Physicians Can Partner with Patients To Help Manage Diabetes

In New York City, where one in eight adults has diabetes, helping patients monitor and manage their diabetes is a significant part of physician practice, especially in primary care. The problem of diabetes is particularly acute among minority populations in New York City, where 60% of adults diagnosed with the disease are African American or Hispanic.

There are many things patients can do to manage their diabetes, and participation in diabetes self-management education (DSME) can be an important way to reinforce and extend the teaching that takes place in the physician’s office.

Diabetes self-management education is an evidence-based approach demonstrated to be effective at improving clinical outcomes, behavior change and related health dimensions. It consists of a series of classes, using interactive instructional methods that help each participant to first establish individual goals, and then design a plan to reach them. The Task Force on Community Preventive Services, an independent body appointed by the director of the Centers for Disease Control and Prevention, recommends that DSME be taught in community gathering places such as senior centers, libraries and faith-based institutions. The task force found in a comprehensive review of the published literature that DSME is effective at improving glucose control when delivered in such settings.

IPRO is one of a select group of Quality Improvement Organizations working under the direction of the Centers for Medicare & Medicaid Services (CMS) to promote a diabetes self-management program for Medicare beneficiaries in under-served populations who have diabetes. This program focuses on increasing patients’ ability to manage their illness and also on improving clinician treatment of the disease.

Diabetes Wellness Workshop
Working with 64 physician offices, community health centers and hospital-based clinics, IPRO’s goal is to educate 2,500 Medicare beneficiaries in New York City on diabetes self management. One thousand have already completed the free six-week course, known as the Diabetes Wellness Workshop. These workshops are conducted at convenient locations in the five boroughs using local community health workers and health educators who have been trained by IPRO in the Diabetes Wellness Workshop curriculum.

The success of the workshops will be measured against participant behavior change, which is assessed through pre-and post-tests, and through the tracking of actual lab results for these patients—i.e., hemoglobin A1c and cholesterol levels, weight and blood pressure. Improvements on all of these measures can be expected based on earlier studies of the DSME curricula. Information gathered through this project will be used by CMS to assess how to expand this program nationally.

If you practice in the five boroughs, I encourage you to tell your adult patients with diabetes about these free programs. There may also be opportunities to conduct these programs in other areas of the state. For information on how your practice can get involved, visit http://www.ipro.org/index/diabetes-providers.

This material was prepared by IPRO, the Medicare Quality Improvement Organization for New York State, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS policy. 9SOW-NY- THM7.1-10-17.