Diabetics learn while they shop in disease-management program

Diabetes affects approximately 16 million Americans. The cost of treatment is more than $92 billion annually, primarily for the care of complications. One of every seven dollars spent on healthcare in the United States goes to diabetes-related illness.

Better prevention and treatment could dramatically reduce costs and substantially improve the health and well-being of people with diabetes. A 10year federal study, published in 1993, found longterm complications of diabetes are reduced up to two-thirds when patients' blood-sugar levels are tightly regulated and when people learn to manage and control the disease.

Taking this approach seriously, Crouse Hospital, in Syracuse, NY, is helping diabetics by putting healthcare directly into their everyday lives. While most diabetes instruction consists of a brief explanation at the doctor's office or a short series of classes at a local hospital, Crouse has moved its educational endeavors to the site most visited by its target audience-the supermarket.

GROCERY AISLES BECOME CLASSROOMS

At three Syracuse Wegmans grocery stores, more than 500 diabetics take classes from a diabetic nurse educator, meet with exercise physiologists, receive personal pharmaceutical care, have laboratory tests done, take part in cooking classes, and are accompanied up and down the grocery aisles by registered dieticians who explain the connection between various foods and blood-sugar levels.

"`Partnership for Health' is a diabetes-management program designed to help people with this chronic condition learn how to manage their illness on a daily basis," says Robert Allen, director of communications at Crouse Hospital. "Our mission is to make programs as convenient and accessible as possible by moving them out of the hospital into the community."

The program has improved participants' health; on average, their glucose levels have dropped from 8.4 percent to 7.0 percent in six months. (Experts stress the need to keep the blood-sugar level under 8 percent, and under 7 percent if possible. A higher percentage means increased risk for diabetic complications. )

The goal of the program is to give people "a little information over a long period of time, so that they can better absorb how to manage medication, diet, and exercise and incorporate changes into their lives," adds Allen. "We have found that if too much information, especially on disease, is given at one time, people become confused and are less likely to make necessary changes."

LEARNING To LIVE A HEALTHIER LIFE

Once referred to the program by a physician, the patient meets with a diabetic educator who conducts a risk assessment and helps establish individual goals. The patient then attends classes on health and lifestyle conducted by physicians and other healthcare professionals. Pharmacists explain the role of insulin in the treatment of diabetes and point out over-the-counter drugs that are safe, and those that should be avoided. In cooking classes, local chefs create and test special recipes and demonstrate easy ways to cook food that is delicious and healthy.

After several sessions, the patients meet with healthcare providers to discuss what they have learned and any questions they may have. Many understand for the first time the negative effect their diet and lifestyle have had on them. Status reports and laboratory results from the Wegmans' on-site certified clinical laboratory are sent to the patient's doctor.

Patients learn about the program, which is covered by most commercial insurers, through their physicians, who find the program educational and supportive. Articles on the program have appeared in the local press, and information is available through the hospital and its community outreach programs. Diabetics who use Crouse's inpatient and outpatient services are also identified as possible program participants. o * For more information, contact Robert Allen at Crouse Hospital, 315-470-7582.

Ms. Weiss is a Santa Monica, CA-based healthcare consultant.

Copyright Catholic Health Association of the United States Jan/Feb 1999
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