There are an estimated 60,000 people with diabetes within 75 miles of
Worcester," said David Harlan, MD, chief of diabetes and codirector of the UMass
Memorial Diabetes Center of Excellence. Fortunately, with the center's
comprehensive services, these individuals have access to what he characterizes
as "cradle-to-grave, eyes-to toes care" for this challenging chronic
Staffed by a team of clinical experts including endocrinologists, certified
diabetes educators, a nutritionist and nurse practitioner, the center is a
one-stop resource for advanced treatment, education about self-management,
nutrition consultation, access to clinical trials and, when appropriate,
counseling for behavior modification.
Equally important, the Center of Excellence is working to develop a
coordinated referral system for all the specialists involved in treating
diabetes and its complications including cardiovascular disease, dermatological
problems, impotence, nephropathy, peripheral vascular disease and retinopathy.
In addition, the center's team partners with the UMass Memorial Children's
Medical Center and its team of pediatric endocrinologists, providing exceptional
continuity of care as children with diabetes transition to adulthood.
"Patients want to access all the components of the health care team they need
in an efficient way," Dr. Harlan said. "They don't need 10 different office
visits at 10 different locations with 10 different copays."
This patient-centered approach is the foundation of the center. "With a
disease like diabetes, no health care team will be successful without the
patient playing the most important role," he said. "Education is paramount, so
we're aligning our resources to provide continuous, long-term education and
re-education to empower patients."
The value of this approach is affirmed by a recent survey of people with
diabetes in Worcester County. "The survey data show that individuals with
diabetes are seeking tools to help them better self-manage their care," Dr.
Harlan said. "It is clear that providers and individuals with diabetes need to
become much more active as 'partners' in care. At the same time, we need to find
better ways to keep individuals with diabetes engaged in their own care."
To that end, the center has partnered with nearly 20 community-based
practices to help improve the management of patients with diabetes in the
primary care setting. This Diabetes Collaborative Project, established by the
Center for the Advancement of Primary Care, utilizes an evidence-based,
guideline-driven model of chronic disease management.
"Our aim is to provide seamless, coordinated care between specialist teams
and frontline caregivers who deal with diabetes every day, working together to
see that the patient receives world-class care," Dr. Harlan said. "In most
cases, this means care continues to be delivered by the primary care
"We believe a rising tide raises all boats, and we hope to set a standard for
diabetes care that can serve as a national model," he added.