Diabetics Find Group Visits Help Handle Disease

Article excerpt

Byline: The Health Files By Tim Christie The Register-Guard

Diabetes, say those who have it, is a disease that never goes on vacation.

Managing diabetes can be confounding and all-consuming. Diabetics must test their blood sugar several times a day and adjust their medications accordingly. They have to watch what they eat, check their blood pressure, monitor the circulation in their feet. More than half of all diabetics eventually must inject themselves with insulin twice a day.

Now doctors and nurses at a Eugene medical clinic are trying a new model for diabetes management: treating diabetics in a group setting. Since January, the Volunteers in Medicine Clinic has provided monthly group visits at its office.

The setting provides diabetics with much needed support and gets them into regular, continuing care for their chronic disease.

About 70 people are enrolled in eight different groups at Volunteers in Medicine and a ninth group will begin soon, said Cheryl Ana Moore, a diabetes nurse educator who coordinates the program.

Three of the groups are for Spanish-speaking patients; Mexican-Americans are twice as likely to develop diabetes as white people, according to the federal Centers for Disease Control and Prevention.

The Volunteers in Medicine Clinic, which provides free health care to low-income, uninsured Lane County residents, is one of a handful of clinics in Oregon to try the group approach.

The local program is funded with grants from the Meyer Foundation and Spirit Mountain Community Fund, the charitable arm of the Confederated Tribes of the Grand Ronde.

People with diabetes either don't produce insulin or have a decreased ability to use insulin, a hormone that allows sugar to enter cells and be converted to energy. If untreated, the disease will slowly damage blood vessels and nerves in the body, leading to blindness, kidney and heart disease and amputations.

"It affects every part of your life, and it gets old," Moore said.

Ask Larry Stevens, a 47-year-old Eugene man who was diagnosed with diabetes April 1 after coming perilously close to falling into a diabetic coma.

Stevens has created a daily chart to record which of 12 shot sites he's used to inject insulin; how much insulin he's injected; his blood sugar levels before meals and at bed time; the amount of carbohydrates he consumes; and a description of his exercise.

"I've noticed it's taking almost 100 percent of my effort to manage the diabetes," he said.

Group visits make a difference

Studies have shown that diabetics who participate in group visits reported improvement in their blood sugar levels, improved quality of life and diabetes knowledge compared with patients who received conventional diabetes care. More study is needed to determine why, according to an article in the latest issue of the journal Diabetes Spectrum.

In Oregon, the group visit model is used at the Clackamas Public Health Clinic in Sandy and at the Samaritan Internal Medicine Clinic in Corvallis, said Linda Dreyer, who manages the Oregon Diabetes Prevention and Control Program for the state Department of Human Services.

"We're learning that people who are living with a chronic condition really require an approach to medical care that is different than the acute care model that most of us are exposed to with our medical care provider," she said. …