Integrated Care for Diabetic Management
People living with diabetes face daily challenges managing their condition. These can include diet and exercise, treatment-taking, psychological stress, education, illness and disability. A multidisciplinary team approach is critical to success in diabetes care and complications prevention. Our team of primary care physicians and skilled medical providers work in conjunction with our teams at Wickenburg Community Hospital and WCH Pharmacy to provide you an integrated approach to diagnosis, treatment and care planning. The result is a full continuum of care with the convenience of being close to home. Evidence indicates that a team approach:
- Can facilitate diabetes management.
- Can lower the risk for chronic disease complications.
- Helps educate about ways to reduce risk factors for type 2 diabetes.
Primary Care as a Diabetic
Newly Diagnosed diabetes patients will come into the office for regular check up’s every 3-4 months until the individual can get sugars under control.
- Lab work will be done during every visit during this time: Complete Blood Metabolic, A1C and a urine protein test.
- You PCP will also recommend that you see an eye doctor 1 time per year and consult an RDN.
Primary Care & Diabetes – Current Standard Practice of Medicine
- All new diabetic patients be prescribed a Statin medication, high or low lipids notwithstanding.
- Once your sugars are being properly managed, a diabetes patient will come in 2x a year for a PCP visit unless something warrants a sooner visit.
- For patients that have been diabetic and cannot get their sugars under control, your PCP will look at different medications and insulins.
- If a person is still unable to control sugars after new medications, your PCP will recommend that you consult an endocrinologist.
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Nutrition Management
A Registered Dietitian Nutritionist (RDN) is a nutrition professional equipped to administer evidence-based Medical Nutrition Therapy (MNT) through vigorous training and educational standards. Consulting an RDN is an important diabetes management step to give you a nutritional assessment, education and meal planning.
- MNT includes a nutrition diagnosis as well as therapeutic and counseling services to help you manage diabetes.
- Many insurance plans cover these services. Medicare Part B covers MNT for diabetes and kidney disease. If you have private insurance, check with your individual plan for specific coverage details.
- An RDN can discuss a variety of nutrition approaches to help you manage diabetes. Research shows that meeting regularly with an RDN helps manage weight, improves cholesterol levels, decreases the need for medicines and reduces risk for other diseases.
If you are newly diagnosed with Diabetes an RDN will go through a few different points:
- How much do you currently know about diabetes?
- What is blood glucose?
- What is diabetes?
- Controlling your diabetes with nutrition and exercise
- Controlling your diabetes with medication.
- Carbohydrates and diabetes management, plus the difference between good and bad carbohydrates.
- Using a food journal or a smartphone AP to track your health
- The impact of diabetes on your health and common health complications.
- For those who are already diabetic, it may be finding a balance in your sugars that meets your needs and working with your PCP in finding a good goal so that your diabetes stays steady vs highs and lows.
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Diabetic Foot Care
Because diabetes is a disease affecting many parts of the body, successful management requires a team approach. Podiatric care is an integral part of the treatment team and has documented success in preventing amputations:
- More than 100,000 lower limbs are amputated annually due to complications from diabetes.
- After an amputation, the chance of another amputation within three to five years is as high as 50 percent.
- Including a podiatrist in your diabetes care can reduce the risk of lower limb amputation up to 85 percent and lowers the risk of hospitalization by 24 percent.
The keys to amputation prevention are early recognition and regular foot screenings performed by a podiatrist, the foot and ankle expert.
IF YOU HAVE DIABETES, FOLLOW THESE FOOT CARE TIPS:
- Inspect feet daily. Check your feet and toes every day for cuts, bruises, sores, or changes to the toenails, such as thickening or discoloration.
- Wear thick, soft socks. Avoid socks with seams, which could rub and cause blisters or other skin injuries.
- Exercise. Walking can keep weight down and improve circulation. Be sure to wear appropriate athletic shoes when exercising.
- Have new shoes properly measured and fitted. Foot size and shape may change over time. Shoes that fit properly are important to those with diabetes.
- Don’t go barefoot. Don’t go without shoes, even in your own home. The risk of cuts and infection is too great for those with diabetes.
- Never try to remove calluses, corns, or warts by yourself. Over-the-counter products can burn the skin and cause irreparable damage to the foot for people with diabetes.
- Diabetic foot exams: Preventative care for diabetic patients with evaluation of blood flow and sensation are performed semi-annually on every diabetic patient to prevent further issues down the road.
This information is meant to be informative but not prescriptive. Their purpose is to provide information on diseases and processes, rather than dictate a specific form of diagnosis or treatment. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician after all the circumstances are presented by the individual patient.