Article 106 Team Approach and Diabetes Management
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Team approach and diabetes management can go a long way in providing the best possible care for the diabetics.  That is why, I went right into it when I read a news item that early team approach is the best medicine. Mind you, I am not a stranger to this concept as I have always used this in my practice although not in the diabetes field.

It is best to integrate a team of specialists including an endocrinologist,  diabetes educator, a cardiologist, dietitian, and nephrologist along with other experts in their fields when the specific needs arise to lower the risk of complications.  It can also lower the cost for the health care system.  This is what the survey of physicians found out.

Almost half of the physicians in the survey reported that 50% of their patients developed one of the complications including cardiovascular disease, nerve pain, stroke, blindness, limb amputation, and kidney disease.  The physicians further reported that most patients are not aware of these complications, especially the kidney disease.

Most people do not realize that those diagnosed with type 2 diabetes already have some form of damage in the kidney.  To be aware of these complications, it is good to have an annual testing for those at the earliest stage of type 2 diabetes.  The test should include a microalbumin urine test. 

The diabetics on the latter stage of type 2 diabetes should have blood testing of the kidney function.  Once the test results reveal the impairment, strategies for interventions to prevent further damage to the kidney and other serious type 2 complications like heart disease can be laid out and implemented. 

Some patients do not adhere to lifestyle modifications.  Neither do some of them follow the prescription.  When this happens, the intervention of nutritionist or dietitians can help patients get back on track.  Approximately 63% of the participants in the survey agreed the members of the team can help them. 

The  physicians surveyed believe that some are not using the team approach to prevent complications even though 71%  believe it can and should be done.  Team approach and diabetes management approach will lower both the burden on the patients and the health care system. 

The purpose of diabetes management is to attain glycemic control through lifestyle modification, insulin or oral therapy.  In this case, monitoring and careful follow-up and support are a must.  There is therefore a need for a  group of professionals with different roles and functions who will be able to help the patients with their diabetes care.

This concept of interdisciplinary team approach is not new in the treatment of chronic illnesses.  For diabetes, it is a different story for it is relatively new to this field.  Regardless, there is a need for the diabetes care providers to shift their views as to the roles they play as well as their relationships with the professionals in other fields as well as with their patients.

Even the American Association of Diabetes Educators and the American Diabetes Association recognize the complexity of the treatment of diabetes and so have  endorsed the team approach and diabetes management as the best way to provide diabetes care.

Who will be members of the diabetes treatment team?  It includes, physicians, nurses, dietitians, and behavioral scientists who have the skill and training in diabetes management.  This core team will be able to look after the basic needs like nutrition,  medication, self-monitoring and self-management.  This can extend to exercise physiologists, podiatrists, pharmacists, ophthalmologists, and even gerontology and maternal-child care specialists.  It depends of course on the specific needs. 

The standards of care will be insured by the diabetes care team.  The diabetes care will need to utilize the results of the researches and should also focus on the desired results.  The multidisciplinary team members will encourage and support one another in promoting the best care possible.  This should be patient-centered and goal-directed.  

To control the blood glucose level is the goal and on this the diabetes experts agree.   A better approach to the treatment is required due to the complexity of the constant monitoring and management.  The multidisciplinary team  approach therefore is essential in order to meet this goal.  The end result will be fewer complications.  Let us then set aside our differences and adopt the team approach and diabetes management.

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