Major Gift to Marin General Hospital Will Fund New Outpatient Diabetes Center

A Chance to Make a Difference

GREENBRAE, CA — Bruce Braden thinks he is a lucky man. Before he was diagnosed with Type I diabetes at age 38, the Kentfield entrepreneur had been living an extraordinarily unhealthy lifestyle.

"I'm probably around today because I have diabetes," he says. "My diet and exercise were terrible back then, but diabetes forced me to make big changes. Today, I have zero issues and problems with the disease and I'm much healthier overall."

The extraordinary care and education Braden received from his physician of 26 years, Dr. Linda Gaudiani, made a big impact on him. Now he would like to make sure that same level of care is available to other diabetics.

When Braden discussed his goal with Dr. Gaudiani, a specialist who has been developing patient services for diabetics in Marin for decades, the idea of creating the Braden Outpatient Diabetes Center (BDC) at Marin General Hospital was born. Slated to open in 2012, it will be funded initially by a $1,000,000 gift from Braden and will be directed by Gaudiani. The hospital is announcing the gift today in conjunction with World Diabetes Day.

The Braden Outpatient Diabetes Center will offer a comprehensive program that provides assistance with prevention strategies and self-management of the disease while seamlessly connecting patients to higher level care as needed. . "It's my chance to make a difference," says Braden.

In conjunction with the creation of the Center, Marin General Hospital will establish a Bridge Clinic to help patients stabilize their diabetes while transitioning from hospital discharge to resumption of care with their usual physician.

"Marin General Hospital has operated a highly successful multi-faceted inpatient program for diabetes care for more than six years," says Dr. Gaudiani who directs "Keys to Control", a program at Marin General Hospital that aims to enhance the treatment of all hospitalized patients with diabetes and hyperglycemia (high blood sugars). "The nurses receive specialized training and diabetes champions have been identified throughout the units of the hospital. We've created a culture of diabetes awareness from the time the patient registers to the time of discharge.

"But the gap between hospital discharge and the return to community care, complicated by medication changes and new diagnoses, has been a major source of early readmission," notes Dr. Gaudiani. "By establishing the Braden Outpatient Diabetes Center and the Bridge Clinic, we hope to significantly reduce complications and admissions, reduce the time burden for primary physicians and markedly improve patient compliance and satisfaction."

The basic elements of the BDC will revolve around teaching self-management skills to the patient and family, with a focus on dietary/nutritional therapy including the use of glucometers, lifestyle and preventive measures, peer support groups, and coordination with the Bridge Clinic after hospital discharge. A multidisciplinary team of diabetes educators and staff will instruct patients on the proper use of medications and insulin when necessary. The Center also will maintain active communication with, and education for, primary care physicians serving Marin's diabetic patients.

Braden knows from his own experience that all this will have the potential to make a big difference. "Diabetes is very treatable disease," Braden says. "There's no reason you can't live a long and healthy life if you take care of it appropriately. But when you don't-and the system starts to fail it can fail in a big way. The goal is to prevent that from happening."

The increased focus on diabetes comes at a critical time. Diabetes diagnoses are soaring nationwide, and one in five people hospitalized at any given time is diabetic. Diabetic patients account for 22 percent of all inpatient days and are hospitalized three times more frequently than diabetes-free patients.

Although the incidence in Marin is lower than the national rate, about 7,500 of the county's approximately 200,000 adults have been diagnosed with diabetes. Marin General Hospital sees about 1,000 admissions annually involving diabetics. About 1.5 percent of Marin's 18-44 year-olds, 4.1 percent of 45-64 year-olds and 8.2 percent of adults over 65 in the county have diabetes. Nationally, according to the American Diabetes Association, approximately 8.3 percent of the total population is diabetic.

Particularly troubling is the fact that one in four Type 2 diabetics doesn't know they have the condition because it is often silent in its early years. Untreated or diagnosed late, it can wreak havoc, causing coronary and peripheral vascular disease (two to four times higher incidence), renal disease and blindness. The cost of treating diabetics is more than five times higher per hospital admission than the average patient.

"Fortunately, most people can avoid the complications with better care," says Braden. "I know from experience that having diabetes doesn't mean you can't live your life. It's not an obstacle-it's an incentive."

The working theme of the BDC will be "traveling through life with diabetes," Gaudiani explains, stressing that living with diabetes successfully is a journey.

Braden thinks education is a key to fighting diabetes-and that education needs to start early. He hopes that the Center will conduct outreach to high schools where, he says, "the rate of diabetes is just frightening."

One thing about which Dr. Gaudiani is adamant is the importance of collaboration with physicians in the Marin community. "They'll be able to rely on the Center to provide their patients with state-of-the-art educational resources and to assist them in their patient care plans," she says. "And, by enriching the overall quality of care here in Marin, we hope more people will realize they don't have to drive across the bridge to get everything they need to care for this condition optimally."

"Marin General Hospital has been at the forefront in trying to achieve a hospital-wide culture of diabetes awareness and state-of-the-art-management," said Chief Medical Officer Joel Sklar. "Through the generosity of Bruce Braden, we can now extend our expertise beyond Hospital walls, to make a significant improvement in the health of the community we serve. Bruce has given us a tremendous opportunity."