In an unprecedented show of cooperation, the combined efforts of seven Utah health care plans have resulted in a significant reduction in the risk for complications among patients diagnosed with diabetes. Since 1998, the Utah Diabetes Partnership has been educating people with diabetes and physicians to meet recommended treatment targets.

The Partnership's managed healthcare providers are Altius, DMBA, Healthy U, Molina, SelectHealth, United Healthcare and the Utah Medicaid Program's Bureau of Managed Care. They are joined by HealthInsight, Utah's designated quality improvement organization, as well as the Utah Department of Health (UDOH) Diabetes Prevention and Control Program.

"Utah was one of the first two states to initiate this type of partnership and is currently one of five," said Craig Merrill, health systems specialist, Diabetes Prevention and Control Program, UDOH.

The cooperative nature of the Partnership has enhanced the impact of messages sent to both patients and providers. Many of the interventions are entered into and promoted jointly. However, the Partnership has allowed the plans to learn from each other which methods of patient education and information are most effective in the disease management and prevention of potential diabetes complications among their members.

The Partnership's latest data outline its ongoing success in specific focus areas, including A1C level maintenance, LDL cholesterol level maintenance, annual eye exams and kidney function monitoring. Data come from insurance claims and patient charts, and is collected from a random sample of health plan members with diabetes.

Results of the 2005 data indicate significant improvements in each of the treatment target areas. For example, A1C is the measurement of the percentage of red blood cells with attached sugar molecules. This level represents how well patients have controlled their average blood sugar over the past three months. It is the most effective tool in the evaluation of diabetes control. One of the Partnership's objectives is to have patient's reach an A1C target of less than 7 percent. In 2005, the Partnership measure for patients with documented A1C below target reached 47 percent, essentially doubling the 24 percent found in 1998.

Annual eye exams and urine protein tests to detect early signs of eye and kidney disease are also disease management targets. Diabetic eye disease is the most common cause of blindness among working age adults. The eye exams improved from 42 percent in 1998 to 57 percent in 2005, an increase of 37 percent. Urine protein testing for kidney disease increased 72 percent, from 33 percent to 57 percent in 2005. Diabetes accounts for 45 percent of new kidney dialysis and transplant patients in Utah.

High LDL (bad) cholesterol is particularly common among people with diabetes, and diabetes is a major risk factor for heart attack and stroke. People with diabetes have a risk for future heart attacks and strokes comparable to those who have already suffered a past heart attack or stroke. The 2005 findings show that 48 percent of health plan members achieved the recommended LDL cholesterol target of less than 100mg/dL, compared with 18 percent of health plan members in 1998.

"While these are results of the health plans in the Partnership, the benefit extends to many more since the involved physicians treat about 90 percent of Utahns with diabetes," Merrill said.

The UDOH provides seed money for the activities of the Partnership through a grant from the Centers for Disease Control and Prevention. The health plans match that funding through their own efforts with over $100,000 per year.

For further information regarding the Utah Diabetes Partnership and the health plan data results, please contact Craig Merrill, UDOH Diabetes Prevention and Control Program, at 801-538-7013.

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