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Long-Term Follow Up Key to Keeping Patients on Track

A new patient of mine was diagnosed with type 2 diabetes and obesity. We discussed a weight loss treatment to target both her diabetes and obesity, and she followed our mutually agreed upon treatment plan. Things were going well -- she would visit every three months and we would reassess and make treatment decision changes as needed. Then, my patient did not visit for two years. When she returned, she had gained back her weight plus a few more pounds, and her blood glucose, blood pressure and lipids were out of her target range....

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Getting and Staying Motivated to Be Physically Active

By Sheri Colberg, PhD
This time of year, all of the fitness clubs and gyms run specials to bring in new members, and they know—and even count on the fact that—most of those people will no longer be regularly attending classes or doing workouts by the time spring hits. How do you help your patients avoid joining those exercise dropouts? Here are some tips from our diabetes exercise expert that you can download in PDF format to hand out to your patients.

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Custom Molded Shoes: If the Shoe Doesn’t Fit…

A patient of mine who had diabetes and peripheral neuropathy came home from the hospital after a below-the-knee amputation of her right leg. She lived alone and was housebound. Having lost one leg, I knew she was at increased risk for losing her other leg. While in rehab, she had a professionally custom molded shoe made for her left foot which she started to wear.

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Carbohydrate Loading: Effective If Done Right for Even a Day

By Sheri Colberg, PhD
What is a better topic to discuss after the gluttony most of us experience over the Thanksgiving and other fall/winter holidays than carbohydrate loading? (Actually, it probably should be excess calorie consumption in general, but you get the idea.) The following is excerpted from The Athlete’s Guide to Diabetes (2019) and gives you a better understanding of the topic from an exercise physiology (and diabetes) point of view.

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Insulin Before Exercise May Be Needed to Lower Morning Highs

A man with type 1 diabetes started an exercise program to help him manage his early morning highs. He exercised every evening, at which time his glucose levels would drop during and after exercise. Thinking that exercise would lower his early morning highs, he did not take his insulin before exercise. He was surprised to see his glucose would go up after exercise rather than go down.

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Improving Diabetes Outcomes: Collaborative Patient Care in a New Multispecialty MSO Model

by Guest Writer Richard Purcell
More than 100 million U.S. adults are now living with diabetes or prediabetes, according to the Centers for Disease Control and Prevention.1 This epidemic requires new healthcare models to deliver optimal, patient-focused, guideline-directed care to improve outcomes and reduce costs. The establishment of a new multispecialty Managed Services Organization (MSO) in Arizona spotlights the numerous benefits, to patients and providers alike, of providing end-to-end healthcare services and disease management solutions for complex diabetes.

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Is It Sugar-Free or Isn’t It?

Sugar

One of my long term patients called my office because she could not figure out what was happening with her post breakfast glucose readings. She counted carbs and would typically have a 2 hour ppg of no more than 145 mg/dl but even though her pre-breakfast readings were around 110 mg/dl she was experiencing glucose levels near 200 mg/dl. I had her do a morning food diary for 7 days and we identified 3 days when she was eating French toast when her readings were going over 200 mg/dl. This meal had never been a problem in the past.

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