The Cardiovascular Health and Diabetes Section's mission is to reduce the burden of diabetes in Indiana through data surveillance, health communications, health systems development, and the development and implementation of community interventions and programs.
The Cardiovascular Health and Diabetes Section's vision is a state where the public is fully aware of the impact of diabetes; all patients with diabetes are receiving high-quality care wherever they are in the state regardless of race, ethnicity, and socioeconomic status; and patients with diabetes enjoy the best quality of life possible.
What is Diabetes?
Diabetes mellitus is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Diabetes can lead to serious complications and premature death, but people with diabetes can take steps to control the disease and lower their risk of complications. Nearly 90% of all diagnosed cases of diabetes are Type 2, whereas between 5-10% are Type 1.
Types of Diabetes
Prediabetes is a condition that individuals develop before developing type 2 diabetes, they almost always have "prediabetes"—blood glucose levels that are higher than normal, but not yet high enough to be diagnosed with diabetes. An estimated 79 million people in the United States have prediabetes. Recent research has shown that some long-term damage to the body, especially the heart and circulatory system, may already be occurring during prediabetes.
- Type 1 Diabetes
Type 1 was previously call insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes develops when the body's immune system destroys pancreatic beta cells, the only cells in the body that make the hormone insulin that regulates blood glucose. To survive, people with type 1 diabetes must have insulin delivered by injection or pump. This form of diabetes usually strikes children and young adults, although disease onset can occur at any age. In adults, type 1 diabetes accounts for nearly 5-10% of all diagnosed cases of diabetes. Risk factors for type 1 diabetes may be autoimmune, genetic, or environmental. There is no known way to prevent type 1 diabetes. Several clinical trials for preventing type 1 diabetes are currently in progress or are being planned.
- Type 2 Diabetes
Type 2 was previously called non-insulin-dependent diabetes (NIDDM) or adult-onset diabetes. In adults, type 2 diabetes accounts for nearly 90-95% of all diagnosed cases of diabetes. It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce it. Type 2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Native Hawaiians or other Pacific Islanders are at particularly high risk for developing type 2 diabetes and its complications. Type 2 diabetes in children and adolescents, although still rare, is being diagnosed more frequently among American Indians, African Americans, Hispanic/Latino Americans, and Asians/Pacific Islanders.
Risk Factors for Type 2 Diabetes
- Aged 45 years or older
- Lack of exercise
- Unhealthy diet
- Family history
Preventing Type 2 Diabetes
- Maintain a healthy weight
- Eat a healthy diet
- Become physically active
- Avoid tobacco
- Have blood glucose, blood pressure, and cholesterol checked regularly
- Gestational Diabetes
Gestational diabetes is a form of glucose tolerance diagnosed during pregnancy. Gestational diabetes occurs more frequently among African Americans, Hispanic/Latino Americans, and American Indians. It is also more common among obese women and women with a family history of diabetes. During pregnancy, gestational diabetes requires treatment to normalize maternal blood glucose levels to avoid complications in the infant. Immediately after pregnancy, 5-10% of women with gestational diabetes are found to have diabetes, usually type 2 diabetes. Women who have had gestational diabetes have a 40-60% chance of developing diabetes within the next 5-10 years.
- Other Types of Diabetes
Other types of diabetes result from specific genetic conditions (such as maturity-onset of diabetes of youth), surgery, infections, pancreatic disease, and other illnesses. Such types of diabetes account for 1-5% of all diagnosed cases.
Diabetes Programs and Services
- Programs for Citizens
It’s important to go for DSMES services when you first find out you have diabetes so you can learn how to take care of yourself. However, there are three other times DSMES can help you. Read about them in the table below.
When Do You Need DSMES? Why? When you first find out that you have diabetes When you’re first diagnosed, you may not know where to begin. DSMES can give you the information and support to start managing your diabetes. During yearly follow-up visits with your doctor Check on your progress and get help to prevent complications. When new situations affect the way you take care of yourself New events or conditions in your life can affect your diabetes. Examples include diagnosis of a new health condition, a change in your mobility, depression, or money problems. When other life changes occur that affect the way you take care of yourself Major life changes can affect your diabetes. Examples of life changes include a change in your living situation, your doctors or insurance plan, or your job.
How can I find DSMES services?
Your doctor may give you a referral to a specific program and a number to call. If your doctor doesn’t refer you to specific services, go to the Find a Diabetes Education Program in Your Area website. This website lists DSMES services recognized by the American Diabetes Association or accredited by the American Association of Diabetes Educators.
Will my insurance cover the cost of these services?
Most insurance plans, including Medicare and Medicaid, cover up to 10 hours of diabetes education the first year of diagnosis. After the first year, your coverage may be different. Contact your insurance provider for more information.
Who is my health care team?
Your health care team includes diabetes educators—such as, doctors, nurses, dieticians, pharmacists, and other health can providers—who have special training and experience. Your health care team will help you learn how to take care of yourself and manage your diabetes.
Where can I learn more about DSMES?
Visit the American Association of Diabetes Educators website to learn more about what a diabetes educator and DSMES can do for you.
Diabetes Self-Management Education and Support (DSMES) Toolkit
This toolkit provides resources and tools to assist state health departments and their partners in planning and implementing activities to increase the use of DSMES programs, focusing on access, health care provider referrals, and reimbursement.
- Programs for Employers
Through a grant with the Indiana Department of Health Division of Chronic Disease, the Wellness Council of Indiana is providing consultation services and support to Indiana organizations that seek guidance in learning about diabetes in the workplace. Consultations are designed for wellness program managers and will include:
- Diabetes prevention and self-management guidelines for the workplace
- Best practices and guidelines for diabetes prevention and management
- Discussion of a comprehensive benefits plan designed to support individuals with diabetes
The NACDD Employer Learning Collaborative (ELC) Employer Network is a unique opportunity for employers to work together as health innovators implementing diabetes prevention efforts and leading the way to improved workforce health across the country. The ELC Employer Network is open to all employers who are interested in pursuing employer coverage of the National Diabetes Prevention Program (National DPP) lifestyle change program.
- Programs for Community Health Workers
Through our partnership with the Indiana Community Health Workers Association (INCHWA) and with the help of Eskenazi Health, we are pleased to announce a specialized training for CHWs focused on diabetes.
This training will give CHWs an overview of what diabetes is, nutrition, physical activity, mental health, and smoking related to diabetes. They will also be taught skills on how to find credible resources and tools that can be provided to patients.
Once completed, the trainee will receive a certificate.
The Indiana rule, IC 16-42-19-29, on the prescription requirement for insulin has been repealed as noted in the 2020 Senate Enrolled Act, effective, January 1, 2021. Please reference the copy of the act here.
Could you be at risk?
Why should a person with diabetes get the COVID-19 Vaccine?
It’s important for people with diabetes to get the COVID-19 vaccination.
Adults of any age who have type 1 or type 2 diabetes are more likely to get severely ill because of COVID-19. This includes, but is not limited to, requiring hospitalization, admission to the ICU, intubation, mechanical ventilation, and death. Based on what is known at this time, gestational diabetes may also make you more likely to get severely ill.
For more information about the COVID-19 Vaccine, visit ourshot.in.gov.
Different types of diabetes.
Cardiovascular Health and Diabetes Director
Diabetes Program Director