Diabetes reaches epidemic levels in the U.S.
Diabetes statistics for the U.S. population are the stuff nightmares are made of. And yet, as chronic diseases go, this one is remarkably preventable and/or controllable, which makes diabetes education not just useful, but essential, especially for newly diagnosed patients or those who have not previously received this service. Eastern Plumas Health Care’s telemedicine diabetes education program connects Certified Diabetic Educator, Ginger Farias, with diabetic patients through a secure high quality video connection.
Diabetes is a group of diseases characterized by high blood glucose (sugar) levels that result from defects in the body’s ability to produce and/or use insulin. 25.8 million children and adults in the United States—a staggering 8.3 percent of the population—have diabetes as of 2011, according to the American Diabetes Association. This includes 1.9 million new cases diagnosed in a single year in 2010. In addition, there are 79 million people considered “pre-diabetics.” Pre-diabetics have high blood glucose levels, but they aren’t in the diabetic range yet. A significant number of these patients can bring their blood glucose levels back into the normal range by losing weight and exercising moderately.
Frighteningly, 26.9 percent (25.6 million) of the 65 years old and over population has diabetes in this country. And, 25.6 million, or 11.3 percent of the population age 20 and over has diabetes. Most of these people have Type 2 Diabetes, which is usually brought on by a combination of poor eating habits, overweight, and lack of exercise.

Diabetes related complications
The statistics are made all the more frightening when we look at the serious complications caused by this disease—complications that can be prevented or mitigated for many diabetes patients if they keep their blood glucose levels in the proper range with diet, exercise, and/or properly monitored medications. Diabetes is the leading cause of new cases of blindness in adults ages 20 – 74 years old. 4.2 million (28.5 percent) of people 40 years or older with diabetes have diabetic retinopathy, which leads to severe vision loss and blindness.
In addition, diabetics have heart disease related deaths 2 to 4 times as often as the general population, and their risk of stroke is 2 to 4 times higher. Further, diabetes is the leading cause of kidney failure, accounting for 44 percent of new cases in 2008. Also, about 60 to 70 percent of people with diabetes have mild to severe forms of nervous system damage. And, finally, more than 60 percent of non-traumatic lower-limb amputations occur in people with diabetes.
Armed with these statistics, the newly diagnosed diabetes patient often feels overwhelmed—especially if they learn they’re going to have to give themselves insulin injections. There are a myriad of questions that flood their minds, including: How do I give myself shots? How important is diet change, exercise, and weight loss, and how do I go about making these changes? Will my diabetes change my social life? Will I lose my friends when I have to eat at a certain time, or give myself a shot before a meal? More importantly, will I lose my eyesight? What else will happen to me? These and other questions can leave a new patient feeling helpless and hopeless.

Telemedicine diabetic education to the rescue
Eastern Plumas Health Care’s telemedicine diabetic education program aims to put out the safety net for diabetes patients who must, at times, feel like they’re in free fall. The hospital has taken a leap forward as it joins a new telemedicine provider group, Diabetes Care Pharmacy and Education Center, specializing in a full spectrum of diabetic education and services. New diabetes patients, or those who have missed out on educational opportunities in the past, will be enrolled in EPHC’s Diabetes Health Program. Newly diagnosed diabetics will have an orientation session where they’ll learn how to use their glucose meter to monitor their blood sugar levels. If they’re on insulin, they will also have a one hour face to face injection training at the Portola Clinic with trained medical assistant, Silvia Jawwad.
After their initial orientation and training, they’ll be scheduled for three 2½ hour long telemedicine education sessions with Diabetic Educator, Ginger Farias. These sessions are covered by Medi-Cal and most other insurance carriers, including Medicare. The sessions run on three consecutive weeks.
Farias is passionate about diabetic education, and she’ll help patients feel that they can control their disease rather than letting it control them. She’ll let patients know that, while diabetes might seem scary, there is a lot they can do to prevent complications or to treat them very early with great success.
Her positive attitude is infectious. Farias explains how she runs the sessions: “It’s a very intereactive, eye opening experience,” she said. She uses models of the brain, pancreas, and more, in order to help patients visualize how their organs are working and what they need to do to make them work better. “It’s not a lecture,” she explained. “it’s one on one, where the patient asks questions, gets feedback, gives feedback, and talks about how they feel, so they get the support they need.”
Farias explains that her dedication to diabetic education comes, in part, from having her own genetic conditions and a father who died of a heart attack at age 47. “I didn’t grow up eating healthy,” she said. But, now she works hard to keep on a good diet to stay healthy. “I try to practice what I preach,” she added, “choose better food options so I can share my experiences with the patients that I see…I love it, I really found my niche, and I really enjoy helping others learn about diet, exercise, getting healthier and making these lifestyle changes.”
Thanks to EPHC’s telemedicine program, state of the art technology, combined with a Farias’ dedication and passion for diabetic education gives patients the start they need to care for themselves properly. In addition, telemedicine retinopathy screenings read by UC Berkeley ophthalmologists, a prevention plan whereby patients receive reminder calls when they need lab work or eye, feet, and other exams, and primary care physicians who are part of a network of care providers dedicated to seeing that EPHC’s diabetic patients thrive, makes this program a model of success in rural health care. For more information on these and other telemedicine programs, please call Telemedicine Director Mark Schweyer, 530.832.6604. Or, call 832.6600 to schedule an appointment to discuss diabetes care with your physician.

The following information is for diabetic patients—what to expect from your three telemedicine diabetic education visits:

At the first session, Farias will assess your current diabetes and other health conditions. She’ll analyze your past lab results, your current medications, your diabetes assessment questionnaire, and your blood glucose meter downloads in order to establish a baseline for your future care. (Your glucose monitor will be connected to the local computer in Portola and the results will be “read” and transferred almost immediately to Farias.) She’ll answer your questions, dispel myths, and help you begin to take control of your disease and overall health.
The second session focuses on identifying what you eat and how these foods affect your blood sugar (glucose) levels. Using your blood glucose download data, Farias will give you a better idea of how your current diet helps or hinders your diabetes. She’ll help you develop a customized meal plan that fits your lifestyle and helps your health.
The final class focuses on managing your medications successfully, learning how to best prevent disease complications, assessing the effectiveness of your meal plans, and discussing the important role of physical activity in your program. Your primary care doctor at EPHC will receive a personal assessment report on your progress, which will define key areas that have improved since the start of your program, as well as areas that still need attention. There is also the opportunity for further monitoring and follow up if you and your doctor feel that this would benefit you.