First, welcome to new readers! I’ve kept this blog kind of quiet for the last few months, but feedback has been good, so I am rolling it out to the whole residency today. Lucky you!
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Just a quick post today about diabetes education as it came up in IM IV clinic last week. Both VA and UAB have great help available to you for teaching your patients about their diabetes. It is a life changing diagnosis and really hard to adequately cover in an office visit, even if you didn’t also have to talk about hypertension and back pain and obesity and cancer screening and…
At TKC- you can choose: Diabetes education, AMB (hint, save it as a favorite)
at VA, it is under consults: Diabetes Nurse, Patient Ed.
Services at both places include dietary education, glucometer teaching, insulin administration (including basal/bolus regimens), counting carbs, what do to on sick days, and recognizing and managing hypoglycemia. They also cover things like eye and foot health, long term complications, and managing stress.
Medicare and BCBS pays for 10 hours of education once (ideally after diagnosis, but ok to refer someone diagnosed 20 years ago, if they never got any teaching), then 2 hours every year after that. At UAB, the first course is 5 hours, then there is a 2 hour follow up course. The refresher course is 2 hours. The diabetic educators will send you the pre/post tests of your patients, and you can highlight the things that tripped them up on the test.
At the VA, there is both a comprehesive diabetes managment group class and 1:1 education for insulin administration and complications managment.
There is also a great website developed by the Division of Preventative Medicine here at UAB with a lot of (mostly free) resources for diet, exercise and medication managment.
Sadly, none of the payers are covering nutrition education for non-diabetics (or pre-diabetics) quite yet. You can get nutrition education for your patients at the VA with the MOVE 123 program. Hopefully now that obesity is a “disease”, we’ll start to see more reimbursment. In the meantime, here’s something we can all agree on.