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  1. Centers for Disease Control and Prevention. National diabetes statistics report: estimates of diabetes and its burden in the United States, 2014. Atlanta, GA: U.S. Department of Health and Human Services; 2014.
  2. Fagot-Campagna A, Pettitt DJ, Engelgau MM, et al. Type 2 diabetes among North American children and adolescents: an epidemiologic review and a public health perspective. J Pediatr. 2000;136(5):664-72.
  3. Nathan DM, Cleary PA, Backlund JY, et al. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med. 2005;353(25):2643-53.
  4. Holman RR, Paul SK, Bethel MA, et al. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008;359(15):1577-89.
  5. American Diabetes Association. Economic costs of diabetes in the U.S. in 2007. Diabetes Care. 2008;31(3):596-615.
  6. Herman WH, Eastman RC. The effects of treatment on the direct costs of diabetes. Diabetes Care. 1998;21 Suppl 3:C19-24.
  7. Gilmer TP, O'Connor PJ, Manning WG, et al. The cost to health plans of poor glycemic control. Diabetes Care. 1997;20(12):1847-53.
  8. Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403.
  9. Herman WH, Hoerger TJ, Brandle M, et al. The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with impaired glucose tolerance. Ann Intern Med. 2005;142(5):323-32.
  10. Knowler WC, Fowler SE, Hamman RF, et al. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009;374(9702):1677-86.
  11. Wagner EH: Chronic disease management. What will it take to improve care for chronic illness? Effective Clinical Practice. 1998;1:2-4.
  12. Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness. JAMA. 2002;288(14):1775-9.
  13. Carrier E, Gourevitch MN, Shah NR: Medical homes. challenges in translating theory into practice. Med Care. 2009;47(7):714-22.
  14. Erickson CD, Splett PL, Mullett SS, et al. The healthy learner model for student chronic condition management—part I. J Sch Nurs. 2006;22(6):310-8.
  15. Peterson KA, Radosevich DM, O'Connor PJ, et al. Improving Diabetes Care in Practice: findings from the TRANSLATE trial. Diabetes Care. 2008;31(12):2238-43.
  16. American Academy of Physician Assistants. 2008 AAPA Physician Assistant Census Report. Alexandria, VA; 2009.
  17. Cooper RA. New directions for nurse practitioners and physician assistants in the era of physician shortages. Acad Med. 2007;82(9):827-8.
  18. Goolsby MJ. 2004 AANP National Nurse Practitioner Sample Survey, part I: an overview. J Am Acad Nurse Pract. 2005;17(9):337-41.
  19. Roman SH, Harris MI. Management of diabetes mellitus from a public health perspective. Endocrinol Metab Clin North Am. 1997;26(3): 43-74.
  20. Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness: the chronic care model, Part 2. JAMA. 2002;288(15):1909-14.
  21. Tsai AC, Morton SC, Mangione CM, et al. A meta-analysis of interventions to improve care for chronic illnesses. Am J Manag Care. 2005;11(8):478-88.
  22. Robert Graham Center. The Patient Centered Medical Home History, Seven Core Features, Evidence and Transformational Change. Washington, DC: Policy Studies in Family Medicine and Primary Care; 2007.
  23. Reid RJ, Coleman K, Johnson EA, et al. The group health medical home at year two: cost savings, higher patient satisfaction, and less burnout for providers. Health Aff (Millwood). 29(5):835-43.
  24. Fact Sheet: Medicare-Medicaid Advanced Primary Care Demonstration Initiative. 2010. www.cms.gov/DemoProjectsEvalRpts/downloads/mapcpdemo_Factsheet.pdf
  25. O'Connor PJ, Sperl-Hillen JM. The role of diabetes educators in the medical home. Diabetes Spectrum. 2009;22(2):124-6.
  26. Erickson CD, Splett PL, Mullett SS, et al. The healthy learner model for student chronic condition management—part II: the asthma initiative. J Sch Nurs. 2006;22(6):319-29.
  27. Quickel KE, Jr. Managed care and diabetes, with special attention to the issue of who should provide care. Trans Am Clin Climatol Assoc. 1996;108:184-95.
  28. Scanlon DP, Hollenbeak CS, Beich J, et al. Financial and clinical impact of team-based treatment for Medicaid enrollees with diabetes in a federally qualified health center. Diabetes Care. 2008;31(11):2160-5.
  29. Huang ES, Zhang Q, Brown SE, et al. The cost-effectiveness of improving diabetes care in U.S. federally qualified community health centers. Health Serv Res. 2007;42(6 Pt 1):2174-93; discussion 2294-323.
  30. Ray MD. Shared borders: achieving the goals of interdisciplinary patient care. Am J Health Syst Pharm. 1998;55(13):1369-74.
  31. Funnell MM, Brown TL, Childs BP, et al. National standards for diabetes self-management education. Diabetes Care. 2007;30(6):1630-7.
  32. Shojania KG, Ranji SR, McDonald KM, et al. Effects of quality improvement strategies for type 2 diabetes on glycemic control: a meta-regression analysis. JAMA. 2006;296(4):427-40.
  33. Davidson MB, Castellanos M, Duran P, et al. Effective diabetes care by a registered nurse following treatment algorithms in a minority population. Am J Manag Care. 2006;12(4):226-32.
  34. Silverstein JH, Rosenbloom AL. Treatment of type 2 diabetes mellitus in children and adolescents. J Pediatr Endocrinol Metab. 2000;13(Suppl 6):1403-9.
  35. Brink SJ, Miller M, Moltz KC. Education and multidisciplinary team care concepts for pediatric and adolescent diabetes mellitus. J Pediatr Endocrinol Metab. 2002;15(8):1113-30.
  36. Gaede P, Vedel P, Larsen N, et al. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med. 2003;348(5):383-93.
  37. Gaede P, Lund-Andersen H, Parving HH, et al. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008;358(6):580-91.
  38. Hastings C. The changing multidisciplinary team. Nurs Econ. 1997;15(2):106-8,105.
  39. Engelgau MM, Geiss LS, Manninen DL, et al. Use of services by diabetes patients in managed care organizations. Development of a diabetes surveillance system. CDC Diabetes in Managed Care Work Group. Diabetes Care. 1998;21(12):2062-8.
  40. American Diabetes Association. Standards of medical care in diabetes—2011. Diabetes Care. 2011;34(Suppl 1):S11-61.
  41. Sarkar U, Handley MA, Gupta R, et al. Use of an interactive, telephone-based self-management support program to identify adverse events among ambulatory diabetes patients. J Gen Intern Med. 2008;23(4):459-65.
  42. Fursse J, Clarke M, Jones R, et al. Early experience in using telemonitoring for the management of chronic disease in primary care. J Telemed Telecare. 2008;14(3):122-4.
  43. Piette JD, McPhee SJ, Weinberger M, et al. Use of automated telephone disease management calls in an ethnically diverse sample of low-income patients with diabetes. Diabetes Care. 1999;22(8):1302-9.
  44. Adkins JW, Storch EA, Lewin AB, et al. Home-based behavioral health intervention: Use of a telehealth model to address poor adherence to type-1 diabetes medical regimens. Telemed J E Health. 2006;12(3):370-2.
  45. Ferris FL, 3rd. Photocoagulation for diabetic retinopathy. Early Treatment Diabetic Retinopathy Study Research Group. JAMA. 1991;266(9):1263-5.
  46. Robinson C. Telemedicine. An emerging technology. One the Cutting Edge; Diabetes Care & Education; Academy of Nutrition and Dietetics. 2007;27(6).
  47. Scott JC, Conner DA, Venohr I, et al. Effectiveness of a group outpatient visit model for chronically ill older health maintenance organization members: a 2-year randomized trial of the cooperative health care clinic. J Am Geriatr Soc. 2004;52(9):1463-70.
  48. Kirsh S, Watts S, Pascuzzi K, et al. Shared medical appointments based on the chronic care model: a quality improvement project to address the challenges of patients with diabetes with high cardiovascular risk. Qual Saf Health Care. 2007;16(5):349-53.
  49. Wagner EH, Grothaus LC, Sandhu N, et al. Chronic care clinics for diabetes in primary care: a system-wide randomized trial. Diabetes Care. 2001;24(4):695-700.
  50. Trento M, Passera P, Borgo E, et al. A 5-year randomized controlled study of learning, problem solving ability, and quality of life modifications in people with type 2 diabetes managed by group care. Diabetes Care. 2004;27(3):670-5.
  51. Clancy DE, Cope DW, Magruder KM, et al. Evaluating group visits in an uninsured or inadequately insured patient population with uncontrolled type 2 diabetes. Diabetes Educ. 2003;29(2):292-302.
  52. Deakin T, McShane CE, Cade JE, et al. Group based training for self-management strategies in people with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2005(2):CD003417.
  53. Davies MJ, Heller S, Skinner TC, et al. Effectiveness of the diabetes education and self management for ongoing and newly diagnosed (DESMOND) programme for people with newly diagnosed type 2 diabetes: cluster randomised controlled trial. BMJ. 2008;336(7642):491-5.
  54. Gage H, Hampson S, Skinner TC, et al. Educational and psychosocial programmes for adolescents with diabetes: approaches, outcomes and cost-effectiveness. Patient Educ Couns. 2004;53(3):333-46.
  55. Hampson SE, Skinner TC, Hart J, et al. Effects of educational and psychosocial interventions for adolescents with diabetes mellitus: a systematic review. Health Technol Assess. 2001;5(10):1-79.
  56. Klonoff DC, Schwartz DM. An economic analysis of interventions for diabetes. Diabetes Care. 2000;23(3):390-404.
  57. Loveman E, Cave C, Green C, et al. The clinical and cost-effectiveness of patient education models for diabetes: a systematic review and economic evaluation. Health Technol Assess. 2003;7(22):iii,1-190.
  58. Norris SL, Nichols PJ, Caspersen CJ, et al. Increasing diabetes self-management education in community settings. A systematic review. Am J Prev Med. 2002;22(4 Suppl):39-66.
  59. Boren SA, Fitzner KA, Panhalkar PS, et al. Costs and benefits associated with diabetes education: a review of the literature. Diabetes Educ. 2009;35(1):72-96.
  60. Robbins JM, Thatcher GE, Webb DA, et al. Nutritionist visits, diabetes classes, and hospitalization rates and charges: the Urban Diabetes Study. Diabetes Care. 2008;31(4):655-60.
  61. Duncan I, Birkmeyer C, Coughlin S, et al.: Assessing the value of diabetes education. Diabetes Educ. 2009;35(5):752-60.
  62. Kilpatrick KE, Brownson CA. Building the business case for diabetes self management: a handbook for program managers. St. Louis: Diabetes Initiative, National Program Office at Washington University School of Medicine; 2008.
  63. Brownson CA, O'Toole ML, Gowri S, et al. Clinic-community partnerships: A foundation for providing community supports for diabetes care and self-management. Diabetes Spectrum. 2007;20(4):209-214.
  64. Finch EA, Kelly MS, Marrero DG, et al. Training YMCA wellness instructors to deliver an adapted version of the Diabetes Prevention Program lifestyle intervention. Diabetes Educ. 2009;35(2):224-8, 232.
  65. Ackermann RT, Finch EA, Brizendine E, et al. Translating the Diabetes Prevention Program into the community. The DEPLOY Pilot Study. Am J Prev Med. 2008;35(4):357-63.
  66. Janicke DM, Sallinen BJ, Perri MG, et al. Comparison of parent-only vs family-based interventions for overweight children in underserved rural settings: outcomes from project STORY. Arch Pediatr Adolesc Med. 2008;162(12):1119-25.
  67. Janicke DM, Sallinen BJ, Perri MG, et al. Comparison of program costs for parent-only and family-based interventions for pediatric obesity in medically underserved rural settings. J Rural Health. 2009;25(3):326-30.
  68. Norris SL, Chowdhury FM, Van Le K, et al. Effectiveness of community health workers in the care of persons with diabetes. Diabet Med. 2006;23(5):544-56.
  69. Heisler M. Building peer suport programs: Seven models for success. Oakland, CA: California Healthcare Foundation; 2006.
  70. Domurat ES. Diabetes managed care and clinical outcomes: the Harbor City, California Kaiser Permanente diabetes care system. Am J Manag Care. 1999;5(10):1299-307.
  71. Caravalho JY, Saylor CR. An evaluation of a nurse case-managed program for children with diabetes. Pediatr Nurs. 2000;26(3):296-300,328.
  72. Marshall CL, Bluestein M, Briere E, et al. Improving outpatient diabetes management through a collaboration of six competing, capitated Medicare managed care plans. Am J Med Qual. 2000;15(2):65-71.
  73. Driver VR, Madsen J, Goodman RA. Reducing amputation rates in patients with diabetes at a military medical center: the limb preservation service model. Diabetes Care. 2005;28(2):248-53.
  74. Rith-Najarian S, Dannels E, Acton K: Preventing amputations from diabetes mellitus: the Indian Health Service experience. West Indian Med J. 2001;50 Suppl 1:41-3.
  75. Frykberg RG. Diabetic foot ulcerations: management and adjunctive therapy. Clin Podiatr Med Surg. 2003;20(4):709-28.
  76. Wrobel JS, Charns MP, Diehr P, et al. The relationship between provider coordination and diabetes-related foot outcomes. Diabetes Care. 2003;26(11):3042-7.
  77. Haase R, Russell S. Improving diabetes care and outcomes in a rural primary care clinic. Jt Comm J Qual Patient Saf. 2006;32(5):246-52.
  78. Siminerio LM, Piatt G, Zgibor JC. Implementing the chronic care model for improvements in diabetes care and education in a rural primary care practice. Diabetes Educ. 2005;31(2):225-34.
  79. Litaker D, Mion L, Planavsky L, et al. Physician - nurse practitioner teams in chronic disease management: the impact on costs, clinical effectiveness, and patients' perception of care. J Interprof Care. 2003;17(3):223-37.
  80. Solberg LI, Klevan DH, Asche SE. Crossing the quality chasm for diabetes care: the power of one physician, his team, and systems thinking. J Am Board Fam Med. 2007;20(3):299-306.
  81. Ginsberg BH, Tan MH, Mazze R, et al. Staged diabetes management: computerizing a disease state management program. J Med Syst. 1998;22(2):77-87.
  82. Hirsch IB, Goldberg HI, Ellsworth A, et al. A multifaceted intervention in support of diabetes treatment guidelines: a cont trial. Diabetes Res Clin Pract. 2002;58(1):27-36.
  83. International Diabetes Federation Clinical Guidelines Task Force. IDF Guideline on oral health for people with diabetes. Brussels; 2009.
  84. Albert DA, Sadowsky D, Papapanou P, et al. An examination opopulation. BMC Health Serv Res. 2006;6:103.
  85. Eke PI, Genco RJ. CDC Periodontal Disease Surveillance Project: background, objectives, and progress report. J Periodontol. 2007;78(7 Suppl):1366-71.
  86. World Health Organization. Report on the Global Tobacco Epidemic: the MPOWER package. Geneva; 2008.
  87. Katon W, Unutzer J, Fan MY, et al. Cost-effectiveness and net benefit of enhanced treatment of depression for older adults with diabetes and depression. Diabetes Care. 2006;29(2):265-70.
  88. Hunkeler EM, Katon W, Tang L, et al. Long term outcomes from the IMPACT randomised trial for depressed elderly patients in primary care. BMJ. 2006;332(7536):259-63.
  89. Mukhtar Q, Jack L, Jr., Martin M, et al. Evaluating progress toward Healthy People 2010 national diabetes objectives. Prev Chronic Dis. 2006;3(1):A11.
  90. Aiello LP, Cahill MT, Wong JS. Systemic considerations in the management of diabetic retinopathy. Am J Ophthalmol. 2001;132(5):760-76.
  91. Winters JE, Messner LV, Gable EM, et al. Coordinating eye and primary medical care in a low-income and uninsured population: the experience of the Vision of Hope Health Alliance. Optometry. 2008;79(12):730-6.
  92. Persaud DD, Jreige S, LeBlanc RP. Enhancing vision care integration: 1. Development of practice algorithms. Can J Ophthalmol. 2004;39(3):219-24.
  93. Jones SL, Nichols KK. Diabetic eye examination report. Optometry. 2007;78(11):588-95.
  94. Siminerio LM, Piatt GA, Emerson S, et al. Deploying the chronic care model to implement and sustain diabetes self-management training programs. Diabetes Educ. 2006;32(2):253-60.
  95. Wubben DP, Vivian EM. Effects of pharmacist outpatient interventions on adults with diabetes mellitus: a systematic review. Pharmacotherapy. 2008;28(4):421-36.
  96. Johnson CL, Nicholas A, Divine H, et al. Outcomes from DiabetesCARE: a pharmacist-provided diabetes management service. J Am Pharm Assoc. (2003)2008;48(6):722-30.
  97. Divine H, Nicholas A, Johnson CL, et al. PharmacistCARE: description of a pharmacist care service and lessons learned along the way. J Am Pharm Assoc. (2003)2008;48(6):793-802.
  98. Cranor CW, Bunting BA, Christensen DB. The Asheville Project: long-term clinical and economic outcomes of a community pharmacy diabetes care program. J Am Pharm Assoc (Wash). 2003;43(2):173-84.
  99. Fera T, Bluml BM, Ellis WM. Diabetes Ten City Challenge: final economic and clinical results. J Am Pharm Assoc. (2003)2009;49(3):383-91.
  100. Lavery LA, Wunderlich RP, Tredwell JL. Disease management for the diabetic foot: effectiveness of a diabetic foot prevention program to reduce amputations and hospitalizations. Diabetes Res Clin Pract. 2005;70(1):31-7.
  101. Fitzgerald RH, Mills JL, Joseph W, et al. The diabetic rapid response acute foot team: 7 essential skills for targeted limb salvage. Eplasty. 2009;9:e15.
  102. Sumpio BE, Armstrong DG, Lavery LA, et al. The role of interdisciplinary team approach in the management of the diabetic foot: a joint statement from the Society for Vascular Surgery and the American Podiatric Medical Association. J Vasc Surg. 2010;51(6):1504-6.
  103. Attinger CE, Hoang H, Steinberg J, et al. How to make a hospital-based wound center financially viable: the Georgetown University Hospital model. Gynecol Oncol. 2008;111(2 Suppl):S92-7.
  104. Wolf AM, Conaway MR, Crowther JQ, et al. Translating lifestyle intervention to practice in obese patients with type 2 diabetes: Improving Control with Activity and Nutrition (ICAN) study. Diabetes Care. 2004;27(7):1570-6.
  105. Wolf AM, Siadaty M, Yaeger B, et al. Effects of lifestyle intervention on health care costs: Improving Control with Activity and Nutrition (ICAN). J Am Diet Assoc. 2007;107(8):1365-73.
  106. Hiss RG, Armbruster BA, Gillard ML, et al. Nurse care manager collaboration with community-based physicians providing diabetes care: a randomized controlled trial. Diabetes Educ. 2007;33(3):493-502.
  107. Polonsky WH, Earles J, Smith S, et al. Integrating medical management with diabetes self-management training: a randomized control trial of the Diabetes Outpatient Intensive Treatment program. Diabetes Care. 2003;26(11):3048-53.
  108. Newton KM, Wagner EH, Ramsey SD, et al. The use of automated data to identify complications and comorbidities of diabetes: a validation study. J Clin Epidemiol. 1999;52(3):199-207.
  109. Selby JV, Karter AJ, Ackerson LM, et al. Developing a prediction rule from automated clinical databases to identify high-risk patients in a large population with diabetes. Diabetes Care. 2001;24(9):1547-55.

February 2013