Diabetes
High-deductible health plans: a barrier to care for chronic conditions
At the peak of the coronavirus crisis in 2020, American policymakers were faced with the critical challenge of how to encourage as many Americans as possible to be tested for and vaccinated against the COVID-19 virus. Fortunately, Congress rose to this challenge by passing legislation that, in addition to providing these services to the uninsured, required private insurance plans to eliminate all out-of-pocket costs associated with getting vaccinated or tested. …
Will GLP-1s allow our society to eschew its responsibility to create a healthy environment?
Since Ozempic entered the cultural zeitgeist, I have been overwhelmed with requests from my patients – both those who meet criteria to start the medication and those who do not – for this new class of “miracle” drug. While it does work like a miracle for some, there are also those for whom the promise rings hollow – those who are unable to tolerate the medications due to side effects, …
Emergency department burnout: a cry for change
It’s a busy day in the emergency department. The waiting room is full, and we are short-staffed. I just read an email from administration that morning about how our treat and release times are “slipping,” and in the same breath, they remind us of the importance of patient satisfaction. There are many patients in the department with chronic medical problems or chief complaints that could be interpreted as non-emergent. I …
Overcoming health challenges: one patient’s story
The patient was a typical one in my primary care practice, and for those of you in my field, one familiar to you as well. Jim, as we will call him, was a middle-aged, obese male with a history of hypertension, hyperlipidemia, and diabetes, whose most concerning medical problem was his long history of noncompliance. He came in once a year for the physical his company required but otherwise ignored …
Diabetes and liver disease: urgent screening needs highlighted by personal tragedy
The American Diabetes Association recently released screening guidelines for liver disease in individuals with type 2 diabetes. Notably, 70 percent of people with type 2 diabetes have liver disease, and the most common form is non-alcoholic fatty liver disease. Ultimately, this can lead to cirrhosis and cancer. According to the American Cancer Society, the rates of liver cancer have tripled since 1980. Currently, one in 10 Americans has diabetes, …
Breaking the stigma: Using life coaching to navigate chronic disease [PODCAST]
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Join us with guest Kimberly Jackson-Bekemeier, a family physician with a personal story of managing Type 1 diabetes amidst the pandemic. Kimberly shares her journey of struggling with the diagnosis, feeling lost and alone, until she discovered …
Breaking down barriers: How technology is improving diabetes management in underserved communities
Despite advancements in health information technology (HIT), the prevalence of diabetes in the United States continues to be high and is the seventh leading cause of death. Diabetes management in underserved communities has challenges concerning health care access for high-risk groups, often resulting in debilitating health outcomes worsened by adverse socio-economic consequences. Optimal HbA1c levels, controlled for by risk reduction, are essential. If diabetics encounter barriers to health care services, …
Empowering Type 2 diabetes patients with innovative insulin management tools [PODCAST]
A doctor’s journey: Navigating chronic disease and empowerment through life coaching
On January 2020, I got the dreaded call: You have Type 1 diabetes. The rest is a blur. I went into a global pandemic, one of the highest risk categories, a red lab value that stared at me “HgbA1c > 15.”
As a family physician, I was supposed to manage patients and ease their fears. I was supposed to know all about the disease management of a “bread and butter condition” …
Lack of innovation is leading to disparities in diabetes care
Having spent over 30 years of my career in diabetes, first as a practicing diabetologist and later as a diabetes researcher, I’ve met many people with diabetes. And while diabetes care has evolved significantly over my career, I’m amazed to see that daily insulin management is just as complex and manual for many people, particularly those with type 2 diabetes (T2D) — daily insulin management is just as complex and …
Don’t blame Big Pharma for insulin’s problems
For diabetics, insulin matters as much as H2O. Unfortunately, insulin’s a hell of a lot more expensive than bottled water. High insulin prices force approximately nine million Americans to balance their wallet and well-being.
The American Action Forum reported that a type-one diabetic’s average yearly expense for insulin was $~6000 (i.e., $500/month). It’s easy to lambast Big Pharma companies for the current state of insulin’s affairs, but history and market behavior …
The environmental impact of the diabetes epidemic
The superior doctor prevents sickness. The mediocre doctor attends to impending sickness. The inferior doctor treats actual sickness.”
– Chinese Proverb
The management of diabetes today requires an understanding of the concept of the circular economy in eliminating waste and pollution, circulating products and materials at their highest level, and regenerating nature.
Today, we saw a 64-year-old woman for her follow-up visit to the diabetes clinic. She is our typical Oklahoma patient with …
How people of faith can respond to our broken health system
An excerpt from Care: How People of Faith Can Respond to Our Broken Health System.
“Why do you have to be such an asshole?”
Roger was visibly angry with me and ready to get up to leave. Forty-five years old, he worked long hours repairing cars and had very poor control of …
We need to stop treating diabetes (without a prevention plan)
The recent report from the National Center for Health Statistics on declining U.S. life expectancy painted a bleak picture, fueled in large part by the impact of Covid-19, but not exclusively. Many of the contributing factors are deeply systemic – poverty and health disparities among them — but other longstanding health issues, including high rates of obesity and Type 2 diabetes, are contributing factors.
More than 34 million people – one …
A personal mission to get obese patients on GLP-1 agonists
Admittedly, this comes to you from a place of concussion-inducing-head-banging-against-brick-walls-level frustration.
For the past year, I have made it a personal mission to get people suffering from obesity on GLP-1 agonists. These drugs are all in the same class, have identical mechanisms, and three are the same generics. (Ozempic, Wegovy, and Rybelsus are all semaglutide.)
They are advertised as Wegovy, Ozempic, Rybelsus, Saxenda, Trulicity, and Mounjaro.
To say these are life savers is …
Direct care with a podiatry twist
A patient, let’s call him Jay, came to me refusing a leg amputation. He had open sores that were necrotic, foul-smelling as if he had been neglected for a long time. At his consultation, he fought with every cell of his being, refusing to lose his leg as his uncle did. He wanted a second opinion on whether or not his foot could be saved.
Traditional insurance-based medicine has …
Combining personalized education and digital technology to improve glucose monitors [PODCAST]
“Diabetes uniquely requires patients be experts in their own care and demands 24/7/365 vigilance. Close communication with a health care team eases the burden and improves outcomes.
Glucose management revolves around numbers. Unfortunately, numbers are just noise unless translated into actions. Innovations, such as color for people with low numeracy, are essential …
How long will it take to address clinical inertia in T2DM? [PODCAST]
This article is sponsored by the Academy for Continued Healthcare Learning. Visit the CME activity and Clinical Inertia Assessment Tool. This activity is supported by an educational grant from Lilly.
It’s been over …
20 years and counting. How long will it take to address clinical inertia in T2DM?
This article is sponsored by the Academy for Continued Healthcare Learning, an independently owned and operated full-service medical education company that has been developing certified health care education for nearly twenty years.
Visit the CME activity and Clinical Inertia Assessment Tool. This activity is …
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