A strategic action plan for achieving uncompromising "treat to target" in individuals with insulin-dependent diabetes: a report by the Center for Insulin-Dependent Diabetes Access' Blue Ribbon Panel.

The Center for Insulin-Dependent Diabetes Access, created by the Juvenile Diabetes Research Foundation International and funded by an unrestricted grant from The Medtronic Foundation, convened a Blue Ribbon Panel (the Panel) to identify barriers to achieving universal treatment-to-target in patients with insulin-dependent diabetes and to recommend solutions for addressing those barriers. The Panel was comprised of experts in diabetes care and included providers, academicians, researchers, payers, patient advocates, and policymakers. After reviewing the latest research on diabetes care, the Panel made six overall findings that identify barriers to achieving optimal diabetes care and made recommendations to address those barriers that are intended to achieve the goal of universal, uncompromising "Treat to Target" in insulin-dependent patients. The Panel's findings were: Finding 1: Improving care of patients with insulin-dependent diabetes depends on the public availability and ongoing collection of data that document patient characteristics, processes of care, health outcomes, the benefits and costs of new technologies, and the benefits and costs of different care models. Finding 2: Availability of new technologies and information systems for monitoring and treating insulin-dependent diabetes is critical to achieving recommended hemoglobin A1c levels. Finding 3: Increased reimbursement for new technologies and services provided by the "team" approach to medical management, such as coordinated non-face-to-face care and Internet communications, is imperative to achieving optimal diabetes care. Finding 4: Improving access to endocrinologists, certified diabetes educators, and adopting a chronic care or "team" approach to treating insulin-dependent diabetes are critical to achieving a "Treat to Target" objective. Finding 5: Primary care providers and individuals with insulin-dependent diabetes need to better understand the importance and impact of intensive insulin management and the "team" approach for treating diabetes in improving quality of life and reducing the incidence of long-term diabetes-related complications. Finding 6: Demographic characteristics of individuals with insulin-dependent diabetes require innovative approaches to patient education, outreach, and patient-centric care in order to achieve a "Treat to Target" objective. In the detailed report that follows, each finding is accompanied by a series of recommended action items intended to address the barriers that the Panel identified. A number of entities and organizations have ongoing and planned activities intended to improve diabetes care, particularly for individuals with insulin-dependent diabetes. The Panel recommended that the diabetes community work to coordinate those efforts in order to avoid duplication and ensure more effective program management of those activities.