There's always hope that good ideas will spawn action and change.

Such is the case with the University of Pittsburgh Diabetes Institute, whose decades of research and 107 studies have mapped out a better approach to educating and treating people with diabetes.

Now Johnson & Johnson Diabetes Institute has opened one of its institutes in Milpitas, Calif., based in part on the research and philosophy developed by Pitt's institute.

The company also will use Pitt professionals as faculty members. Janice Zgibor, the Pitt institute's director of evaluation, will serve as a core faculty member at the California institute, while Pitt Diabetes Institute Executive Director Linda Siminerio and others will be guest faculty.

Dr. Siminerio said her institute also developed the strategic plan for the Johnson & Johnson institute.

Kim Kelly, director of the Johnson & Johnson institute, described Dr. Siminerio as "brilliant."

"We picked [the Pitt institute] to help us because it is one of the top programs in the country," he said. "I've been reading about them for a long time, and I have a great deal of respect for them, especially Linda."

He said Dr. Zgibor, who helped write and edit case studies for the California institute, gave such "a fantastic presentation" at the first meeting that she was named to the core faculty. Pitt officials will teach whenever possible.

Former acting U.S. Surgeon General Kenneth P. Moritsugu, who serves as Johnson & Johnson institute chairman, said national costs to treat diabetes have risen to $174 billion a year.

New strategies are necessary to raise the level of care, including "stepped-up education and hands-on training of health professionals working at the local level," he said.

Johnson & Johnson already operates a training center in Japan with plans to open new centers in China and France. The goal is a global network of alumni to share information and insights on diabetes care.

Currently about 21 million people in the United States have diabetes, with the numbers escalating dramatically each year. If current trends continue, it's estimated that one in three people born in 2000, and one in two minorities, will develop diabetes in their lifetime.

Pitt's success is based on research in diabetes education and care, coupled with efforts to put the research into action. Dr. Siminerio, for example, is working with Gov. Ed Rendell to develop a statewide chronic-care model for diabetes.

A major problem nationwide, she said, is the lack of diabetes educators, endocrinologists, nurses and educational centers to educate people about diabetes. Johnson & Johnson, with help from Pitt, is working to relieve such shortages.

Diabetes care requires a patient to monitor blood-sugar levels, then react to those readings by taking insulin or other medications or adjusting caloric intake to keep blood sugar at or near normal levels.

People with diabetes also must learn about medications, how to monitor blood sugar, and figure out how different foods and exercise affect blood sugar and health.

Pitt's institute has been a world leader in advocating self-management of diabetes as a means of maintaining reasonably normal blood-sugar levels 24 hours a day. But self-management and good control are impossible without instruction, Dr. Siminerio said.

"Our ultimate goal is to prepare the patient and have a pro-active team to help the patient," she said, noting that collaboration is key. There's also growing evidence that peer support from others with diabetes is helpful.

Pitt research has proven that a systematic approach to chronic-care management improves outcomes and expands life spans.

"It's fun to see industry, health care organizations and government policy-makers opening up their minds to a new approach," Dr. Siminerio said.