In the United States, 20.8 million people have diabetes, according to the American Diabetes Association.

That's about 7 percent of the population.

It's a disease that can affect every organ system in the body and has no cure.

Those with the disease require close monitoring -- necessary to maintain a high quality of life and prevent devastating complications that can arise such as kidney disease, heart disease, blindness, lower-limb amputations and nervous system damage.

In fact, for many, the disease often goes undiagnosed until one of the complications sets in.

It's a disease that crosses many medical specialties, and diabetes care is often segmented and dependent on the patients' own diligence to regular follow-up and preventive care.

Shouldn't individuals with diabetes get a more holistic, all-encompassing approach? One in which close monitoring, regular preventive check-ups and education on how to manage the disease occur all in one place?

Introducing The Center for Advanced Evaluation of Diabetes Mellitus.

Raising the bar in diabetes care

Munster center provides unique one-stop, holistic approach

As an infectious disease specialist, Dr. Alexander Stemer says an alarming number of the problems he had been evaluating and treating were related to complications of diabetes.

As time went on, he discovered that when a patient's diabetes is controlled in a more proactive manner, with baseline tests enabling measurement of even the slightest changes and education aimed at empowering patients to manage the disease more effectively, the rate of complications slowed.

This notion stayed with him as Munster Medical Specialists began expanding in the early 90s. As the practice's president and CEO, Stemer collaborated with the group's endocrinology physicians to begin adding technology and services relevant to the total care package needed by diabetes patients, whose numbers had been exploding in Northwest Indiana.

Now known as The Center for the Advanced Evaluation of Diabetes Mellitus, located at Munster Medical Center, the practice serves as a one-stop shop for diabetes patients, who now have the tests they often need, namely, a battery of blood tests, coronary calcium scan, ankle-brachial index test, diabetic retinopathy exam and bone mineral density test all under one roof, at no additional cost and even before their first visit.

This way, "all of the complications of diabetes are evaluated, measured and explained to the patient" at the very first office visit, Stemer says.

In a typical practice, Stemer explained, a patient might be referred to an ophthalmologist, for example, to check the status of his retinas. But if the result falls within a "normal" range, the referring endocrinologist might not learn the specific results or see the test to be used as a baseline to compare against future tests.

Not only does the center provide a baseline to detect the most subtle changes at no additional cost to the patient, but particularly with the diabetic retinopathy exam, the technology is better than most, Stemer says.

"We're one of the very few practices that actually have the ability to take a photograph of your retina while you're here and send that photograph via the Internet to the finest eye center in the universe which is Johns Hopkins," Stemer said.

Next up might be a coronary calcium scan that will tell the doctors if diabetes is affecting the patient's heart along with other tests measuring bone density, vascular health and nerve function.

In the past, tests like these were either underutilized or used in a "piecemeal" fashion, Endocrinologist Dr. Ludo DeKeyser said.

He says diabetes is not an easy disease to take care of, but with these new techniques and diagnostic tests, the ability to treat it has improved.

"With good therapy, we can reverse complications if detected at an early stage," DeKeyser said.

With all the diagnostics at their disposal, DeKeyser says it will be easier to keep patients from falling through the cracks.

"This program allows for more comprehensive and systematic way to assess patients and where they are with diabetes, control and complications," he said.

Lucy Cole, diabetes coordinator, helps patients digest the vast amount of information they need to be active participants in their care.

"Very often, they don't get the knowledge or they get it but there is so much knowledge coming at them it's hard to absorb," Cole said.

That's why she often meets with patients right after their doctors' visit to help them make sense of all the information as well as the aspects of their care that need to be self-directed such as diet, exercise and lifestyle factors.

"What excites me about (the center) is the opportunity that it's given to Northwest Indiana," Cole says. "They can go to one place and have all of their tests completed and not just one test but a screening for their health and that is very unique."

Jonathan Nourie, 25, is an example for how the center's proactive, holistic look at diabetes works to the benefit of patients.

He is confident his disease is managed well and he feels sufficiently educated about his disease because of what's available to him. He gets the diabetic retinopathy exam every year along with regular blood tests.

In a nutshell, he says the doctors leave no stone unturned.

This is important, he says, because too often, people get treatment too late, when complications are already setting in.

"There will be a lot less complications and being able to possibly fix something before it really starts," he says.

Ultimately, Stemer's goal is to change the dynamic between doctors and patients, at least in Northwest Indiana.

"I would like to raise the bar for patients with diabetes," Stemer says.

Next on the horizon, Stemer says, is a similar center for the care of lung disease. While all the pieces are not yet in place, The Center for Advanced Evaluation of Lung Disease is developing, again, in response to the needs of the region, which suffers from a high prevalence of lung disease.

Cole emphasized the team concept as the glue that makes the center so unique and effective.

"If you stand alone and work by yourself, it's like using a spoon to dig a hole in a mountain. But when you have a whole team with you, there's a synergistic effect. There's more power, more knowledge, more impact."