SCKMC Gets Aggressive With Diabetes Care

June 25, 2012

Diabetes is a disease in which blood glucose (sugar) levels are above normal and cannot be regulated through the insulin produced by the body's pancreas. The disease affects 25.8 million people in the United States, and 8.5% of Kansas adults. The average medical expenditures among those diagnosed is 2.3 times higher than those without diabetes, totaling $174 billion in 2007.

With the number of reported cases on the rise SCKMC has formed a proactive group of diabetes care providers to educate newly diagnosed patients, or re-educate patients who have become less vigilant with their diabetic care as time has gone by. The team is headed by the hospital's Registered Dietitian, Diane Ray, and also includes members of the physical therapy and nursing departments.

"Through my diet counseling I found out that a lot of the (diabetic) patients weren't getting the whole picture. They needed someone to sit down and answer questions for them. What is the best time to take blood sugars? What should I expect my blood sugar to be? It's surprising how many people haven't researched what diabetes is and the types of problems it can cause," Ray said.

Diabetes can contribute to serious health complications including heart disease, blindness, kidney failure, nerve damage, stroke, high blood pressure, and lower-extremity amputations. According to the Centers for Disease Control and Prevention, it is the seventh leading cause of death in the United States.

While diabetes is a disease that should be taken seriously, Ray explained that it is manageable with the proper support.

"We are being proactive in educating our patients. Some can actually defeat the disease if they lose weight and get into better shape," Ray said.

Ray focuses her time with the patients on their diets. She educates the entire patient's family on basic meal planning, understanding portion size and carbohydrates, and the importance of eating on a regular schedule. However nutrition is just one piece of the patient education process.
Megan Graber is one of the medical center's physical therapist who has joined the diabetic team. Graber focuses on exercise and places special emphasis on proper foot care.

"We really hit hard on foot care and ulcers on the feet. When you have diabetes you usually have nerve desensitivity (known as neuropathy). You can have wounds you have no idea about," said Graber.

The American Diabetes Association website states as many as 33% of people with diabetes will have a skin disorder, such as neuropathy, caused or affected by diabetes at some time in their lives.

The final educational piece deals with wound care. Since diabetics typically take longer to heal, the SCKMC nursing staff takes the time to explain to the patients how to properly care for any open cuts or sores. In addition patients are taught when to seek additional care from a medical professional.

The medical center's program has been in place since March and has slowly started to grow as the local physicians become more familiar with the training.

"We don't expect large numbers (to require the diabetic education), but the ones we do help are important numbers," Ray said.

To date, diabetic team education has been focused on hospitalized patients, however the services can also be provided in an outpatient setting if it has been ordered by a doctor. Anyone interested in learning more about this program should contact their primary care physician and request a referral to SCKMC for nutritional counseling and physical therapy for diabetics.

Photo: Megan Graber, Physical Therapist with SCKMC, reviews diabetic foot care with a patient.