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March 2009 Issue

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Diabetes Clinic Helps Patients Better Manage Their Disease

By Katie Pence
Published March 2009

Terrance Cole knows diabetes is a serious illness, but now he’s even more aware of it.

“This is very educational,” he says after attending the first instructive diabetes clinic of its kind at UC, held to inform patients about their disease and to get them in the doctor’s office for a checkup.

Cole was one of 28 patients who made their way to the second floor of Hoxworth Blood Center on Feb. 6 to participate in the afternoon event, which included not only educational videos and checkups but also a raffle, healthy snacks and take-home “goodie” bags.

“If you’re at home by yourself, you often forget that you need to take your insulin or track your blood sugar, or you may not have everything you need,” Cole says.

He adds that the day helped encourage him to more proactively manage his illness and to help others around him who live with diabetes.

“I have two friends, a mother and a son, who both have diabetes and don’t take care of themselves like they should,” he says.

“I’m going to pass this information on to them. “You have to fight diabetes head-on, and we need this support,” says Cole.

The clinic, facilitated by Eric Warm, MD, associate professor of medicine, and a team of nurses, internal medicine residents and even some first-year medical students, was held as a way to reach out to patients who were not scheduling regular checkups and managing their illness appropriately.

“We went into the computer system and flagged individuals whose diabetes was not quite under control,” Warm says. “We then contacted these patients and asked them to come to a planned visit for their diabetes.

“We just want to make sure people don’t fail with their treatment.”

Warm says some patients aren’t quite sure how to care for their disease at home. Justin Smith, MD, a secondyear resident who participated in the clinic, experienced this firsthand.

“I was talking to one of our patients—a type 2 diabetic—and I asked about her blood sugar numbers,” he says.

“She was giving me numbers that sounded a little strange, and I thought she may be making them up.” Smith asked the patient to use the glucometer to check her blood sugar in front of him. “She didn’t know to use it,” he says.

Smith taught the patient the correct way to check her blood sugar and marked it in her chart for her regular doctor or resident to note.

“Now, she can manage this correctly at home, and we have prevented future problems that would have arisen if we wouldn’t have caught this in clinic,” he says.

Warm says the clinic not only helps patients but also gives residents and medical students—who haven’t had much experience in clinical settings—some first-hand experience. “Our team is very unique,” Warm says.

“We’re training first-year medical students in chronic care and diabetes recognition, and we’re helping residents form relationships with their patients.” Malia Harper, MD, a resident, says the benefits are apparent.

“Chronic disease is difficult enough to take care of by oneself,” she says. “If these patients see someone different during each visit, the care doesn’t have the same impact.

“We are with these patients every step of the way, even over the telephone. We help them learn to care for themselves, and we save health care dollars by teaching them about their illness, possibly preventing them from ending up in the emergency room or the hospital.”

Sara McCune, MD, chief resident, says the clinic strives for continuous care.
“Patients come to us with a lot of complications,” she says. “We address all of those needs in a comprehensive plan. Residents in this clinic focus on one area, and patients have all of their needs met at once. Patients and residents connect at this early stage to show the investment in the patient’s care.”

Warm says reaching out to patients through a clinic such as this shows a true concern for their wellbeing.

“We strive for quality care,” he says. “If these patients get a call from their doctors at home, asking where they’ve been, it tells them that they are a priority and that their health really matters to us.”

Warm says his team tracks data for patients who come to the clinic for chronic disease care, such as diabetes or hypertension, to see if the numbers of health maintenance activities improve.

“We’ve seen our percentages go up since 2006,” he says, adding that residents receive points on a “report card” for improved numbers. A certain quality number is required of them.

Warm says that clinics addressing other chronic diseases, such as hypertension, may be in the works for future patient follow-up.

“Most of the horrors people with chronic diseases face are preventable,” he says. “We want to do our part to make sure it doesn’t get to that point. So, why not call these people up and do the things that need to be done?”

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