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Item #13
Simple
But Effective Diabetes Team Approach Successful
All
the measurements taken by the groups to gauge success showed
improvement.
Helping
people set their own goals. Giving them a call when they're due for a
lab test or physical exam. Coaching them on how to manage their
health.
These
seem like simple enough steps, but they can make a significant
difference in the health of people with diabetes.
A
dozen clinical teams from around New Mexico came together under the
leadership of the New Mexico Medical Review Association to try these
approaches in helping patients manage their diabetes.
"This
really is just the beginning," said Leslie Shainline, director of
the collaborative. "The teams will now spread the patient
registry and system of change to other doctors, clinics and (apply
them to) other chronic diseases."
The
results, which encompass 1,435 patients, showed that:
*
The percentage of patients meeting a goal that exemplifies good
blood-sugar management only increased from 30.8 percent to 32.3
percent. However, the percentage of those meeting the next highest
measurement increased from 40.9 percent to 66.5 percent, while those
falling below the third rung rose from 40.9 percent to 78.7 percent.
*
Those meeting a "lofty goal" of LDL (low-density lipoprotein
-- the "bad" cholesterol) levels below 100 milligrams per
deciliter only rose from 23 percent to 29.8 percent. But those who
kept their LDL levels below 130 rose from 31.2 percent to 64.5
percent. Higher LDL levels contribute to heart disease, a major
complication of diabetes.
*
The percentage of patients who got a documented annual eye exam rose
from 34.2 percent to 63.3 percent. Diabetes can lead to blindness.
*
Only 12.8 percent of patients had set goals for managing their
diabetes, compared to 53.6 percent a year later.
Dr.
Robert Ferraro, an Albuquerque endocrinologist in private practice,
said he and his patients sign a contract in which they spell out their
goals and what steps they will take to manage their disease.
"It's a negotiation. You can't dictate to a patient," he
said.
An
aging population will bring a Social Security crisis and a Medicare
crisis, he said. "The rates of diabetes in this population will
double in the next 10 years," he said. "Lifestyle
improvements can moderate this disease."
Ferraro
has a patient registry to track whether people were getting needed
tests to watch for blood-sugar control and complications. He also set
up group visits, in which patients could get check-ups, access to
different experts and educational sessions.
"It
was a cohesive team approach," said Mary Lynn Johnston, diabetes
educator at UNM. In the past, patients sometimes would be told one
thing by one health care provider and another thing by another --
spurring them to ignore all the advice, she said. Now they are getting
a consistent message and are more likely to respond, she said.
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FACT:
Only about 15 percent of adults in the United
States regularly engage in the modest amount of activity required to
obtain health benefits.
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