Friday, January 23, 2009

Diabetes Resource Center Debuts at Sinai Hospital

Diabetes may be a manageable disease, but patients often develop complications stemming from a lack of education and too little communication with their physician. This is why experts say it’s time for a new approach to diabetes care that focuses as much on the patient’s psyche as it does on the physical ramifications of the disease.

“One-third of patients have a fear of injections, and physicians have not acknowledged that fact,” says Sally Pinkstaff., M.D., Ph.D., the medical director of the Diabetes Resource Center at Sinai Hospital of Baltimore.

In addition to addressing the fear about regular injections, staff members at the center acknowledge the constant maintenance required in controlling diabetes. By taking into consideration a patient’s feelings and daily lifestyle, the center is re-inventing diabetes management.

Dr. Pinkstaff recalled a recent visit from a 60-year-old patient who was diagnosed with diabetes 16 years ago and had stopped taking her insulin.

“The first words out of her mouth were ‘I’m here because I’m noncompliant,’” Dr. Pinkstaff says. Dr. Pinkstaff went on to suggest that she and the patient start over and develop a new plan that would help the patient get back on track. By taking the time to talk with the patient, Dr. Pinkstaff was able to convince her of the importance of not only taking her insulin, but also learning more about her disease.

“I said, ‘Here is a window of opportunity. Let’s see if we can do something,’” Dr. Pinkstaff says.

Education is key to helping people with diabetes manage their disease, so group classes are offered for ongoing education and support. The center’s components also include glucose monitoring, medication and/or insulin instruction, nutritional counseling, and a focus on prevention of complications. Other staff members at the center include diabetes nurse educators, pharmacists and registered dieticians.

There is a close relationship with patients. Physicians and staff can facilitate care with other specialists in the LifeBridge Health system, including the Krieger Eye Institute, the Sleep Center at Sinai and the Heart Center at Sinai. Plus, new technology at the Diabetes Resource Center includes real-time glucose monitoring, insulin pump therapy and intensive insulin treatment.

Diabetes is defined as having high blood sugars, but there are additional health problems associated with diabetes. They include blindness, heart or kidney disease, or atherosclerosis (hardening of the arteries). An estimated 17.9 million people in the United States have diabetes and most of them lead full and healthy lives.

In Maryland, the rate of diabetes has grown over the past 10 years, from 6 percent of adults in 1998 to 7.9 percent of adults in 2006. By the end of 2007, there were 358,000 adults with the disease in the state, according to the state Department of Health and Mental Hygiene. In Maryland it is estimated there is another undiagnosed group of 143,000 adults.

The Diabetes Resource Center staff makes it their mission to educate people on the risk factors for diabetes, including obesity. It is no coincidence that the obesity rates are tied to the rise of type 2 diabetes. There are 21.4 million men and 22.9 million women in the United States are obese.

“There’s a rising epidemic of obesity,” says Sigrid Anderson, R.N., M.S.N., C.D.E., B.C.-A.D.M., a consultant with the Diabetes Resource Center. “That is directly correlated to the rate of type 2 diabetes, which is at epic proportions.”

But the experts at the center always stress that diabetes can be controlled with a commitment on the part of the patient, family members and physicians.

“These programs treat the patient but really impact the whole family. Sinai is raising the standard of care,” Dr. Pinkstaff says.

PHOTO CAPITON: Sally Pinkstaff., M.D., Ph.D., earned her medical degree from the Medical College of Virginia and was an intern and resident at the University of Chicago hospitals, where she also completed her endocrinology fellowship. Dr. Pinkstaff also received a Ph.D. in physiology from Northwestern University and is currently an Assistant Professor of Medicine at Johns Hopkins School of Medicine.

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