Post written by Gwenyth Wagner, DNP, APRN, Adult Nurse Practitioner, Diabetes Clinic
The diabetes clinic is a specialized clinic at Health Partnership Clinic. Patients are referred to the clinic from their primary care provider if the provider feels like the patient would benefit from more concentrated care for the diabetes. Typically, this is a patient who is having difficulty reaching their goal A1C which is a measure of blood glucose. The goal set out by the American Diabetes Association is less than 7.0. If a patient has an A1C of nine or greater then they may be referred to the diabetes clinic.
How is an appointment with the diabetes clinic different than a regular appointment?
The diabetes clinic focuses on providing comprehensive care for the diabetic patient to help them improve the A1C. The diabetes clinic is made up of a medical assistant, a diabetes coordinator, a behavior health clinician and the nurse practitioner. We all have our roles. As the nurse practitioner, I am responsible for ordering medications which include oral agents and injections that will work best for the patient and to work with the patient to find a routine that works for them. I also do routine labs and conduct a physical exam to watch for any complications of the disorder. Education is very important to controlling diabetes well, and the patient will receive education and tips from both the nurse practitioner and the diabetes coordinator. The diabetes coordinator helps things run smoothly. She makes appointments, monitors the diabetes schedule, and will make follow up calls to the patient, especially when there have been changes to their insulin or medication regimes.
A behavioral health clinician meets with patients as well at the time of their visit. They help identify barriers which affect the patient’s ability to follow through on their treatment plan. These might be mental health issues such as depression, or practical challenges such as finances and access to medications.
How do patient’s receive help to get them the medications they need?
In the diabetes clinic we try to help patients get their medications in several ways. There is a pharmacy discount program that helps those who are uninsured or who have inadequate insurance get access to some of the new diabetes medications. Some patients are eligible for prescription assistance plans and we will help patients apply for their needed medications. Finally, we also have a limited supply of some insulin products for patients who qualify.
Have you seen patients make improvements?
We have had several “success stories” of patients who have met their A1C goal or at least made an improvement. The patients who have made progress list the following things as key to their success:
- Increased knowledge of a healthy diabetic diet and learning how to count carbohydrates. We have seen incredible improvements in those patients who are heavy soda drinkers when they stop drinking sugar sweetened beverages.
- Access to medication: Patients often just need help getting the right medications and finding options that are affordable – this can make a big difference in their care.
- More consistent appointments that focus just on diabetes. That increased accountability has been helpful to some patients in obtaining improved control over their diabetes.
Our goal is to help patients help themselves. We want to provide our patients with the tools, resources and education to enable them to be successful and improve their health. It will benefit them in so many ways in the future if they can improve the control of their diabetes today!