This article originally posted 31 October, 2006 and appeared in Issue 336
Practices Bring in Diabetes Educators With Great Results
Having a diabetes educator in your office practice can have dramatic results in improving diabetes control.
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When a diabetic patient needs to see a diabetes educator, convenient access
can boost compliance and help improve health outcomes.
That's the experience of Dr. Francis X. Solano Jr. and his primary care colleagues,
who refer patients with newly diagnosed or uncontrolled diabetes to a certified
diabetes educator—and the educator sees patients on-site.
With the educator right there in the office on designated days, most patients
follow through and receive the prescribed diabetes self-management education
(DSME). As a result, they have improved their health outcomes, Dr. Solano said
in an interview.
He has data to prove it. “Having a diabetes educator in-house showed us
the value of what we can do with our outliers and our new diabetics,”
he said. “Some 65% of our patients now have an A1c less than 7, and only
8% have an A1c greater than 9. When we started [the project], at least 20% of
our patients were above 9.”
Dr. Solano's practice is one of six primary care practices in Community Medicine
Inc. (a group of 65 practices owned and managed by the University of Pittsburgh
Medical Center) that are participating in a project aimed at integrating DSME
directly into primary care offices, where it can be most easily accessed.
Physicians “need to think outside the box and look at what kinds of
relationships they can develop with hospital program leaders,” said Linda
M. Siminerio, R.N., Ph.D., C.D.E., director of the University of Pittsburgh's
Diabetes Institute and senior vice president of the International Diabetes Federation.
“There are all kinds of clever ways you could do it outside the [traditional]
system” of education occurring in hospitals, clinics, and endocrinologists'
offices, she said.
Dr. Jennifer Mayfield, a family physician from Seattle who commented on the
project at the meeting, said that such problems are common and that primary
care physicians all over need help.
“I don't think insurers understand how difficult it is for us to do
the education—we don't have the training and the expertise,” Dr.
Mayfield said. “And insurers don't appreciate the fact that many patients
won't go across town.”
Internal Medicine Volume 39, Issue 20, Page 1,4 (15 October 2006)
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FACT:
Fighting Colds with Exercise: If you have diabetes and therefore more prone
to colds and flu, here's another way to protect yourself during cold and flu
season. Researchers from the Fred Hutchinson Cancer Center in Seattle found
post-menopausal women who work out regularly seem to catch about half the colds
of those who don't. Over 12 months, the 115 overweight women either participated
in a moderate exercise program - 45 minutes a day, 5 days a week, mostly brisk
walking, or they took part in 45 minute stretching sessions once a week. In
the final 3 months of the study, the risk of colds was 3 times higher in the
stretchers than the exercisers. Exercising during a cold is another matter.
Past studies has shown that if the cold symptoms are severe, heavy exercise
could cut the immunity, not boost it. American Journal of Medicine, Oct 2006.
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