Diabetes is an extremely common condition in our country and particularly type 2 diabetes we are seeing the epidemic level of type 2 diabetics mostly because of obesity and it's defined as insulin resistance and your body's inability to handle blood sugar circulating in your bloodstream and it leads to all kinds of complications and increasing macrovascular complications like heart attack and stroke. Microvascular complications like problems with your vision or circulation problems with your kidneys or even your nerves we in family medicine see a lot of diabetics and we care a lot about because of those complications and trying to prevent it. What we want to do we want to first start with lifestyle modifications there's a reason why especially in the u.s. we really are struggling with this you know our diets are very very heavy in carbohydrates and simple sugars so trying to reduce those is my first step so trying to keep it easy to have them you know take out pop and sweets and snacks and you know certainly some of the fast foods and those type of things that really drive up blood sugar and they're not really very nutritious and so that's step one and then as patients were able to maybe stop alcohol or pop or some of the things that really raise blood sugar. We can start working on some of the second kind of phases of that and looking at better nutrition and we use dietitians here and thank goodness because you know the physicians need that type of help and the patients need it too to sit down and really dig into. What they're doing each meal and trying to help shape a better and healthier eating habit and then exercise patients they can defend off diabetes in the early stages if they make those lifestyle changes and that's what patients want they don't want more medications they want to be able to do it naturally if they can we hope for that as well but it's tough and then making those lifestyle changes and sticking to it is really really difficult for patients but we have great resources especially in our offices with nutritionists and health coaches to help to help those patients along with their physicians for patients they should know that it's different than maybe in the past where you came for a visit and then you may have had the doctor kind of talk to you about a few those things and draw some blood work you hear the results and a few recommendations and you come back months later the medical home model and using kind of a team approach with our ends and in our clinics that are what we call health coaches there. They're really there to guide through that time where you're at home and you're not within the clinic to reach our goals between visits having the dietician and in others are part of that team too to accomplish those goals and so it's really chronic condition management at a higher level not allowing patients to just kind of flounder three to six months in between those visits you know patients are busy. It's not always their number-one priority they need that help sometimes patients uh you know even comment that we were you know trying to contact him too often and you know I think that would be probably the same way I feel as well until they understand that then they're meaning behind it and the reason why we're doing it is really for those outcomes and once they hear those things and realize that it's you know their blood Sugar's are better they're losing weight there are less medications or they're reaching their goals they're they're excited about that and they they want to you know turn in their blood sugar logs they want to you know hear those calls from the health coaches or from the dietician but for patients what they what they are gonna I guess experience is it's more than just the phone calls, it's it's really a different mentality about about their disease and trying to make sure they have the right resources so the phone calls are more often the sicker you are or the more uncontrolled your condition is setting those expectations and making sure they understand the reason behind it. How even how they want to be communicated with is really important so we have multiple ways we can communicate with patients and we have patients now they're able to even upload their logs right into our patient portal and send those to our health coaches and to the doctors to review and it really speeds up the ability to titrate their medications by the time they get back in for that next maybe three-month visit or six-month visit. When we draw their blood work we already know it's gonna be much improved and they may already be a goal as a physician that's been really rewarding it's been very successful for showing how our overall population of patients has improved with diabetes so you know that's great and I think patients are appreciative of that as well that they do have to understand expectations and understand what you know the partnership is about and how what we expected them and then what we're gonna we're going to do for them you.
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