Diabetes Outreach Network
Abstract
Oral and Poster Presentations by MDON staff

Title: Implementing Quality Diabetes Care to the Uninsured and Underinsured

Authors: E. Patrick Juras, MD, Julie Shippy, RN, BSN, CDE, Robin Williams, MA ,RD, CDE, and Diane Henry, BS, LPN

Objective: The uninsured and underinsured in Northern Michigan often receive fragmented medical care. Socio-economic barriers prevent routine medical visits, and the purchase of medical supplies to optimally control diabetes. Our goal In the Traverse City Community Free Clinic was to improve control of diabetes and prevent complications by improving continuity of care.

Method: A volunteer physician established “Diabetes Day” once a week. A diabetes care protocol and “Diabetes Flow sheet” were used to assist with continuity of care and to track outcome data. The flow sheet was based on the ADA’s 2005 Clinical Practice Recommendations and was developed by TIPDON (Northern Michigan’s Diabetes Outreach Network). Patient’s were evaluated and enrolled in assistance programs, and referred to Diabetes Education and allied heath professionals. Assistance for supplies and education were funded by a local diabetes charity. Patients were seen for follow-up by the same physician. Outcome data was submitted to TIPDON for analysis.

Results: Forty patients were assessed. After treatment, ninety eight percent reduced their A1C. Twenty three patients had an A1C less than 7%. LDL Cholesterol decreased an average of 40 mg. Eighty-five percent met the ADA’s Blood Pressure goal.

Conclusion: Continuity of Diabetes care improved outcomes. Using the Diabetes Flow Sheet with a clinic staff that expresses respect and develops rapport with each patient as an individual, regardless of their life situation, promoted continuity of care and improved self-management. Patient’s attitude and ability to self-manage improved despite socio-economic and psychosocial barriers.

Contact: Robin Williams or Julie Shippy, (231) 237-9681