May 2008

New drugs and treatments make it easier than ever for individuals with diabetes to avoid many of the serious health consequences of the disorder. However, patients still need to make lifestyle changes and work closely with their health care team to control the disease.

This is why PAMF’s Diabetes Program combines high-tech resources with personal attention to provide patients with the comprehensive tools and support they need to be their healthiest.

"As many resources as we now have for high-tech disease management, setting lifestyle goals is a process that must take place one-on-one with the patient playing an active role,” says Linda Klieman, R.N., MSN, ANP, a nurse care manager for PAMF’s Online Disease Management. "If the patient doesn’t have buy-in to the changes he or she will need to make, it will not work."

Diabetes is an increasingly common disorder where the body loses the ability to regulate how much sugar is in the blood. According to the U.S. Centers for Disease Control and Prevention, one in three Americans will now develop diabetes in his or her lifetime.

Diabetes cannot be cured, but it can be controlled with medical treatments such as injections of the sugar-processing hormone insulin, and lifestyle changes such as eating a diet lower in sugar and fat, exercising more and losing weight.

However, making these lifestyle changes is easier said than done. For patients with type 2 diabetes, which is the most common and fastest growing form of the disorder, the diagnosis typically comes after age 40, when the diet and exercise habits that put them at risk for diabetes in the first place have become ingrained over the years, and thus are more difficult to change.

The symptoms of type 2 diabetes are often outwardly mild and may include feeling fatigued and irritable, being very thirsty, having blurred vision, and urinating more frequently. Because few people see their doctors for such symptoms, as many as a third of people with diabetes may not even know they have it. However, inside the body, diabetes can begin to damage organs and the circulatory and nervous systems long before the disease is detected.

To increase the chance that diabetes is caught early, PAMF doctors typically recommend that all pregnant women and anyone who has one or more diabetes risk factors – including being overweight, having high blood pressure, being over age 45, having a close relative with diabetes or being a member of an ethnic group that has a high incidence of the disease – have their blood glucose level tested.

To keep diabetes patients committed to controlling their disease – not just for a few months or years, but for the rest of their lives – PAMF’s Diabetes Program offers a broad array of resources that can be combined in numerous ways to meet individual needs:

• For those who feel most comfortable in group situations, PAMF offers classes on diabetes-related health topics, and a monthly support group for patients and their families.
  
• Patients who prefer to research their disease on their own can visit PAMF’s Community Health Resource Centers and receive assistance from a registered nurse health educator.
  
• Individuals who are having a hard time controlling and managing their diabetes may receive individual phone and in-person consultations with a PAMF diabetes educator. In addition, if depression is making it hard for patients to take charge of their lives and their disease, PAMF offers a weekly "Diabetes and Depression" drop-in support group.
  
• For patients with special needs, like diabetes during pregnancy (gestational diabetes), or individual cultural concerns and risks factors, there are resources tailored just for them. These include a special Gestational Diabetes class and the PRANA (Prevention and Awareness for South Asians) Wellness Program.
  
• Finally, for patients who have their disease under control and need little added support, viewing their electronic health record online via PAMFOnline, PAMF’s e-health service, can help them keep track of medications, test results and health care appointments, anywhere there is access to the Internet. One diabetes patient, for example, uses PAMFOnline to manage his disease as he travels around the country by RV for months at a time.

"In the future, even more patients may choose to take advantage of these high-tech disease management capabilities, but the human element will always be at the heart of any diabetes program," said PAMFOnline Manager Barbara Love.