigator

Funder: National Heart, Lung, and Blood Institute

Practices Enabling Adapting and Disseminating in the Safety Net—SPREAD-NET

This five-year study compares the effectiveness of different strategies to support community health centers as they adapt and implement the ALL (aspirin, lovastatin, and lisinopril) intervention, which is designed to increase appropriate medication prescription for patients with diabetes. We will assess the minimum level of support needed, as well as what hinders or facilitates each strategy at the clinic level, and how the strategies may be adapted to address barriers.

Rachel Gold, PhD

Principal Investigator

Funder: National Heart, Lung, and Blood Institute

Cumulative Glycemic Burden and Cardiovascular Disease Risk in Type 2 Diabetes

This study assessed whether cumulative glycemic burden predicts cardiovascular disease (CVD) risk in people with diabetes mellitus better than individual A1C measures, or mean A1C. We also examined whether there are threshold levels of cumulative glycemic burden above which CVD risk becomes markedly elevated among people with diabetes. The sample for the study included adult Kaiser Permanente members who were newly diagnosed with diabetes in 1995–2005 after at least 12 months of membership.

Gregory Nichols, PhD

Principal Investigator

Funder: National Institute of Diabetes and Digestive and Kidney Diseases

Press Release

Lifestyle Intervention Helps People Taking Antipsychotic Medications Lose Weight and Reduce Diabetes Risk

People with serious mental illnesses already at higher risk for obesity; medications that control their symptoms often lead to additional weight gain.

9/15/2015

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Copyright © 2016, Kaiser Permanente Center for Health Research

Kaiser Permanente identifies financial conflicts of interest (FCOI) and other situations that may give rise to conflicts of interest, and addresses such situations to ensure research decisions made are in the best interests of KP, its research participants, patients, and members. Kaiser Permanente operates in accordance with federal regulations addressing research financial conflicts of interest through our Policy on FCOI in Research.