K. David McCowen, MD, FACP, Medical Director, Diabetes Endocrine Consultants Northwest for Franciscan Medical Group. Talking about diabetes prevention best practices.

1. K. David McCowen, MD, FACP
Medical Director, Diabetes
Endocrine Consultants Northwest
Franciscan Medical Group
Prevention of T2DM
Stemming the Tide

2. • T2DM: 93% of all DM
• Rapid expansion of disease incidence
• Always preceded by Impaired Glucose
Tolerance (IGT) 790.21
• FBS = 100 – 125 mg/dl
• HgbA1c – 5.7 or 6.0 to 6.5 %
2 | Creating Healthier Communities | Best practices for managing high-risk clinical populations

3. Diabetes Prevention Program (DPP)
• Treated IGT patients: Life Style Changes vs Metformin (Met)
vs no intervention. Now we have 10 year data.
• Delay development of DM: LSC = 11%; Met = 3%.
• Reduction of DM incidence: LSC = 20%; Met = 8%.
• Above compared to the no intervention arm.
• Reduced microvascular, neuropathic, and CV complications.
• Quality Adjusted Life Years (QALY): cost $8800 LSC;
$29,900 Met.
• Survival up 0.5 years LSC; 0.2 years Met.
3 | Creating Healthier Communities | Best practices for managing high-risk clinical populations

4. DPP continued
• THE COST EFECTIVNESS IMPROVED WHEN THE
INTERVENTIONS WERE IMPLEMENTED IN
ROUTINE CLINICAL PRACTICE
• Last month FMG implemented a robust DM treatment
pathway.
• We included the therapy of IGT as equally (and
probably more) important than the DM1 and DM2
pathways.
4 | Creating Healthier Communities | Best practices for managing high-risk clinical populations

5. 5 | Creating Healthier Communities | Best practices for managing high-risk clinical populations

6. 6 | Creating Healthier Communities | Best practices for managing high-risk clinical populations
Identify

7. Assessment & Diagnosis

8. Treatment

9. THANK YOU

10. THANK YOU