New Diabetes Model: Treatment in a Group Setting
posted 06/11/03

"We're learning that people who are living with a chronic condition really require an approach to medical care that is different than the acute care model.”

Managing diabetes can be confounding and all-consuming. Diabetics must test their blood sugar several times a day and adjust their medications accordingly. They have to watch what they eat, check their blood pressure, monitor the circulation in their feet. More than half of all diabetics eventually must inject themselves with insulin twice a day.

Now doctors and nurses at a Eugene medical clinic are trying a new model for diabetes management: treating diabetics in a group setting. Since January, the Volunteers in Medicine Clinic has provided monthly group visits at its office. The setting provides diabetics with much needed support and gets them into regular, continuing care for their chronic disease.

About 70 people are enrolled in eight different groups at Volunteers in Medicine and a ninth group will begin soon, said Cheryl Ana Moore, a diabetes nurse educator who coordinates the program.

Three of the groups are for Spanish-speaking patients; Mexican-Americans are twice as likely to develop diabetes as white people, according to the federal Centers for Disease Control and Prevention. The Volunteers in Medicine Clinic, which provides free health care to low-income, uninsured Lane County residents, is one of a handful of clinics in Oregon to try the group approach.

Studies have shown that diabetics who participate in group visits reported improvement in their blood sugar levels, improved quality of life and diabetes knowledge compared with patients who received conventional diabetes care. More study is needed to determine why, according to an article in the latest issue of the journal Diabetes Spectrum.

In Oregon, the group visit model is used at the Clackamas Public Health Clinic in Sandy and at the Samaritan Internal Medicine Clinic in Corvallis, said Linda Dreyer, who manages the Oregon Diabetes Prevention and Control Program for the state Department of Human Services.

"We're learning that people who are living with a chronic condition really require an approach to medical care that is different than the acute care model that most of us are exposed to with our medical care provider," she said.
Under the acute care model, people see their doctor only when they get sick. They get a prescription, go home and don't think about seeing a doctor until next time they get sick, she said.

"Chronic conditions aren't going away," she said. So doctors and nurses need to figure out a better way to treat such conditions, she said.

The group meetings are combination of a regular visit to a doctor and a support group. A doctor and nurse are there to provide education, check blood pressures and adjust medications, but much of the good seems to come from the support and information the diabetics provide to each other.

At a group visit last Thursday morning at the Volunteers in Medicine Clinic, Dr. Hugh Johnston, the clinic's medical co-director, explained how different diabetes drugs work, why some are effective and some aren't. Then he talked with the patients individually.

The setting allows doctors and nurses to cover the bases more efficiently.
"Essentially you get better management," Moore said. "You're giving the same information to six or seven or eight people instead of one, so you don't start dribbling off details after the fourth or fifth patient."

Each patient also brings a binder to document their self-treatment.
"The object of the notebook is that they learn they are managing the disease and I am not," Johnston said.

Group members also talked together informally, sometimes offering advice. For example: Mark Royce gave Sheila Werth a tip to liven up her diet without compromising its healthfulness: Tabasco. Diabetics often must eat bland diets to keep their blood sugars in check.

Werth said she's tired of trying to eat a healthy diet. "I'm in rebellion," she said. "I want to eat Cheetos."

But the group, she said, has been a big help. "I never learned anything about diabetes before I came here," she said. "It's like any support group. You've all got the same problem. You learn what other people are going through." For more information: Contact Volunteers in Medicine at 685-1800. New Diabetes Model:

Source: Diabetes In Control Dot Com.

June News Article Index

Home - Table of Contents - Donate Now - About Diabetes - Warning Signs - Complications - Screening Test - Diabetes Terms - Site Search - Meet Mr. Diabetes®  -  Wake Up And Walk® Tour - Latest News - Headlines & News Stories - Health & Fitness - About Us - FAQ - Research Form - -  Message Board - Privacy Policy - Legal Notices - How to Contact Us - Comments form - Suggestion Form - Our E-Mail Addresses - Our Address and Phone Numbers - Links - Contact Us