Keeping diabetes under control with patient engagement

The COVID-19 pandemic began more than 18 months ago, and while a sense of normalcy is returning to daily life, lingering evidence shows the lockdowns have affected Americans’ health and routines in many ways. Gregory Small, M.D., Director of Primary Care Medicine at GBMC HealthCare, says he’s seen an increase in type 2 diabetes diagnoses in primary care patients because of the pandemic.

“There were definitely patients who went from pre-diabetes to diabetes during COVID-19,” he explains. “There was a transition from having properly controlled habits to poorly controlled [ones]. We saw a rise in the use of alcohol and a lot more stress.”

Dr. Small says primary care physicians and nurses at GBMC have a responsibility to continue re-engaging with the almost 6,000 patients in the system who are diabetic and partner with them to properly manage their disease.

Optimal diabetes control comes down to a collaboration between the patient and their provider, Dr. Small says.

“At GBMC, we take ownership of our patients’ health by engaging in short-term follow up and reinforcing points of education,” he says. “It’s important that physicians have a partnership with their patients, which is much more complex than just prescribing medications.”

One of the ways GBMC goes above the standard of care is by having a Registered Nurse (RN) Care Manager on staff, who serves as an extension of the physician team outside of office visits.

“As an integral part of the care team, the RN can consult with the prescribing clinician for medication adjustments outside of traditional office visits while also arranging for nutritional education and providing other tools for supporting patients,” Dr. Small says.

Because the severity of type 2 diabetes can be influenced and affected by lifestyle changes, Dr. Small says patients need to be armed with the right education so they understand how the decisions they make regarding their disease can influence the way diabetes affects other parts of their lives. Dr. Small adds diabetes care goes beyond monitoring glucose levels.

“Poorly controlled diabetes can bring a lot more kidney and heart problems,” he explains. “We track blood pressure control, [and] we screen for protein in urine.”

Diabetic retinopathy is a diabetic complication that can affect the eyes, so regular eye exams are also a part of the comprehensive care provided by GBMC Health Partners.

To help with the mental effects of diabetes, GBMC also has a behavioral health counselor on hand who works with the primary care clinicians.

“Many patients with a chronic illness that’s been poorly controlled will also suffer from depression or anxiety,” Dr. Small says. “Our behavioral health support helps break down barriers patients may be facing to help improve their mental and physical health conditions.”

Above all, Dr. Small emphasizes, the clinicians at GBMC are committed to holding themselves accountable in helping patients manage chronic illness.

“It’s about creating a system to have the right levels of support and education for our patients,” he says. “We want to partner with patients to ultimately minimize the medicines they need and keep their diabetes under control.”