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Year one of the three-year initiative by the American College of Physicians (ACP) and the ACP Foundation to improve diabetes care by stressing a team approach to assessment and education was marked by significant achievements, according to the program's leaders.
Vincenza Snow, MD, clinical director of the diabetes initiative and director of clinical programs and quality of care at ACP, provided an update on the efforts during a media briefing at the ACP Annual Session in Philadelphia held April 6–8. The initiative was launched at the 2005 annual meeting with the announcement of a $9.3 million unrestricted grant from Novo Nordisk (DOC News, June 2005).
Highlights of achievements so far include doubling the number of diabetes educational sessions (16 this year) at the annual meeting, with topics ranging from use and interpretation of blood glucose records to differentiating insulin resistance and the metabolic syndrome. Some of the workshops, such as one on understanding diabetes care devices, will be considered for ACP Clinical Skills modules, compilations of interactive materials used to teach practice-relevant procedures and skills to small groups.
"To achieve success, no single care-giver—the doctor, the diabetes educator, the eye doctor, the nurse, even the patient who acts as caregiver when he selects meals, gives himself insulin, etc.—can tackle this disease alone," Snow says.
Diabetes also has its own module as part of ACP's Closing the Gap program, designed to train teams of physicians, nurses, and office administrators about best practices to deliver evidence-based treatment for chronic diseases.
Closing the Gap encourages a "totally different" way of caring for patients, says Michael A. Weisz, MD, program director for internal medicine training at the University of Oklahoma in Tulsa and governor of ACP's Oklahoma chapter. The program figures out ways to focus on the disease while changing the approach to managing it, he says.
Each practice team is experimenting with different patient education techniques to improve self-management. They've learned the "secret" to more effective patient care is in small steps, such as building a tracking system to monitor changes in glycated hemoglobin (A1C) to see which patients need better control.
Nathaniel Clark, MD, MS, RD, vice president for clinical affairs for the American Diabetes Association (ADA), represents ADA on the advisory board for ACP's diabetes initiative. "It's an exceptional program that's confronting a very important issue, which is how to help the primary care team provide better care for patients with diabetes—a goal that ADA shares," Clark says.
ONWARD AND UPWARD, IN PLAIN LANGUAGE
An illustrated patient information guide being written at an approximately fifth-grade reading level, in Spanish and English, will cover themes such as diet, physical activity, medication tracking, insulin use, and blood glucose monitoring. An accompanying manual for moderators can make the guide a useful teaching tool.
The materials and education emphases were guided by input from 16 focus groups of patients, physicians, diabetes educators, and others.
"For instance, our data showed that the physicians need help coaching
patients on changing harmful behaviors and helping them develop better
self-management skills," Snow says. "So we are developing
materials to help physicians in their offices motivate patients to implement
lifestyle changes and self-management techniques." 
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| DOC News | Diabetes | Diabetes Care | Clinical Diabetes | Diabetes Spectrum |
