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Diabetes and chronic disease

Improving quality of life for patients with diabetes and chronic disease

Our research in prevention and management of chronic illness is key to improving lives. By translating new findings into care, we reduce the impact on individuals, their families and communities.

We study diabetes management, complications and interventions as well as innovative technologies. Our International Diabetes Center has conducted hundreds of diabetes-related studies. This includes participation in landmark studies such as Diabetes Control and Complications Trial (DCCT), Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial and the Glycemia Reduction Approaches in Diabetes: A comparative Effectiveness Study (GRADE).

Our hypertension research program is also well established. We participated in several landmark multicenter trials funded by the National Heart, Lung, and Blood Institute. These trials examined blood pressure and heart outcomes. They include ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial), the Women’s Health Initiative, and ACCORD. We have also studied blood pressure outcomes, including methods to improve hypertension through telemonitoring and pharmacist support.

Investigators

Key projects

Demonstrating how technology can improve diabetes management

We developed and gathered consensus for the ambulatory glucose profile (AGP), the first continuous glucose monitoring (CGM) software to analyze and display glucose patterns. The American Diabetes Association, along with seven other diabetes organizations around the world, endorsed the value of the AGP. Learn more at the AGP website.

We showed use of real-time CGM improves the way people with type 2 diabetes use basal insulin to manage their condition. This data expands the number of people who could benefit from these devices, and points to a possible future in which CGMs are common in primary care clinics.

We studied whether an automated insulin dose guidance system can offer more effective ways to tailor doses of insulin and improve diabetes management.

Maintaining healthy blood pressure at home

Routinely logging blood pressure measurements at home and speaking with a pharmacist every two to four weeks significantly reduced patients’ blood pressure over a span of 24 months, according to a study led by our researchers. The study suggests blood pressure improvement lasts for about a year after a telemonitoring program ends, which extends the impact on health and costs. The degree of blood pressure lowering because of this study reduced the number of cardiovascular events by about half.

Health Care Homes Minnesota Care Coordination Effectiveness Study (MNCARES)

In collaboration with the Minnesota Department of Health and MN Community Measurement, we were awarded $4 million from the Patient Centered Outcomes Research Institute to study the effect of care coordination on patient outcomes. We will compare two approaches to care coordination for patients with high health care costs and multiple morbidities. The goal is to learn what approaches produce the best care quality, utilization and patient-centered outcomes.

Can clinical decision support impact management of obesity?

For the more than 12 million people in the United States who are clinically obese and living with diabetes, there are many effective weight-loss treatments. Data show, however, that clinicians and patients alike don’t fully understand the treatment options and their benefits. With a grant from the National Institutes of Health, we’ll use our clinical decision support platform to help primary care physicians personalize treatment recommendations for severe obesity in patients with type 2 diabetes. And we’ll analyze data from 40 primary care clinics to assess whether this platform impacts active management of obesity, weight trajectories, and patient and clinician satisfaction with the decision support intervention.

Artificial pancreas

International Diabetes Center was one of 10 sites worldwide to study the Medtronic 670G hybrid closed-loop system. The system uses a continuous glucose sensor that communicates wirelessly with an insulin pump. The pump has a built-in formula that determines the amount of insulin needed to keep glucose as normal as possible. Study results led to U.S. Food and Drug Administration approval of the first-ever hybrid closed-loop system, often called the first-generation artificial pancreas. We continue to study advancements in this technology.

Key publications

Learn more about our diabetes, primary care/pediatrics and chronic care investigators and their publications by visiting Knowledge Exchange.