As our society struggles to adjust to the ever-increasing burden of type 2 diabetes, it becomes a challenge to stem the tide from the deluge of newly diagnosed patients without compromising care of those who have battled the disease for years. Two novel U-M initiatives address both patient populations, and with them, the next generation of diabetes care has arrived.
The Type 2 Diabetes Cure Clinic
People with type 2 diabetes diagnosed within the past five years who are overweight (with a body mass index of 35+) are now being referred to U-M’s T2D Cure Clinic, spearheaded by William Herman, M.D., M.P.H., director of the NIH-funded U-M Center for Diabetes Translational Research, and Amy Rothberg, M.D., one of the first physicians to be certified by the American Board of Obesity Medicine. Aggressive plans for weight management help patients decrease symptoms and approximately 65% of participating patients have reversed their disease, including improved insulin sensitivity and restoration of normal blood glucose control.
Along with proven weight loss interventions, the Cure Clinic’s success comes from intensive patient education, medical management to improve risk factors, and a personalized approach. “We understand that weight loss is not one-size-fits-all, and each person’s journey is unique,” says Rothberg.
Most people with type 2 diabetes receive care from an endocrinologist only when blood sugar spirals out of control or when diabetes complications arise – typically five or more years after diagnosis. By then, much of the damage of diabetes may already be underway. The Cure Clinic’s multidisciplinary team puts their tools to work for patients early enough for maximum effectiveness in turning the disease around, improving patients’ quality of life.
The Intensive Type 2 Diabetes Program
On the other end of the spectrum are patients who have been living with type 2 diabetes for many years, only to find it increasingly difficult to manage their disease. U-M offers an evidence-based clinical approach for them too: the Intensive Type 2 Diabetes Program. As the program’s director, Israel Hodish, M.D., Ph.D. explains, “Diabetes is progressive. After the first ten years, patients often become resistant to oral medications, increasing their likelihood of serious complications.”
Hodish estimates that about half of all type 2 patients fall into this high-risk category. And studies show that noncompliance is the cause of health problems in only about 20% of cases. Rather, these patients need more frequent attention, especially when beginning insulin therapy. Hodish’s preliminary findings indicate that these patients benefit most when insulin levels are adjusted regularly – once a week or every few weeks – to maintain desired glucose levels.
Given the national shortage of providers, such frequent patient interaction often isn’t feasible in a traditional clinic setting. Or is it? To develop a workable clinical model, Hodish first adapted some elements from the proven approach used to manage drugs like Warfarin that require frequent adjustment. A suite of communication tools, including email and phone calls, replaces many face-to-face consultations, and U-M-developed software helps keep all of the pieces working together, generating personalized calendars to prompt patient contact, monitoring medications and vital signs, and making it easier to update clinical notes. These elements come together in the U-M Intensive Type 2 Diabetes Program.
To connect with these clinics or to refer a patient, contact M-Line at 800-962-3555.