VII. Chronic Disease Prevention

FY 2000 Performance Plan - Revised Final FY 1999 Performance Plan

Diabetes and Other Chronic Conditions

Almost 16 million people in the United States have diabetes, with approximately 800,000 new cases each year or 2,200 new cases each day. The number of individuals with known diabetes has increased steadily, especially within selected racial and ethnic communities. Diabetes remains the 7th leading cause of death in the U.S. People with diabetes also suffer significant complications such as kidney disease (approximately 30,000/year), high blood pressure (60 to 65% of people with diabetes have high blood pressure), amputations (approximately 57,000/year or 150/day); blindness among working aged adults (approximately 20,000/year or 60/day); and end-stage kidney disease (approximately 30,000/year or 70/day).

The goal of CDC's diabetes control program is to eliminate preventable diabetes-related morbidity and disability while improving the overall quality and length of life for all persons with diabetes. This effort requires a multi-faceted approach that works to translate research findings into clinical and public health practice. The CDC diabetes prevention and control program emphasizes (1) support for state-based diabetes control programs in all 50 states to develop or expand diabetes control efforts in the state with additional funding for selected states to conduct comprehensive control efforts statewide; and (2) activities to improve the quality of care received by persons with diabetes.

Performance Goals and Measures

Performance Goal: Reduce the prevalence of chronic and disabling conditions and improve quality of life for those already affected by these conditions by building nationwide programs in chronic disease prevention and health promotion, and intervening in selected diseases and risk factors.

Performance Measures:

FY Baseline	FY 1999 Appropriated	FY 2000 Estimate
FY 2000: 60% (1998).		100% of CDC-funded state diabetes control programs will adopt, promote and implement patient care guidelines for improving the quality of care received by persons with diabetes.
FY 2000: Eye 62% (1996). Foot 52% (1996).		For all states that receive CDC-funding for comprehensive diabetes control programs, increase by 10% the percentage of diabetics who receive an annual eye exam and annual foot exam.
4 Applied Research Studies (1997).	At least 5 applied prevention research studies will be conducted to better understand how to apply diabetes scientific findings in clinical and public health practice and the results published in peer-reviewed journals.
21 states/jurisdictions or 36% (1994).	At least 75% of the 58 State Diabetes Programs will have core capacities: surveillance of diabetes and diabetes-related conditions and risk factors; formal relationships with medical and private, non-profit organizations; communication networks with collaborating organizations; assessment of quality of care of diabetes patients; and public awareness campaigns.
Total Program Funding	$80,134	$80,134

Verification/Validation of Performance Measures: Performance will be verified through quarterly state reports to CDC and periodic site visits, demonstration of CDC development of studies, and, for efforts in Native American/Alaskan Native populations, program reports submitted to CDC and demonstration of the number of programs supported by CDC.

Links to DHHS Strategic Plan

These performance objectives are related to DHHS Goal 4: Improve the quality of health care and human services, and specifically Goal 4.1: Promote the appropriate use of effective health services. This goal area reflects the intent of having state programs adopt and promote patient care guidelines for persons with diabetes, which in turn enables both health care providers and patients to know what is needed for quality diabetes care. This effort, along with other educational and programmatic activities, should lead to an increase in foot and eye exams for diabetics.

In addition to state health departments, CDC collaborates with the American Diabetes Association, Juvenile Diabetes Foundation, American Association of Diabetes Educators, and managed care organizations in the control of diabetes and its complications.

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