Diabetes is growing at an epidemic rate in the U.S. According to the Centers for Disease Control and Prevention, nearly 30 million Americans have diabetes, which puts them at risk for complications such as heart disease, stroke, limb amputation, kidney disease and blindness.
In South Carolina, approximately 576,211 adults—14 percent of the adult population—have diabetes. About 127,000 of these people don’t know they have diabetes. Another 1,314,000 people in South Carolina, or 37.2 percent of the adult population, have prediabetes and are considered high-risk for developing diabetes.
Diabetes complications occur more frequently and are more severe among those whose diabetes is poorly managed—nationwide, approximately 43 percent of people with diabetes.
But what if people who fall into those three groups—those who don’t know they have diabetes, are high-risk for developing diabetes or have poorly controlled diabetes—could be identified and treated proactively, before their condition led to serious problems?
That’s the question that a group of researchers from Greenville Health System (Prisma Health) and Clemson University is tackling, thanks to funding from the Prisma Health Health Sciences Center’s Research Seed Grant program.
Ron Pirrallo, MD, MHSA, vice chair of Prisma Health’ Department of Emergency Medicine and principal investigator on the project, is looking at retrospective data from Prisma Health’ six emergency departments to quantify how many patients could be identified using existing screening tools and placed into one of the at-risk categories. From there, he and his team plan to use what they learn to bolster their chances of earning a grant from the National Institutes of Health that will lead to a plan for providing appropriate care to those identified as fitting into one of the at-risk groups.
More than 400,000 people visit Prisma Health Emergency Departments and MD360® Convenient Care facilities each year—albeit some more than once in a year. The combined population of Greenville, Spartanburg, Anderson, Oconee and Laurens counties is estimated to be 1,126,193.
“What we wish to find out is, when people visit the emergency department or an MD360, is this an opportunity to look at risk factors captured in their medical record and, at that point of unscheduled care, see if they fit into one of these populations,” Dr. Pirrallo said. “The common electronic health record makes it possible to see whether a person has any other potential high-profile diabetes risk factors and intervene.”
He continued, “Whether the person initially came to the ED for flu symptoms, shortness of breath or a car crash, after we stabilize their condition, we can look further and hopefully identify a disease process—diabetes—that can be prevented.”
Dr. Pirrallo says the seed grant will help the team identify patterns in those who fall into the three at-risk categories, which will inform the development of treatment protocols.
“Once you know who is at risk, then you can develop an appropriate treatment plan,” he said.
Dr. Pirrallo’s project is one of 20 being funded by the Research Seed Grant program this year. All projects began in May 2018 and are funded for up to a year.
The goal of the program is to jump start pilot research and scholarly activities in three focus areas—diabetes, transformative care (with a focus on population health) and cancer care delivery research—with an ultimate goal of securing funding from other organizations that will help bring innovative approaches to care and measurable positive health outcomes to the Upstate.
“There’s a wonderful vision behind the seed grant program,” Pirrallo said. “It enables us to answer the initial question that gives us evidence and data to compete and apply for other grants, with the immediate effect that the community benefits from the research being done.”