Using the Essential Public Health Services as strategic leverage to strengthen the public health response to diabetes.

If current trends continue, health systems will soon be overwhelmed by type 2 diabetes mellitus. Successful population-based diabetes prevention and control efforts require a sound and continually improving infrastructure. In states and U.S. territories, the Diabetes Prevention and Control Programs supported by the U.S. Centers for Disease Control and Prevention's Division of Diabetes Translation serve as a fulcrum for building and refining the infrastructure that links diverse and dynamic partners dedicated to increasing the years and quality of life and achieving health equity among people with and at risk for diabetes. The National Public Health Performance Standards offer a conceptual framework that articulates the requisite infrastructure and services provided by an interconnected network of intersectoral partners to strengthen the public health response to diabetes. These standards associated with the Essential Public Health Services are valuable tools to assess the status of the performance of the health system's infrastructure to guide improvement. The process of engaging system partners in a system-wide assessment informs and leverages cross-sectoral assets to improve health outcomes for citizens in communities shouldering the growing burden of diabetes.

Understanding diabetes population dynamics through simulation modeling and experimentation.

Health planners in the Division of Diabetes Translation and others from the National Center for Chronic Disease Prevention and Health Promotion of the Centers for Disease Control and Prevention used system dynamics simulation modeling to gain a better understanding of diabetes population dynamics and to explore implications for public health strategy. A model was developed to explain the growth of diabetes since 1980 and portray possible futures through 2050. The model simulations suggest characteristic dynamics of the diabetes population, including unintended increases in diabetes prevalence due to diabetes control, the inability of diabetes control efforts alone to reduce diabetes-related deaths in the long term, and significant delays between primary prevention efforts and downstream improvements in diabetes outcomes.