Diabetes Patients Need Guidance and Support

Date
August 21, 2012
August 19, 2019
Translating local innovation into statewide policy: Lessons from a medications for addiction treatment (MAT) prior authorization pilot in Camden, New Jersey
In this brief, we outline our prior authorization pilot program and our work with partners to translate the pilot into successful statewide policy.
Natasha Dravid and Alex Staropoli
August 19, 2019
Camden residents identify barriers to health in their neighborhoods
Members of organizations that have participated in our Faith in Prevention program conducted a health assessment of their Camden neighborhoods.
Whitney Buchmann
Camden Coalition staff and Community Advisory Committee members participate at the Housing and Community Development Network of New Jersey’s Annual Legislative Day at New Jersey State House
July 18, 2019
Camden Coalition joins the call to fully fund the Affordable Housing Trust Fund
To help secure FY2020 funding for the Affordable Housing Trust Fund, CAC members took part in HCDNNJ's Annual Legislative Day at the NJ State House.
Whitney Buchmann
July 16, 2019
From siloed systems to ecosystem: The evolution of the Camden Coalition’s complex care model
In this four-part series, we describe the phases of our care model as we addressed challenges and tested new solutions.
Kathleen Noonan and Kelly Craig
July 15, 2019
Graduates of Interfaith Homeless Outreach Council program reflect on their fresh start
Now in its 28th year, the Interfaith Homeless Outreach Council — or IHOC — has transformed countless lives.
Bill Nice
Camden Coalition care team member helps patient fill medication box.
July 11, 2019
Bringing it home: The shift in where healthcare is delivered
In this blog post for JAMA Forum, Lauran Hardin and Diana Mason write about two new opportunities to incentivize innovative complex care models.
Lauran Hardin and Diana Mason

By Francine Grabowski, Lead Diabetes Educator

You are fired. These words can instill fear, grief and chaos in the lives of the recipient.

These words were heard by Mrs. Jones 5 years ago – not from her boss, but from her primary care physician (PCP).

The doctor, who worked with her for 10 years, warned her during every visit that if she didn’t start controlling her diabetes with diet and medication, the disease would kill her. Mrs. Jones tells of seeing her diagnosis on the bill, “uncontrolled diabetes,” and feeling frustrated and condemned to a life of the disease. Then she received a letter stating that her doctor would no longer work with her because she was not taking care of herself. “I was fired,” she says. “I was humiliated and felt hopeless.”

After being asked to leave her PCP office, Mrs. Jones came to the Camden Coalition of Healthcare Provider’s Diabetes Self-Management Education (DSME) classes every Friday for 13 weeks. She learned techniques to understand how her daily activities affect her blood sugar levels. One step at a time, she began to learn to control her diabetes.

First, she learned how to inject her insulin properly, which was difficult because she is left-handed, as well as when to take the medication. Once she was using insulin optimally, she had to look more closely at eating patterns. Mrs. Jones sometimes skips meals, so she learned techniques to control her blood glucose in those instances. She began using the healthy food plate model to eat properly, filling half her plate with vegetables and a quarter with starches. She learned that eating a teacup of rice did not affect hear blood glucose.  Slowly, she experimented with different food patterns.  What happens if I eat Chinese food?  What happens if I skipped lunch? What happens if I eat pizza?  What happens if I sleep in? What happens if I forget to take one medicine? When Mrs. Jones first came to class, her blood glucose was in the 400s.  At the end of 12 weeks, it was typically in the 100s.

Mrs. Jones’ story is not a one of an unruly patient sabotaging her health despite the best efforts of her physician.  It is one of a patient overwhelmed by her disease and lacking the proper education and support structure necessary to manage a chronic illness.

Rather than fire a patient, a health care provider should be asking questions. What am I doing or not doing to contribute to my patient’s high blood glucose. What resources exist to help me help my patient?  What is the root cause of my patients “non-compliance”?

Mrs. Jones often talks to the class about being called uncontrolled and being “fired” from her doctor’s office. But now she ends her story differently. She no longer takes the blame, noting that if she had known what to do, she may have been able to control her diabetes.

 

 

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