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Diabetes Prevention and Education

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NEW ALBANY, IN The Centers for Disease Control and Prevention (CDC) reports that more than 29 million adults in the United States have diabetes, and nearly one-third has prediabetes. The CDC predicts that, without major changes, one in three US adults will have diabetes by the year 2050. The Joslin Diabetes Center Affiliate at Baptist Health Medical Group in New Albany, Ind., has worked since 1997 to turn this trend around. An affiliate of the Joslin Diabetes Center in Boston, Mass., New Albany’s Joslin Diabetes Center is the premiere diabetes center in the area, with a full team devoted to helping patients with diabetes.

“We provide services in the entire spectrum of endocrinology, but our main focus is diabetes,” says Vasdev Lohano, MD, medical director of the Joslin Diabetes Center at Baptist Health Medical Group. “We have three endocrinologists, one nurse practitioner, two diabetes educators/dieticians, and one registered nurse/certified diabetes educator.”

The medical staff at Joslin Diabetes Center stays on top of research and looks for opportunities to adapt new technology advancements and therapies into practice. “A lot of work has been done on the technology side of diabetes treatments,” says Lohano. “A new pump has just been approved that combines insulin pump technology with continuous glucose monitoring, and we hope to have this available for patients in the spring of 2017.”

Diabetes Prevention Program

Education is a primary aspect of diabetes treatment at Joslin Diabetes Center, and Lohano believes their Diabetes Prevention Program (DPP) is what truly sets the practice apart.

The DPP is based on research funded by the National Institutes of Health and the CDC. The study found that eating healthier, increasing physical activity, and losing a small amount of weight can prevent or delay the onset of type 2 diabetes in a person with prediabetes by as much as 58 percent. Additionally, weight loss of six to seven percent was also seen in those who participated in the program. Program goals include reducing body weight by seven percent and increasing physical activity to 150 minutes per week.

“We are offering this to the community, and everyone is welcome,” says Lohano. “It is a year-long educational program, with weekly classes for the first six months and monthly classes for the second six months. One group has just finished the program, and we are about to start a second. Our goal is to have one group start in the spring and a second group start in the fall, with 10 people in each session.”

The cost of participation in the DPP is $375 for the year-long program, and can be paid for using a payment plan if necessary. “In comparison to the cost of treating diabetes, $375 is nothing,” says Lohano. “If you take one medicine for diabetes, that can be $500 a month. Whether that is paid for by the patient, insurance, or government, it all contributes to the high cost of healthcare. People are getting diagnosed with diabetes at a younger age, and it is a chronic disease. If you are diagnosed and expected to live another 30–40 years, the cost of medications is astronomical, and that is not even including the health complications that can accompany diabetes. Every bit you can prevent is useful, even if it is just one percent.”

Apart from the DPP, the center also offers group and/or individual classes, depending on patient needs. When a physician or nurse practitioner orders diabetes education, the patient will go through a pre-assessment to determine the best course of action for their educational needs. Regardless of whether the patient receives one-on-one education or is in a group class, everyone gets individual attention and diabetes educators are available to provide whatever help the patient needs.

This comprehensive education program covers the entire disease process, including therapies and medications, along with how treatments work in the body and possible side effects. “It is our belief that if patients understand how the medicines work, it will improve compliance and willingness to participate in therapies,” says Lohano.

The Importance of Education

Lohano believes that diabetes care involves two key components: the physician and diabetes education. “Diabetes is a chronic condition that the affects the patient 24-7,” he says. “Empowering the patient to understand the disease process and how different activities and foods affect blood sugar is as crucial as taking medication. It is a progressive disease. Even if you can control it today, there is no guarantee it will be under control in three or six months. After patients go through our DPP, our diabetes educators are available to them as a resource. If they have questions or issues, they have someone they can talk to who has seen them and knows them and can address their particular issues. To me, that is invaluable.”

Another piece of the diabetes treatment puzzle that Lohano finds particularly valuable is early treatment. Due to the amount of information available on the internet and through social media, people are educating themselves and identifying themselves as at risk to develop diabetes. “We are getting more calls from people who come in for prediabetes at an earlier stage and demanding to see a specialist, whereas before we would not see a patient until much later in the disease process,” says Lohano. “Seeing patients sooner definitely helps, because once a complication – such as blindness, renal failure, or an amputation – occurs, we cannot reverse it. Prevention is key.”

Lohano estimates that staff at the Joslin Diabetes Center sees 250–300 patients per week, but hopes to reach more. The center is open to any patients and physicians who wish to take advantage of the resources and services it has to offer, whether for diabetes or other endocrinology-related conditions. “We are happy to serve them,” states Lohano. “We are available however they want. If they just want to see educators, they do not have to be seen by a physician; they can just get the education and return to their own physician. I personally think we are fortunate to have this center in the area, and it should be utilized as fully as possible.”

Empowering the patient to understand the disease process and how different activities and foods affect blood sugar is as crucial as taking medication.– Dr. Vasdev Lohano

Seeing patients sooner definitely helps, because once a complication – such as blindness, renal failure, or an amputation – occurs, we cannot reverse it. Prevention is key.– Dr. Vasdev Lohano