Tuesday, January 3, 2012

Diabetes Office Visit Simplifies Diabetes Care

The rate of adherence with complex diabetes regimens is only 67 %
American Diabetes Association. Diabetes statistics: data from the 2011 national diabetes fact sheet. http://www.diabetes.org/diabetes-basics/diabetes-statistics/. Accessed September 15, 2011
Over 36 million people with diabetes have NINE cardiovascular risk factors to manage. Studies show that only 7% of people with diabetes achieve the target goals for A1c, LDL cholesterol, and blood pressure.
(JAMA 2004;291:335-342, a recent update in 2010 showed an improvement to 11%)
Diabetes Office Visit can significantly improve those numbers by simplifying diabetes risk management to managing nine numbers.
How do we do it ?
Simple and Specific Goals Empower Patients

Start Simple. Set goals.
Initially, you donʼt need to know what the numbers mean to affect them.
You just need to learn the targets and what levers to pull to move your numbers toward your target.The very first lever to pull is learning how to discuss the lab
values with your doctor.TheDiabetes Office 
Visit suite empowers the patient to have that conversation.

Be Specific
Diabetes Office Visit provides the goals and a patient-focused template for a conversation with their doctor about their goals.   The point is to focus each conversation on the specific goals where a patient is not hitting the target.       

Repeat, Repeat, Repeat.
Over time, repeated conversations about lab values create opportunities for every patient to learn how to manage their disease. Our goal is to empower patients to gain 
understanding of their disease over time and actively partner with their health care provider to manage it.

Remember- “you fail to achieve 100% of the goals you donʼt set “

Managing the NINE, Why It Works:

Correcting just one risk factor is already proven effective!

The Collaborative Atorvastatin Diabetes Study (CARDS) was done on typical people with diabetes without known  without known heart disease but who had risk factors for heart disease. This study
demonstrated that correcting just one risk factor (LDL Cholesterol ) prevented 37
 major vascular events per 1000
people over 4 years. 

The Heart Protection Study also focused on LDL cholesterol over a 5 year period
and prevented a major vascular event in
70 to 100 people per 1000. A key finding was that regardless of whether you do or don't have diabetes , and whether you do or don't have heart disease , you benefit from treating one risk factor for heart disease. Imagine how that number grows when you correct more than one  risk factor.

Diabetes Office Visit provides the tools in different formats to manage and correct
NINE risk factors and thus could easily help you preserve your own good health.

CARDS (Lancet 364(9435)685-96 2004)
 Heart Protection (The Lancet vol.360 July 6,2002 page 7 to 22
Correcting a few more cardiovascular risk
factors saves lives...

Blood Pressure Control
Blood pressure control reduces the risk of cardiovascular - Heart disease and stroke - among people with diabetes by 33 to 50 percent. 
In general, for every 10 mmHg reduction in systolic blood pressure , the risk for
any complication related to diabetes is reduced by 12 percent . Reducing diastolic pressure from
 90 mmHg to 80 mmHg in people with diabetes
reduces the risk of major cardiovascular events by 50 percent.

Glucose Control
In patients with type 1 diabetes, intensive insulin therapy has long-term beneficial effects on the
risk of cardiovascular disease .
Source: National Diabetes Statistics, 2011- National Diabetes Information Clearinghouse

Diabetes Office Visit provides a simple, yet comprehensive approach to solving the complex challenge of managing glucose and preventing cardiovascular disease for people with diabetes. As a bonus , this approach works just as well for anyone concerned about heart disease .

The Diabetes Office Visit is available today to help accomplish that goal. We have produced a paperback book, an e-book, an app ( for iPhones, iPad and iPod ) and a web site .


The web site is designed to support the app and includes regular blog entries, a discussion forum, and training videos. The content is focused on helping people understand how to manage risk factors and preserve their good health . The
discussions comply with the American Diabetes Association standards of care. There is also a comment section and a soon to be added Q&A section.
Visit today and make a comment.      

 Make up your mind today to fix one target goal .  That wellness exam above is mine and I am picking waist circumference. My goal is 36 .
                              Have fun . David Calder,MD

1 comment:

  1. tracy.rose@healthline.comJune 6, 2012 at 7:58 PM


    Healthline recently finished an infographic that shows the increasing impact type 2 diabetes has on everything from pregnancy to national health expenditures. You can find the infographic at: http://www.healthline.com/health/type-2-diabetes/statistics-infographic

    We encourage you to embed this graphic on your site & share with your followers, friends, & network.

    Please let me know if you have any questions.

    Warm Regards,


Your comments and questions are appreciated. David Calder,MD