Paper
Saturday, November 3, 2007
23
A Disease Management Approach to Diabetes
Sharon M. Weinstein, MS, CRNI, FAAN, Core Wellness International, Core Consulting Group and the University of Illinois, Lake Forest, IL, USA
| Learning Objective #1: discuss implementation of a diabetes disease management program to enhance outcome of care. |
| Learning Objective #2: identify populations at risk for developing co-morbidities associated with diabetes. |
This presentation will focus on improving quality by collaboration and teamwork through a disease management approach to diabetic care. Diabetes has reached epidemic proportions nationwide and in the US, the average American born today has a 1 in 3 chance of developing diabetes. For Hispanics and African-Americans, the risk is a staggering 1 in 2 according to the Centers for Disease Control and Prevention (CDC). Diabetic Peripheral Neuropathy (DPN) is a common and often disabling complication of diabetes mellitus (DM). The Diabetic Lower Extremity Screening and Assessment Program allows an out-patient facility of a hospital to screen and assess the diabetic population for lower extremity disease that may lead to complications causing multiple hospitalizations, multiple surgeries, and ultimately amputation. The methodology promotes a disease management approach, identifying other co-morbidities present in this same population, such as eye, heart, kidney disease and clinical depression. Identification of these complications enhances outcomes and patients are encouraged to utilize alternative methods of dealing with possible neuropathies. Implementation of the screening program expands the population base from the 10% of the diabetic population that has wounds to 100% of the population who may be candidates for ulcers and other diabetes lower extremity complications, but have not yet developed them. Finding the high-risk patients far upstream before the first acute event, then using a primary prevention methodology to prevent the first acute event, results in a significant reduction of human suffering. A collaborative approach to disease management, using all healthcare disciplines as well as patient and family, results in quality improvements.