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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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This article originally posted 31 October, 2006 and appeared in  Issue 336

Past five issues: Issue 611 | Issue 610 | Diabetes Clinical Mastery Series Issue 68 | Issue 609 | Diabetes Clinical Mastery Series Issue 67 |

 
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