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Virgin Islands Diabetes Center of Excellence Testimony 36th Legislature of the Virgin Islands 1 Introduction Good morning, Senators, members of the 36th Legislature of the Virgin Islands and the viewing and listening audience. I am Dr. Julia Sheen, Executive Director of the Virgin Islands Diabetes Center of Excellence (VIDCOE). I would like to begin by acknowledging Senator Ray Fonseca, Chair of the Health, Hospital and Human Services Committee, as well as other distinguished members of this legislature. Thank you for the opportunity to confirm VIDCOE’s commitment to reducing diabetes complications and improving the quality of life for people living with diabetes. I would like to also thank the 36th Legislature in advance for supporting bill number 36-0093, an Act to appropriate funding to support the Centers operations. The Challenge Before Us Senators, I would like to remind you of the challenge before us, as diabetes is a serious public health crisis in the U.S. Virgin Islands, affecting more than 14,000 residents and ranking as the 7th leading cause of death. The territory’s prevalence of diabetes for exceeds national averages, with high rates of hypertension, cholesterol and obesity compounding the issue. VIDCOE’s Mission and Approach VIDCOE, is a 501(c)(3) nonprofit organization, whose mission is to prevent diabetes and reduce its complications through education, treatment, health promotion, and research. Our goal is to reduce the burden of diabetes while improving the quality of life for individuals living with or those at risk for this disease. VIDCOE recently relocated its St. Croix office to the Sion Farm Shopping Center, Suite 1 in Christiansted and will host a ribbon cutting/open house and annual Free Diabetes Health Fair at this location on Saturday, July 26th from 8am to 5pm. I am inviting you to participate in the ribbon cutting ceremony and official invitations will be forthcoming. This year’s health fair will include A1C testing, visits with our Endocrinologist, Podiatrist, Diabetes Eye Exams, and nutrition classes. Accomplishments and Impact Since receiving ARPA funding, VIDCOE has made significant strides in expanding access to diabetes care and education. Over the past year, we have provided services to more than 2,301 diabetes patients through monthly outreach activities, diabetes Self-Management and Support classes, Nutrition and Medication Management programs. Seventy-seven (77%) percent of our patients have Type 2 diabetes, twenty-one (21%) percent have prediabetes, and two (2%) percent have type 1 diabetes. Sixty-eight (68%) percent of our patients have high blood pressure, and Forty-one (41%) percent have high cholesterol. Eighty (80%) percent of our patients are overweight, and Fifty (50%) percent are obese. Metric Percentage/Number Patients with Type 2 Diabetes 77% Patients with Prediabetes 21% Patients with Type 1 Diabetes 2% Patients with high blood pressure 68% Virgin Islands Diabetes Center of Excellence Testimony 36th Legislature of the Virgin Islands 2 Patients with high cholesterol 41% Patient who are overweight 80% Patient who are obese 50% Additionally, VIDCOE continues to raise awareness and reach underserved communities. VIDCOE recently launched its Diabetes Mobile Health Initiative where we go into the community and conduct diabetes screenings to identify new cases of diabetes and people with uncontrolled diabetes. In the month of June we have conducted four diabetes screening events using our mobile health van. To further increase accessibility, we have purchased an ADA-compliant, 6-passenger van to transport patients to their appointments. For the first time in decades, our pediatric endocrinologist is seeing children with Type 1 diabetes, helping to address a longstanding gap in care and has seen over thirty (30) children ages 4-18. I am happy to report that VIDCOE is partnering with the Department of Education and the Bennie and Martha Benjamin Foundation to launch its Childhood Diabetes Prevention Program in August. VIDCOE will conduct diabetes screenings for Children in the 4th and 5th grades on May 8th at the Eulalie R. Rivera K-8 School on St. Croix. Children identified with diabetes will participate in interactive education on preventing diabetes through healthy eating, physical activity, and lifestyle choices. Parents will be encouraged to schedule a visit with our pediatric endocrinologist for diagnosis and next steps. I would like to thank Mary Moorhead and the Commissioner of Education, Dionne Wells-Hedrington and her team for their support. We are partnering with Howard University and Freestyle Libre to provide continuous glucose monitors (CGM) at no cost to our patients and we will use those monitors to help manage the care of our patients over a 12-month period. This program will roll-out in the summer. In recognition of National Diabetes Awareness Month, we partnered with the University Center for Excellence in Developmental Disabilities to launch eight public service announcements (PSAs) to promote diabetes education and prevention. Our partnerships are expanding. VIDCOE receives referrals from the Department of Health, Federally Qualified Health Centers, the local hospitals, Cleveland Clinic, and local private providers. I would like to thank the 34th and 35th Legislature for including VIDCOE in the miscellaneous budget and for supporting our work. We are expanding our footprint in this community with outreach, education and awareness activities. Over the past 12 months we have conducted and/or participated in over 50 outreach events. Our efforts also include launching a CDC-approved Prevent T2 Diabetes Program, a year- long initiative designed to delay or prevent the onset of Type 2 diabetes. Most recently we conducted a cooking class in partnership with the UVI School of Agriculture Cooperative Extension Services Community Nutrition Program on St. Croix on April 3rd and on St. Thomas on April 10th. We have grocery store walk-throughs scheduled for April 17th on St. Thomas and April 24th on St. Croix. Our monthly Diabetes Medication Management and Nutrition classes are held virtually from 12pm to 1pm. Among our recent innovations is the remote patient monitoring initiative, which has already yielded promising results. As of September 2024, 80% of patients with uncontrolled diabetes have seen improvements in their A1C levels. Notably, 21% of patients showed a marked Virgin Islands Diabetes Center of Excellence Testimony 36th Legislature of the Virgin Islands 3 reduction in their A1C, and those with A1C levels greater than seven experienced reductions ranging from 10% to 40%. These results underscore the value of these types of initiatives. Improved health outcomes for our patients will lead to reduced hospitalization costs, decreased long-term medical costs, reduced disability and increased workforce productivity and prevention savings from early intervention. Innovations and Expansions Other examples of the impact our programs have had include the: ✓ Over 580 people participated in diabetes related educational programming ✓ Obtained CDC Prevention Center Recognition ✓ Partnered with Howard University to provide Endocrinology Services ✓ Recruited an Ophthalmologist from Johns Hopkins University to screen VIDCOE’s patients for diabetes retinopathy ✓ Partnered with United Health Care on Health & Wellness Initiatives ✓ Partnered with the Division of Personnel on Health Promotion activities for all GVI employees ✓ Conducted a very successful Diabetes Health Fair on August 24th at the UVI 13D Innovation Center on St. Thomas where over 200 people received Rapid A1cs, had visits with diabetes specialists, got their feet and eyes examined and participated in nutrition classes ✓ Purchased two retinal imaging cameras one for each district. ✓ Invested in telemedicine infrastructure and upgraded our electronic health records to participate in the Territory’s Health Information Exchange. ✓ Collaborated with Amazon Web Services to enhance our data infrastructure. VIDCOE’s Return on Investement VIDCOE is already demonstrating a return on investment. With your support we can expand our diabetes mobile health services, reach more people with diabetes, continue to target children and adolescents with early interventions and improve the quality of life for people living with diabetes. Without this continued support, we risk losing momentum on the tremendous progress made in prevention, treatment, and education. Access to essential diabetes care for thousands of Virgin Islanders, especially seniors, children and low-income families will be significantly compromised. VIDCOE’s preventive work helps reduce government healthcare spending and increase access to diabetes related services for vulnerable populations. When you consider the patient cost of managing diabetes at $10k-$15 per year verses $80-$100 per month for dialysis treatments, VIDCOE’s services is a worthy investment. Virgin Islands Diabetes Center of Excellence Testimony 36th Legislature of the Virgin Islands 4 VIDCOE represents hope and healing for thousands of Virgin Islanders battling diabetes. With your continued support, we can turn the tide on this epidemic and build a healthier, stronger territory. Closing VIDCOE is unique in its holistic, patient-centered model of care that combines medical treatment, education, behavior change, and community engagement --- aligning with the U.S. Department of Health and Human Services’ Healthy People 2030 objectives. VIDCOE represents not just a clinic --- but a community solution to one of the most pressing public health challenges in the Virgin Islands. Together, we can make diabetes preventable, manageable, and no longer life-threatening in our Territory. We are ready to partner, expand, and deliver--- Thank you for your continued support.