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AACE 2015: Physicians Say Patient Care Guided by CDE-Ambassadors Better

Professionals trained by endocrinologists shown effective in reducing patients’ glycemia, blood pressure, lipids and body weight…

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Certified diabetes educator “ambassadors” (CDE-A) – professionals trained by endocrinologists and practicing in primary care settings – can help patients with diabetes achieve significant patient improvements while easing the shortage of endocrine specialists available to treat the increasingly prevalent illness, says a medical team from the State University of New York (SUNY) at Buffalo.

The Buffalo SUNY group, composed of internal medicine specialists, endocrinologists, internal medicine and RN/CDEs, shared its findings today at the American Association of Clinical Endocrinologists’ 24th Annual Scientific and Clinical Congress.

The team conducted a retrospective review of 100 type 2 diabetes patients whose care was being managed by a CDE-A in a primary care setting and compared medical test results of those receiving CDE-A intervention with those who were not. The CDE-As continued to consult with the endocrinologist trainer on an as-needed basis, and any changes suggested by the CDE-A to the patient’s diabetes regimen had to be authorized first by the PCP.

The differences between the two groups were substantial: in the CDE-A intervention group, during the study’s four-and-a-half month period, patients’ A1c levels, weight, BMI, blood pressure measurements, LDL cholesterol and triglyceride levels showed a marked improvement. In contrast, another group of patients with diabetes from the same practice who were not referred to a CDE-A showed no significant change in any of the measures.

“The improvements that occurred in ambassador-guided patients’ glycemia, blood pressure, lipids and body weight could potentially lead to significant reductions in macro- and microvascular complications as well as an improvement in the quality of life for these patients,” said Paresh Dandona, MD, PhD, FRCP, FACP, Director of the Diabetes and Endocrinology Center of Western New York at the State University of New York at Buffalo. “Further, this treatment approach can help reduce the magnitude of expenditures which currently occurs in the management of these complications.”

Practice Pearls:

  • CDE-ambassador intervention in diabetes patients resulted in significant reductions in HbA1c, BMI, BP and lipid levels.
  • These changes may result in a reduction in both microvascular and macrovascular complications among diabetic patients.
  • Prospectively randomized, multicenter research is now underway due to the significant results found in this study.

Fida Al-Atrash. THE CDE-AMBASSADOR: A NOVEL APPROACH TO CONTROL DIABETES AT THE PRIMARY CARE LEVEL LEADS TO SIGNIFICANT IMPROVEMENT IN GLYCEMIC CONTROL AND CARDIOVASCULAR RISK FACTORS. Abstract #275. Presented at the AACE 24th Annual Scientific and Clinical Congress. AACE Press Release