The staff at Swope Health Services-Independence has launched an all-hands-on-deck initiative to identify diabetes in their patients, help manage the chronic disease, and most importantly, work to prevent it.
The program is the brainchild of Dr. Naiomi Jamal, who holds both a medical degree and Master’s degree in public health.
“I am always focused on prevention,” said Dr. Jamal, noting that the clinic serves a high number of patients with hypertension, obesity and diabetes.
According to the Centers for Disease Control and Prevention (CDC), more than 30 million people in the U.S. have diabetes. Diabetes is the No. 7 cause of death, and the No. 1 cause of kidney disease, limb amputation and blindness, Dr. Jamal said.
In addition, one in three people have pre-diabetes, and 90 percent of them do not know they are at risk, she said.
“To a large part, diabetes is preventable,” she said. “We are working to create an environment to do that.”
The initiative at the Independence clinic begins with a specific diabetes checklist used with every patient to look for early signs of those three dominant diabetes-related issues: kidney disease, limb amputation and blindness. At least once a year, all patients are asked to complete lab tests to evaluate kidney function and receive a foot screening.
Diabetics are also predisposed to infections such as pneumonia and influenza. Their vaccination status for both these conditions is updated and monitored at every visit.
Starting in November, the clinic will add one more exam: an annual eye test to capture images of each patient’s retina. Those images are then examined by an optometrist for abnormalities linked to diabetes.
“In every visit, we try to make sure we are not missing anything,” said Dr. Jamal.
A second component of the initiative is counseling. In addition to medical treatment, patients are offered personal sessions with a chronic disease counselor and group visits with a trained and certified diabetes educator.
These small group sessions – 10 or fewer patients and their family members – are held every six to eight weeks at the Independence clinic. Topics include a detailed explanation of diabetes, insulin and medications, and steps to take to better control diabetes with diet and exercise.
Dr. Jamal has seen the group sessions produce results. She recalled one patient who had been under care for about a year but had difficulty controlling her diabetes.
The patient reported to Dr. Jamal that she was taking her medications, but in reality, she wasn’t. When she came to a group session, she encountered another woman from her neighborhood who talked about how she had been able to manage diabetes – using the same regimen the patient was prescribed.
“That peer interaction did something,” Dr. Jamal said. “My patient decided she, too, could be successful, and she started taking her medication.” That patient now has been able to control her diabetes.
The diabetes initiative has been operating for nearly a year in Independence, and as checklists are completed on more and more patients, the results are starting to show promise.
This includes higher rates of diabetic foot exams, vaccinations, renal disease screening, and overall diabetic control (compared to the same period last year, before the program was introduced).
“This truly is a team effort,” Dr. Jamal noted. Starting with Patient Service Representatives who schedule and remind patients, to nurses and medical assistants who review patient histories in pre-visit sessions, to clinic staff who print out flyers and educational materials, counselors who educate and providers who diagnose and treat – all play important roles in reaching patients and encouraging the changes that drive results.
In 2019, this checklist approach – with lessons learned from Independence – will be rolled out across all SHS clinics.
“It is so very difficult to make healthy choices,” Dr. Jamal noted, “but we can make it easier.” For people who are diagnosed as pre-diabetic, lifestyle changes can frequently mean avoiding medication. “Prevention is possible,” she added.
There has never been a better time to come in for a checkup, at Independence or any of the Swope Health Services locations. “We want to see you,” Dr. Jamal said. “We want to partner with you to help you achieve your health goals.”
In this month of diabetes awareness, it’s a good time to make an appointment for an examination. Call 816-923-5800 to schedule an appointment. SHS can help prevent diabetes in some cases, and if you have diabetes we can help with medication and education, including nutrition guidance, to lessen its impact on your life.