Nearly one in 11 Americans have diabetes, a chronic condition associated with serious complications.
Presented at the American Association of Diabetes Educators annual meeting on August 8, the study included 1,263 diabetic patients in a low-income immigrant population in Northern Manhattan. As part of the DSME program's multifaceted approach, participants underwent a comprehensive initial assessment and received four 30-minute individual sessions with a diabetes nurse educator, followed by group sessions focused on reinforcing self-management behaviors and individual goals. Individual patient sessions concentrated on helping patients achieve their goals, while group sessions helped give patients a deeper understanding of their condition and the implications of their actions.
The program's components concentrated on seven self-care behaviors: healthy eating, physical activity, monitoring vital signs, medication management, problem solving, healthy coping and risk reduction. Using the holistic medical home approach to care, patients were referred to specialty services, such as endocrinologists, ophthalmologists, podiatrists, dentists, dietitians, social workers and other providers on an as needed basis.
"Apart from assessing a patient's physical condition," said the study's lead educator, Yesenia Cabral, BSN, RN, disease care manager, NewYork-Presbyterian/
After 15 months, participants on average lowered their A1C (blood sugar) levels by 67 percent and their LDL cholesterol levels by 53 percent. Twenty-five percent of participants had high blood pressure at the end of the study, versus 32 percent beforehand. Also noteworthy, there was a 7 percent increase in participants with a recommended AIC below 7 percent at the conclusion of the study. The A1C test, which measures blood glucose levels, is an indicator of how well diabetes is being managed.
"What sets this program apart is its patient-centered approach," said the study's lead investigator, Lovelyamma Varghese, MS, FNP, BC, RN, director of nursing practice and quality and DSME for NewYork-Presbyterian/
As a result of the study's impressive results, best practices culled from this program are being implemented throughout New York-Presbyterian/Ambulatory Care Network.
NewYork-Presbyterian Hospital, based in New York City, is one of the nation's largest and most comprehensive hospitals and a leading provider of inpatient, ambulatory, and preventive care in all areas of medicine. With some 2,600 beds and more that 6,500 affiliated physicians and 20,000 employees, NewYork-Presbyterian had more than 2 million visits in 2013, including close to 15,000 infant deliveries and more than 310,000 emergency department visits. NewYork-Presbyterian comprises six campuses: NewYork-Presbyterian/Weill Cornell Medical Center, NewYork-Presbyterian/Columbia University Medical Center, NewYork-Presbyterian/Morgan Stanley Children's Hospital, NewYork-Presbyterian/The Allen Hospital, NewYork-Presbyterian/
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