Here at Diabetes Self-Management, we often write about someone’s “health-care team” or “diabetes team.” These phrases evoke an ideal of a unified group of doctors, nurses, diabetes educators, dietitians, and others working with a patient and his family to produce the best outcomes. Of course, how closely reality matches this ideal varies from person to person. Some people with diabetes most definitely see doctors and other health-care professionals who do not communicate or cooperate with one another, while others see only a primary doctor regularly. Traditional medical practice, in which a patient sees medical specialists only when acute problems arise, does not always easily support a team-based treatment strategy.
Yet across the Unites States and around the world, there are dedicated diabetes centers designed to apply a team-based approach to diabetes care. This approach was pioneered by Dr. Elliott Joslin, who founded the Joslin Diabetes Center in Boston in 1952. Diabetes centers may be freestanding or part of a hospital, clinic, or university; some perform research, while other focus only on patient care. Specific programs offered vary from center to center. How do you know if getting care from a diabetes center might be right for you?
As a recent article in the Boston Globe highlights, one impetus for joining a comprehensive diabetes-management program is difficulty achieving recommended lifestyle changes on one’s own. The article profiles a retired police dispatcher who joined a lifestyle-management program for people with Type 2 diabetes and experienced improvements in his habits, yet when the program ended he lapsed into his old ways. By joining a new, more intensive program that sends social workers to participants’ homes each week, he was able to again sustain dietary changes.
The Globe article predicts that as the rate of Type 2 diabetes in the United States increases — it is expected to double or even triple by 2050 — lifestyle-intervention programs will become increasingly important. The recently released preliminary results of a large study on lifestyle-intervention programs for Type 2 diabetes confirm the medical benefits such programs can have. The Look AHEAD (Action for Health in Diabetes) study has 5,145 participants at 16 centers across the country; over the first four years, participants assigned to the lifestyle-intervention group showed numerous improvements compared with those assigned to the support-and-education group. These include an average weight loss of 6.15% versus 0.88%, an average drop in HbA1c level of 0.36% versus 0.09%, improved treadmill fitness, and lower blood pressure.
Do you get your care from a dedicated diabetes center? If so, what led you to the center, and how has its care affected your health and well-being? Would you be interested in joining a lifestyle-intervention program offered by a diabetes center? If you have participated in such a program, did you find it helpful? Should more people seek specialized, intensive diabetes treatment? Leave a comment below!