Treating the Patients, Not the Diabetes

After your doctor diagnoses you with diabetes, the idea of possibly having to skip the big family dinner every Sunday may seem like a big punishment.

But following 's Diabetes Self-Management Education Program, which is designed to work with individual patients regardless of their cultural backgrounds and norms, may be able to help.

"A standard diet is not going to work for every person,” Bismruta Misra, MD, MPH, endocrinologist at Stamford Hospital's Diabetes and Endocrine Center, told Patch. “If a patient is part of a big Italian-American family and every week there is a big family dinner, it becomes stressful enjoying family dinner. Our diabetes educators will really work with them. They don’t say you can never eat those things again. Maybe you cut the portion size of what you ate or give up a couple things, not everything.”

Each year, 800 to 1,000 people with diabetes enter the Diabetes Self-Management Education Program for the first time. The program is within the hospital’s Diabetes and Endocrine Center.

This is an important step for newly diagnosed patients, and those managing the disease, to prevent serious health complications down the line.

“Chronic untreated diabetes is a contributor of heart disease, can cause blindness, and is the number one cause of kidney failure,” Dr. Misra said.

The disease is also associated with vascular disease, neuropathy and can lead to amputations.

The good news, however, is that the program has been shown to work. “Patients who meet with certified diabetes educators tend to do better than those who don’t,” said Dr. Misra. “When I refer them, I see they are better managed than those who don’t go.”

Patients in the program learn how to live with the disease day-to-day. “We spend time on what to do and detailing a plan,” Dr. Misra said.

This includes everything from discussing what carbohydrates are, going over how much sugar can be consumed and learning how often to check blood sugar. The patients’ primary doctors are kept in the loop throughout the process.

Mismanaged or unmanaged diabetes affects more than just health. It creates a hefty economic burden. According to the American Diabetes Association, the cost of diabetes in Connecticut is $2.4 billion, with $1.7 billion attributed to excess medical costs and the rest from indirect costs from reduced productivity and absenteeism at work.

In Fairfield County, 6 percent of adults have diagnosed diabetes, according to the Centers for Disease Control and Prevention. However, this percentage increases with age and fluctuates based on race/ethnicity and gender. Over 25 percent of the nation’s seniors 65 and older have diagnosed diabetes.

Recently, Stamford Hospital’s Diabetes Self-Management Education Program received an Education Recognition Certificate from the American Diabetes Association.

“With the American Diabetes Association program recognition, it shows we met expectations of the ADA for providing quality educational services,” Debbie Milne, RN, director of Stamford Hospital’s Diabetes and Endocrine Center, told Patch. “We have a staff of professionals well-versed in diabetes care, coaching and support.”

“The hospital’s program goes beyond what primary care physician can usually do for diabetes patients in a typical visit,” she added, which usually is to diagnose and prescribe.

Milne said that area physicians refer patients with diagnosed diabetes to the center for additional support.  

“We are strategists who help create behavior change,” she said. “We’re empowering patients with coaching. Typically, you will not find that that in a primary care office.”

“The true goal is to empower the patient in having them understand the disease in all aspects that surround the disease,” Dr. Misra added. She explained that the more educated the patients are, the more complications can be prevented from happening.