Best practices in innovative type 2 diabetes program management: a case study

To illustrate, through a case study format, a successful type 2 diabetes disease management program.

Intermountain Health Care (IHC) has implemented an evidence-based, integrated approach to the management of type 2 diabetes that includes multiple interventions: (1) a regularly updated treatment algorithm; (2) a comprehensive data registry to rapidly identify patients with type 2 diabetes; (3) a system of regular patient reminders for laboratory and other relevant testing, such as eye and foot examinations; (4) patient education that fosters an understanding of the benefits of antidiabetic medications and the need for consistent treatment; (5) pharmacist and nurse involvement to facilitate physician appointments when needed, track medication use, ensure consistent compliance, and answer questions; and (6) physician performance reports that provide an opportunity for rapid peer-to-peer outcomes comparisons. The implementation of this program has yielded a substantial increase in the number of patients within the system identified with type 2 diabetes and an increase in the percentage of patients with improved glycemic control based on HbA1c, as well as an unexpected benefit--an increase in the number of patients with improved low-density lipoprotein cholesterol levels.

An integrated, evidence-based disease management program, such as the one developed by IHC, can improve type 2 diabetes outcomes in the managed care setting and, perhaps, reduce long-term costs.