Diabetes is the seventh leading cause of death in the U.S (CDC). Rates of both diabetes and prediabetes in Illinois are higher than the national averages. An estimate 13% of the population (1.3M people) has diabetes and an additional 38% (3.6) has prediabetes, with 90-95% of all cases attributed to Type-2 diabetes (T2D). The impact of diabetes is even greater among Black populations. Diabetes prevalence among Black populations is 18.7%, compared to a prevalence of 7.1% among non-Hispanic white populations. The disproportionate burden of diabetes is evident in Chicago. The rates of diabetes-related mortality and diabetes-related hospitalization are 2.0 and 3.0 times higher, respectively, among Black populations as compared to non-Hispanic white populations. Current demand for endocrinologists far exceeds the number of trained specialists. Vigersky et al (2014) identified a gap of 1500 adult endocrinologists and projected the shortage to exceed 2700 by 2025. As a result, patients and providers often experience frustration in getting timely access to specialty care. With many subspecialists limiting the number of uninsured or underinsured patients they treat, access to subspecialty care becomes even more difficult for Medicaid and uninsured patients and their providers. While diabetes care is usually in the province of primary care providers (PCPs), reported barriers among PCPs in diabetes care include limited resources and environmental constraints, limited knowledge and skills in complex diabetes management, frequently changing diabetes recommendations, lack of comfort or familiarity in initiating insulin regimens, and difficulty with patient adherence.

This series will address these known challenges and gaps in care, to help PCPs implement and sustain evidence-based, patient-centered diabetes management practices by providing practical knowledge and skills for managing diabetes patients with medically and socially complex needs.