Diabetes Outreach Network
Abstract
Oral and Poster Presentations by MDON staff

Author: S. A. Parker

Background and Aims: To assure that persons with diabetes receive care according to the clinical practice recommendations of the American Diabetes Association.

Materials and Methods:  The Michigan Diabetes Outreach Network (MDON) collaborates with health care providers through a systematic continuous quality improvement initiative. Consultation, education, scannable forms, data entry software, and reports are provided by the Network to partner providers.

The current MDON database includes information on over 30,000 clients (intake data) and 19,000 clients (follow-up data) from 165 provider agencies (physician offices, home care, state certified diabetes education programs, community health care centers, and other settings).

Changes are measured for clinical indicators such as the completion of an annual HgA1c (glycosylated hemoglobin) test, dilated eye exams, and foot exams. Behavioral and lifestyle changes are measured such as exercise, nutrition management, and smoking cessation.

MDON data reports are provided to each partner agency quarterly. Reports detail demographic trends and client outcomes serving as the basis for quality improvement activities.

Results: Trends in follow-up data from FY 1996 through FY 2001 for glycosylated hemoglobin, foot exam, and microalbuminuria (all done at least once annually) show a significant improvement in number of persons with diabetes having these tests done.

Glycosylated hemoglobin tests increased from14 percent in FY 1996 to 78 percent in FY 2001 and foot exams done increased from 58 percent in FY 1996 to 77 percent in FY 2001. Microalbuminuria tests were added to the data system in FY 2000 and show an increase from 22 percent to 28 percent in number of persons having the test between FY 2000 and FY 2001. Individualized data analysis from the regional Diabetes Outreach Networks show a positive downward trend in the levels of glycosylated hemoglobin. Between 1995-97 there was a decrease in the glycosylated hemoglobin values of 0.69 percent (N-9,617 intakes and 4,749 follow-ups). Between 1999-01 there was a decrease value of 1.15 percent (N-10,982 intakes and 3,158 follow-ups).

Conclusions: Results from the MDON Diabetes Care Improvement Project have helped to close the gap in Michigan's excess diabetes related mortality compared to national averages.

A regional network of collaborating agencies can improve diabetes care through use of a coordinated diabetes care improvement program and working together to problem solve with creative strategies.

Contact: S. A. Parker (616) 735-1118