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Worldwide, the burden of diabetes continues to increase to staggering numbers. A recent report from the International Diabetes Foundation estimated that 366 million people have this chronic condition. Additionally, despite advances in diabetes treatment and prevention over the past 30 years, this number continues to rise. This increase applies to both the developing world and the developed world. For example, in 2010, the US Center for Disease Control fact sheet stated 26 million patients in the United States now have diabetes and 79 million have pre-diabetes. Much of the increase is related to the rising rates of obesity. As the numbers of patients with diabetes increases, so does their associated health care expenditures. Not surprisingly, the challenge of diabetes management is greater in those with mental health conditions, (Frayne et al., 2005) the elderly, and minority populations (www.ahrq.gov, 2011). Overall, diabetes and its complications and the often ineffective approaches to delivery of care lead to demonstrable quality gaps and increased costs. As a result, treatment strategies designed to improve outcomes are needed.

Shared Medical Appointments: Implementing Diabetes SMAs to Improve Care for High Risk Patients and Maximize Provider Expertise