Safer Living with Diabetes: A Team Approach

Purpose Few published reports have described the use of interprofessional diabetes education courses to improve clinical outcomes, including hypoglycemic events and hemoglobin A1c (HbA1c) in geriatric patients with Type 2 Diabetes Mellitus (T2DM). The complex nature of T2DM in older adults necessitates a team of healthcare providers to focus on the various aspects of the disease including pathophysiology, complications, medications, and diet. Additionally, because of the increased risk of falls and hospitalizations associated with hypoglycemia in older adults, this should be an essential component of any education course. The aim of our study is to determine the effect of interprofessional interventions in improving HbA1c outcomes and reducing hypoglycemic episodes in older adults with T2DM. Methods The ‘Safer Living with Diabetes’ diabetes education class is an interprofessional two-hour patient education course taught by a pharmacist, nurse practitioner, and dietician explaining the disease process, complications, medications, and healthy diet. Eligible patients were referred by their medical provider and must have been diagnosed with pre-diabetes or T2DM. Point-of-care HbA1c levels were collected in patients requiring clinical assessment. Prior to the course, the nurse practitioner and pharmacist met to review treatment plans for patients scheduled to attend the course. Following the course, attendees met with either the nurse practitioner or pharmacist to review their point-of-care HbA1c results for possible medication adjustments. Attendees then followed-up with either the nurse practitioner or pharmacist in the clinic as appropriate. Attendees were asked to complete a pre- and post-course questionnaire to assess diabetes knowledge. Results Thirty-five patients (28% female, 94% T2DM) participated in the diabetes education course from September 2016 to June 2017. Mean age of participants was 74 years. Pre and post course surveys found improvement in patient’s understanding of the risk of hypoglycemia. HbA1c levels were reduced following the education course (7.88% prior, 7.64% post). A follow-up telephone survey to determine number of hypoglycemic events and the participants’ overall thoughts of the course is planned. Conclusion An interprofessional diabetes education course appears to benefit HbA1c levels in older adults with T2DM.