After years spent researching and documenting the advantages of education and team-based care for people with diabetes, Linda Siminerio is getting the word out, big time.

Dr. Siminerio, executive director of the University of Pittsburgh Diabetes Institute, is national spokeswoman for the World Diabetes Day campaign. Today is World Diabetes Day; November is National Diabetes Month.

"It's more than an epidemic; now it's a pandemic," said Dr. Siminerio, a Ph.D. and registered nurse.

The number of people with the disease is estimated at 285 million, she said. By 2030, it's expected to reach 435 million.

Dr. Siminerio hopes to highlight the importance of national diabetes education as well as efforts to improve prevention and care in Pennsylvania, and to raise awareness about diabetes globally.

"What has happened is a whole paradigm shift," she said, "[acknowledging] the need for people to get educated; for people to get team-based care, for prevention instead of just treatment, treatment, treatment."

The International Diabetes Federation, a worldwide alliance of more than 200 diabetes associations in more than 160 countries, is leading the campaign.

From the first World Diabetes Day in 1991, a cooperative effort of the federation and the World Health Organization, the global push for better diabetes care gained momentum in 2007 with a United Nations resolution.

Dr. Siminerio has led efforts emphasizing how critical it is to teach and support a person who is at risk or who has diabetes to make healthy decisions about food, activity, monitor blood-sugar levels and take medication. In addition to self-management, Dr. Siminerio's work promotes support for patients from a team of health care providers.

"Diabetes self-management is so important," she said, adding that an emphasis on patient education will bring about better care.

In Pittsburgh, the Diabetes Institute has 39 diabetes self-management programs in Western Pennsylvania. Dr. Siminerio maintains that diabetes requires consistent follow up.

"It's not just a dose of self-management education. That doesn't last for a year, you have to have constant support and follow up. ... Seeing a physician four times a year just isn't going to cut it."

Dr. Siminerio said the increase in type 2 diabetes cases is skyrocketing worldwide, especially in Southeast Asia and India. In those countries, being overweight is not considered a problem, although she said diet has changed around the world and may be linked.

"I think we were bred to be hunter-gatherers, then our diet changed," she said. "I think we weren't ready for societal changes. That's still under study."

Current research in immunology that's taking place in Pittsburgh gives her hope. The research centers around creating and re-creating beta cells to treat or cure type 1 diabetes.

"It isn't just sitting in Oakland, it's really taking it as far as we can, not just in the lab, or the hospital, but in the community centers," she said.

Her research focuses on sharing information proven to help prevent diabetes and treat people in underserved communities. She leads the international group in putting that information to use as part of the BRIDGES program -- Bringing Research in Diabetes to Global Environments and Systems program.

As far as the current debate about health care reform, Dr. Siminerio is confident things can't get worse than they are now in preventing and treating diabetes: "Whatever decisions that are made, we can't continue the way we do now. We've got to do something."

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