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The Diabetes Center of Excellence: A Model to Emulate.

INTRODUCTION Diabetes is an epidemic that deserves a strategic approach to its prevention and management in our military health system (MHS). The Centers for Disease Control and Prevention estimates that 29.1 million Americans have diabetes and 86 million, or 1 in 3 adults, have prediabetes. More troubling is the notion that 9 out of 10 of these individuals with prediabetes are unaware of their current condition and future risk. If consistent lifestyle changes are not enacted, 15 to 30% of these individuals will progress to Type 2 diabetes within 5 years. The Air Force, whose beneficiary population is not immune to the diabetes epidemic, finds itself with an ever-widening gap between the number of empaneled patients with diabetes (approximately 50,000) and the number of providers that can successfully manage the complex and ever-evolving diabetes standards. The AF Medical Operations Agency in 2011 determined that the Air Force lacked standardization in diabetes care and prevention among the Air Force medical treatment facilities (MTFs). This deficiency highlighted the need to bolster the AF Diabetes Center of Excellence (DCOE) mission and vision to encompass a three-tiered approach: Clinical Excellence, Translational Research, and Outreach/Training. While the DCOE is funded by the Air Force, housed at Wilford Hall Ambulatory Surgical Center in San Antonio, the intent is to develop Tri-Service participation and impact.