by Jennifer Porter Gore
Without question, diabetes has long been a scourge in the Black community: slightly more than one in 10 Black adults suffer from the disease. In Chicago, the news is even worse: the city’s public health department found that up to 37% of adults living in vulnerable communities have been diagnosed with diabetes.
Yet a highly-effective program that reduced wait times for diabetic care and helped patients more effectively manage the disease could end if funding is allowed to run out.
Since 2020, the ECHO-Chicago Complex Diabetes program has addressed the city’s urgent need for diabetes care by building virtual learning communities with specialist teams. The teams share best practices with area doctors, nurses and other primary care providers and provide expert guidance so patients can access the care they need.
Before ECHO-Chicago launched its diabetes program patients were often waiting up to four to six months to see a diabetes specialist.
“ECHO-Chicago’s first series was focused on resistant hypertension based on the request from community health center providers. Since that time, we have initiated training in more than 50 topic areas,” says Dr. Daniel Johnson, ECHO-Chicago’s founder and director. “The diabetes series impacted 24 community health centers in Illinois, primarily in Chicago. Across all of its programs, ECHO-Chicago has trained providers at 1430 sites of care.”
Nationally, the Black population has the second-highest rate of diagnosed diabetes at just over 12%. In Illinois, diabetes rates range from 7% to 13% depending on demographics.
The University Chicago adopted the Extension for Community Healthcare Outcomes to create ECHO-Chicago in 2010.
ECHO is a tele-mentoring system originally designed to improve healthcare access in underserved areas where clinicians and their patients can be hundreds of miles from disease specialists.Through the connections, specialists provide virtual training sessions for local clinicians that enhances their ability to treat complex health conditions.
The ECHO model was first used in 2003 to treat hepatitis-C in rural New Mexico. The system is now available in underserved areas across the U.S. and in more than 200 countries.
In New Mexico, for example, ECHO-trained providers helped diabetes patients improve their glucose control, which significantly decreases risk of complications like blindness and kidney failure. ECHO-Chicago has demonstrated the model works in urban areas as well as it does in mostly rural states. Chicago participants have reported their patients now take newer oral medications more often and see much improved glucose levels.
The program also helped healthcare providers learn about new medications and methods to manage medically and socially complex cases.
That includes “addressing the social needs such as food insecurity or housing instability that make it difficult for patients to prioritize their health” says. Dr. Monica Peek, professor of General Internal Medicine at the University of Chicago.
“Health systems and insurance companies are starting to support efforts for us to do just that within the clinical setting,” she says. “It has been a game-changer in our ability to provide holistic care to patients at most risk for poor diabetes control and diabetes complications like amputations, kidney failure and blindness.”
Working on the initiative, Peek says “was an extremely rewarding experience, bringing together a multi-disciplinary team with expertise in social work, behavioral health, diabetes education, and clinical pharmacy to conduct the interactive sessions for providers in the greater Chicago area.”
More than 20 years ago, research confirmed that type 2 diabetes can be prevented. But a snafu in the Illinois state legislature has put funding for the program in limbo. And at the federal level, the Trump administration canceled funding for the Diabetes Prevention Program Outcomes Study, a continuous 30-year, nationwide study.
The American Diabetes Association, a nonprofit advocacy group, said in a statement that it is “extremely concerned” about the move, “and the resulting support for people at risk of type 2 diabetes.”
Eliminating funding for the DPP/DPPOS 30-year nationwide study, the organization said, “means the loss of a decade’s worth of important findings and progress toward diabetes prevention and understanding Alzheimer’s disease and associated dementia in diabetes, a recent focus of the study.”
Dr. Celeste Thomas, an endocrinologist and professor at the University of Chicago, said although Columbia University is the primary recipient of the grant, “more than 90% of funds go to research activities at 29 institutions outside of Columbia [University} and in 21 additional states.” says. Thomas also directs the Kovler Diabetes Center.
Last week, she said, they had to notify more than 80 study participants that despite the program’s progress it was ending.
“These generous, committed individuals enrolled in the study in the late 1990s and we shared our hopes to get funding restored,” says Thomas. “We [also] need to get the word out because the infrastructure for this important project will collapse and our connection with the over 1,700 research participants across the United States threatened if funding is not restored immediately.”
Source: Seattle Medium
