DiamC applies innovative model of care to type 2 diabetes, improves outcomes
‘The idea is to change behavior,’ says practice president
Shreveport, LA (June 20, 2019) – When Roderick* began receiving diabetes treatment at the Diabetes Assessment and Management Center (DiamC) in Shreveport, he was in a state of denial about his condition.
“At first, I denied that I had diabetes, but with symptoms of depression, weight gain and heavy fatigue, I realized I had a major problem with my health,” he said in a recent patient testimonial for DiamC. “I took major precautions to win my life back from diabetes and live a healthier, happier lifestyle.”
His efforts, with the support of DiamC, were successful: In just four months, Roderick reduced his A1C, or blood sugar level, from 11.2 to 7 percent and dropped 20 pounds – and his results are standard among the type 2 diabetes patients at DiamC, where patients routinely achieve a two-four percent reduction in A1C in 90 days.
In a state where diabetes is among the leading causes of death, the success of DiamC in improving outcomes for type 2 diabetic patients in such short timeframes is generating national attention, thanks in part to DiamC physician Dr. William Gibson’s recently published article in Diabetes Spectrum, a peer-reviewed journal of the American Diabetes Association.
According to the American Diabetes Association, nearly 14 percent of Louisiana’s adult population has diabetes, and another 37.5 percent have prediabetes with blood glucose levels higher than normal, but not yet high enough to be diagnosed with diabetes.
In North Louisiana, along the I-20 corridor, more than 4,850 Medicaid enrollees age 21+, and nearly 620 youths under the age of 21, have been diagnosed with diabetes, according to the 2017 Diabetes and Obesity Action Report for the Healthy Louisiana Medicaid program.
Given those statistics, it’s perhaps unsurprising that most of DiamC’s patients are Type 2 diabetics. Type 2 diabetes is a largely preventable progressive disease influenced by risk factors that can be changed such as smoking, obesity, physical inactivity, high blood pressure and poor diet.
“Treating type 2 diabetes is about changing lifestyles,” explained Clay Crenshaw, DiamC President. “Our purpose is to improve the quality of life for people with diabetes through better health outcomes and reduced costs. We apply an intensive diabetes treatment protocol to help our patients better manage their conditions and make better decisions about their health.”
As part of that intensive protocol, patients are required to complete nine visits in 90 days, compared to the standard two visits per year in many practices, Crenshaw said. “The idea is that you cannot change behaviors in type 2 diabetics if you only see them twice a year. The increased number of visits leads to increased accountability.”
Patients must complete diet and physical activity journals, and bring the journals with them to each visit to review with DiamC’s clinical staff. They must also complete a 3-5 day round of continuous glucose monitoring with a Medtronic device, Crenshaw noted.
“This device does a glucose reading every five minutes, and we can then download the report and plot a graph that shows the exact data specific to that patient,” he explained.
In addition to increased accountability and enhanced data analysis, patients also receive the benefits of peer-to-peer motivation. In the clinic’s exam rooms as well as its website and Facebook page are regular testimonials – like Roderick’s – designed to inspire other patients to stick to their treatment plans to achieve better health.
Perhaps the most important element in DiamC’s approach, however, is its focus on patient education and engagement. Led by Dr. Gibson, the clinic created a 13-lesson diabetes self-management educational program for patients. Each module includes a brief quiz in which patients must apply the knowledge gained in the lesson, said Crenshaw.
“Diabetes education provides the foundation to help people with diabetes to navigate daily health decisions and activities, and has been shown to improve their health. The overall objectives of diabetes education are to support informed decision-making, self-care behaviors, problem solving, and active collaboration with the healthcare team in order to prevent or delay the complications of diabetes, such as heart disease, stroke, nerve damage, kidney damage, eye damage and amputation,” he explained.
In the coming months, this program will be expanded, thanks to a grant from Louisiana Healthcare Connections, a Healthy Louisiana Medicaid health plan, he added. The grant will enable DiamC to transition its diabetes education to a digital format with a series of 31, three-five minute videos.
“These videos will provide the patient with self-paced education and eliminate the need for them to come to a ‘brick-and-mortar’ facility for education,” said Crenshaw, adding, “We will also be exploring ways to partner with Louisiana Healthcare Connections to make the videos available to their statewide membership to advance improved diabetes self-management. With 40 percent of our patients enrolled in Medicaid, Louisiana Healthcare Connections is a valued partner.”
“DiamC has helped many of our members regain control of their health through improved diabetes self-management. We share DiamC’s commitment to achieving improved outcomes through cost-effective, evidence-based care, and look forward to partnering with DiamC to increase statewide access to quality diabetes education for our members,” said Kendra Case, Louisiana Healthcare Connections Chief Operating Officer.
According to Crenshaw, DiamC is seeking the opportunity to partner with other like-minded healthcare and community organizations to continue to drive improvements in health outcomes for diabetics.
“It is very rewarding to watch our patients reverse their diabetes with the help of our program. I’ve seen patients reduce or eliminate expensive medications for diabetes, blood pressure and cholesterol, and many patients experience weight loss and find improvement in other comorbid conditions,” he said. “We want to build partnerships to help scale what we know works and help patients transform their lives.”
*Patient’s last name removed to preserve healthcare privacy.