Daily Piece: Much Anticipated FreeStyle LibreLink App is Now Available

Do you love technology as much I do?  I recommend the FreeStyle Libre on daily basis to persons with diabetes as it makes glucose monitoring easy.  What has been missing an app to compliment this great technology.  The wait is now over.  So excited to have the 14 day sensor as well as the FreeStyle LibreLink app!   Make sure to download this app.

https://www.bloomberg.com/news/articles/2018-11-01/abbott-wins-fda-approval-of-much-anticipated-insulin-monitor-app

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#technology    #diabetes     #Libre  #app

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Daily Piece: Thank You to All Diabetes Educators

Did you know that it is National Diabetes Educators Week?  What a great week to celebrate all diabetes educators who work tirelessly with persons with prediabetes and diabetes to empower them to have the best quality of life possible.   Click below to read about Jamillah (a diabetes educator) and her innovative practice.

https://www.diabeteseducator.org/news/member-update/july-2018/july-2018-details/forward/2018/07/10/july-2018-member-spotlight

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#national    #diabetes     #educators   #celebrate

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Daily Piece: Hitting Pause Button

During clinic this morning, I had my second visit with a precious lady who has gestational diabetes. She was excited that the dietary changes were working to bring her glucose down. She had even persuaded her husband to eat healthy as well.  She also felt much better physically especially more energy.  She became disheartened when I shared that medication was needed to assist in bringing her glucose into target range.  She was shocked and confused.  How could this be?  She had lots of questions regarding effects of elevated glucose on her baby, and how the medication worked to lower her glucose.  I paused and stopped worrying about getting to the next patient.  I slowed down and allowed time needed to answer each of her questions.  After having her questions answered, she was relieved and understood why she needed the medication.  Now that is patient care.

 

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#slow    #down     #diabetes   #questions

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Daily Piece: Happy Halloween – Before You Grab A Yummy Candy Treat

You are winding down from a fun Halloween evening, You are tempted to grab some candy from your child’s treasure of yummy treats or the left over candies.  Stop…before you do, click below to check the carb content.  Moderation is key. My favorite is candy corn. What is your favorite candy?

https://dlife.com/halloween-candy-carb-chart/

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#halloween    #yummy     #candy

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Daily Piece: Caring for the Whole Person

Bill is one of my favorite patients as he is elderly gentlemen with a loving supportive family.  During his last visit with me, he shared his frustration of having the benefit of medical transportation to his dialysis appointments discontinued due to his “improved health.” As it turns Medicare discontinued this vital service for Bill because his health improved.  This is an issue because Bill also has dementia and can not remember how to get home from the dialysis center if he drives for his treatment.

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While I am a diabetes educator, I have the responsibility and privilege of caring  for the “whole” person as in Bill’s scenario.  Good news, after following up with his PCP, the paperwork is being processed for Bill to get his medical transportation to dialysis center back.

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#caring    #whole     #patient

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Daily Piece: Dig Deep and Break Through

It is tempting at times to give up when hitting a brick wall.  Today, I celebrated breaking through the brick wall.

Meet Sally a senior adult with Type 2 diabetes that I have been working with and supporting her in managing her Type 2 diabetes.  I have felt like I keep hitting that “brick wall” with Sally.  Today would be different.

I reviewed Sally’s chart when I arrived at office this morning.  At her last office visit, her blood sugar was over 500 mg/dL. Oh no, I thought.  She had been closer to target range prior to that office visit.  What was happening?  When Sally arrived for her visit, I checked her blood sugar and reviewed her blood glucose log (most values in 300 – 499 mg/dL range).  Oh no!  I assessed her abdominal area for any fatty deposits (lipodystrophy).  No fatty deposits.  I asked her to demonstrate how she injected her insulin. Spot on, no issues with insulin administration.  So I ask her about her 500 mg/dL blood sugar during last office visit. She states, “I ate a tomato sandwich without taking my bolus insulin.”  Ummm.  Now, I honestly did not see how that would cause such a glucose elevation. Keep digging!  Keep digging!  After doing a diet recall with her, the pieces of the puzzle still do not fit.  Ummm…what about beverages?  She only drinks orange juice when her glucose is low.  Turns out, she loves to drink an old fashioned Coke Cola.  She enjoys drinking her coke most every day.  The culprit for the significant glucose elevation..an old fashioned coke. After a bit of discussing and bargaining, Sally agreed to limit her coke to only when she had a low glucose.  Often times, we must dig, dig and dig to discover the obvious.

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#dig     #deep     #break #through

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Daily Piece: Navigating the OTC Aisle

Cold and flu season is upon us. Do you know how to properly navigate the OTC aisle to find just the right product you need?  Please  click below to learn more about how to navigate the OTC aisle.

https://www.healio.com/endocrinology/diabetes/news/print/endocrine-today/%7Bf4b242a9-cc65-4967-98ca-4b9b44a66a5d%7D/helping-people-with-diabetes-navigate-the-otc-aisle

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#navigating     #OTC     #aisle

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Latest Blog…Millennials with an Affinity for Urgent Care Centers

In this blog, I am shifting away from my regular focus on diabetes to a broader healthcare topic which became of interest to me after reading a fascinating Washington Post article. The article focused on how people that live in large cities or move to new geographical locations on a regular basis are not developing long-term relationships with Primary Care Providers. In fact the article goes on to explain that many are utilizing Urgent Care Centers for their primary healthcare needs. And if you haven’t already guessed it – Yes, the Millennial Generation is leading this charge! …the “Disrupters of Value Based Healthcare!”

Value-Based System
The overall landscape for healthcare is the process of becoming a truly value based structure which emphasizes a variety of healthcare across the various stages of our life. Access to care is a crucial component of the value based system. Within this structure, the Primary Care Provider is viewed as the reliable medical adviser and coordinator of one’s healthcare needs. Also, Care Managers play an essential role in coordinating individual care for each patient, especially those who require complex levels of care. The Value Based System places a strong emphasis on avoiding high cost containers such as frequent emergency room visits for basic health care, as well as, attempting to avoid any duplicative care services between physicians.

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Disruption of the System
At the same time, disrupters within the network of healthcare are creating some challenges for the Value Based System. Consumers no longer feel they are at the mercy of the healthcare system, but rather they can take control and coordinate healthcare themselves. Advances such as telemedicine and patient portals enhance the care possible through a Value Based System. However, another disrupter, is the bust of urgent care centers, whether free standing or within pharmacies. These urgent care centers, if utilized for primary care, have the potential to create fragmentation in the “continuum of care” we find offered within the Value Base System.

Millennials, born between 1981 and 1996, want price transparency, convenience, and immediate care. They are not willing to wait a couple of days to see a primary care provider for an acute illness such as strep throat, flu, or scratched elbow. They have peeled away from the model of office-based primary care which they were accustomed to as a child under the care of a parent’s health insurance! The concern with this shift to an urgent care facility based healthcare plan lies in moving away from a one on one relationship with a Primary Care Provider. This can also fragment an individual’s healthcare and drive up overall healthcare costs.

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The Millennial generation is opting for retail clinics within pharmacies or other retail outlets, free standing urgent care centers, and online telemedicine sites. These all allow for convenience, transparency in costs since prices are likely posted, and provide digital connectivity. The Kaiser Family Foundation conducted a survey of 1,200 randomly selected adults and the findings indicated 26 percent of adults surveyed did not have a primary care provider Also, more specifically noteworthy is 45% of 18 – 29-year olds asked did not have primary care provider. While in an Employee Benefit Research Institute 2017 survey – only 33 percent of millennials did not have a regular doctor.

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Shifting to Address Disrupters
Primary Care Practices are hearing the Millennials loud and clear! The practices are responding and working diligently to attract and retain patients. How? Digital access has been incorporated allowing for online patient portals with ease in accessing their medical records, contacting their provider and making appointments with greater ease. These practices are adjusting their delivery model to incorporate additional providers, thus allowing for increase in patient capacity, incorporation of walk in patients, and urgent care clinics within many medical practices. The advantage of having the walk in or urgent care clinic within the primary care practice is the variety of care and treating the whole patient.

Reece’s Piece
I view change and adaptions within our healthcare environment to adjust to generational differences as positive. While I am certainly concerned with fragmentation and potential drivers of increase healthcare costs, I am thrilled to see Primary Care Practices transform to provide for the change demanded by Millennials. After all, we have come many light years since the doctor traveled to their patients’ home to provide care. Or have we? Home visit service is commonly offered by larger Primary Care Practices today. Like the rest of life, we come full circle. I encourage we proceed with great caution – we deserve the best healthcare!

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#millennials     #affinity    #urgent  #care

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