Member of the Executive Committee:  American Diabetes Association

Message from the President,
Health Care and Education

Over the last two years, I have had the pleasure of working toward a specific goal with several other committed ADA volunteers. The charge given to the Outcomes Research Task Force in fall 1998 was to "identify one or two major pivotal studies in outcomes research that ADA should consider funding." The original task force included:

• Eugene Barrett, MD, PhD
• Jonathan B. Brown, MPP, PhD
• Michael M. Engelgau, MD
• Russell E. Glasgow PhD
• Sheldon Greenfield, MD
• Sheila Roman, MD, MPH
• Donald C. Simonson, MD
• Patricia Splett, PhD, RD
• Morris Weinberger, PhD
• Elizabeth A. Walker, DNSc, RN, CDE, Chair

Chairing this task force was outside of my role on ADA’s Executive Committee, but I did it because it is a charge to which I am very committed. This group met face to face only once and then continued the work by conference call, e-mail and fax with the staff support of Matt Petersen, director of Research Programs, and input from Chief Scientific & Medical Officer Richard Kahn, PhD. What follows is a brief history of the journey we took to arrive at the final approved document, which is in fact a Request for Proposals (RFP), currently in search of funding. And I share this history with you so that you also can appreciate the expert community of volunteers we have in the ADA.

We agreed on our working definition of "outcomes research" as …an effectiveness evaluation that describes the relationship between diabetes care practices under real-world conditions among communities, systems, providers, and/or patients and measurable patient outcomes. These measurable patient outcomes include health status, quality of life, health behaviors, morbidity, and mortality, as well as economic impact and use of health resources, among others.

Of the 15 potential questions we discussed in that first meeting, two emerged as potentially significant areas of study and funding by ADA. The first asked the question found in the title of this President’s message: What are essential characteristics of effective diabetes self-management education (DSME)? The second question related to optimal algorithms for treatment of new-onset type 2 diabetes. Over 6–8 months of the task force’s work, the first question emerged as the priority for ADA funding of outcomes research. There had been too many instances when we desired evidence about effective DSME and simply did not have that evidence.

A smaller workgroup of the task force then developed the request for proposals document focusing on the chosen question. I sincerely thank Russ Glasgow, Morris Weinberger, Pat Splett, Mike Engelgau, and Sheila Roman for continuing to work closely with the writing and review through this long process. The result is a document now approved by ADA’s Research Policy Committee, chaired by Alan Cherrington, PhD, and ADA’s Executive Committee. The search for funding partners in what is expected to be a multiyear, multisite study has begun. Because the budget for this kind of (outcomes) research is much greater than our usual ADA grant mechanisms, the RFP will not be released until that funding is secure. We feel this is the most responsible course of action.