IUSM part of largest diabetes study ever undertaken by CDC

The Indiana University School of Medicine (IUSM) is one of six research centers selected by the Centers for Disease Control and Prevention (CDC) for a five-year study in managed-care environments designed to evaluate and improve the health care and health status of people with diabetes. Total first-year funding for the project is $2.4 million.

The CDC announced the kick-off of the new multi-center study Monday. The study is the largest of its kind undertaken by the CDC. The new initiative has been dubbed "translational research."

Diabetes has different impacts on different ethnic groups. Scientists do not know why. Through "translational research" at centers providing a geographic and ethnic representation of the United States, the study's ultimate goal is to improve diabetes health-care delivery in a managed care environment.

Translational research has three components: to assess the level and quality of care implemented in practice; to explore the factors that affect variations in implementation and to identify barriers to change; and to identify and test change strategies aimed at achieving optimal care. "Translational research is the study of how to get the latest medical advances and care quickly to the people who need it most," said Dr. Frank Vinicor, director of CDC's Division of Diabetes Translation.

IUSM is nationally recognized for research into diabetes care. It has one of the original Diabetes Research and Training Center designations and is one of only four medical centers in the nation with both a Diabetes Prevention Program grant and a Diabetes Research and Training Center.

"This study will help us understand and improve the quality of care and quality of life for people with diabetes," said Dr. Venkat Narayan, the CDC's principal investigator for the study.

More than 16 million people have diabetes, which is a leading cause of new cases of blindness, kidney failure and amputations. The direct and indirect costs of diabetes are $98 billion annually.

David Marrero, associate professor of medicine, is the principal investigator for IUSM's portion of the nation-wide study. IU will receive more than $300,000 the first year, which will be spent organizing the study and establishing common protocols for all six centers to follow.

"The goal of the study is to design, implement and evaluate interventions to improve diabetes health-care delivery in a managed-care environment," Marrero said.

Ultimately, the CDC hopes the study will lead to better use of the existing treatments available to individuals with diabetes. Education of persons with diabetes can significantly improve control of the disease. The potential benefits to the Medicare and Medicaid programs, as well as improvements in the quality of life of our aging population, could be profound. Despite the value of these treatments, they are not currently used as much as they should be, said Dr. Narayan. The other research centers are located in California, Hawaii, Michigan, New Jersey and Texas. The centers, along with a coordinating center and the CDC, will work together to assess the existing quality of care and quality of life among people with diabetes, and to identify the major modifiable barriers to improvement in care across different ethnic groups.

The CDC selected the six research centers after a competitive review process. "These centers provide a geographic and ethnic representation of the United States, including African Americans, Native Americans, Hispanic-Latinos and Asian-Pacific islanders and Caucasians," said Vinicor. "We know diabetes has different impacts on different ethnic groups, though we don't know why. But we hope to learn how efficacious treatments can be effectively delivered and the burden of diabetes can be reduced for all Americans."

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