Diabetes Coaching Program is Helping Struggling Patients Improve Dangerously High Blood Sugars
A diabetes diagnosis is life changing. For many patients, implementing new medications and exercise & healthy eating plans is overwhelming. For some, dealing with the mental health implications of a future with diabetes can hinder being successful.
The American Diabetes Association-recognized diabetes education program at the UMass Memorial Health Diabetes Center of Excellence (DCOE) covers a wide variety of topics including nutrition, insulin pumps & continuous glucose monitors, preventing complications, physical activity and more.
Diabetes education has been shown to lower A1c and blood glucose similar to medication but without side effects. Many research studies have shown that people who receive diabetes education are more likely to utilize primary care and preventative services, take medications as prescribed, and control their blood glucose, blood pressure and cholesterol levels. As a result, those people reportedly have lower health costs.
Despite receiving diabetes education, some people still struggle to keep their blood glucose within a healthy range. The DCOE piloted a Care Coach Program to provide supplemental support to help them manage blood glucose levels. Participants have successfully lowered their A1c and demonstrated a reduction in the distress caused by their diabetes by implementing behavioral, lifestyle, and medication changes, thanks to more frequent contact with a diabetes expert. Funding for this initiative was provided, in part, by the George F. and Sybil H. Fuller Foundation.
The Problem: Uncontrolled Blood Sugars
Despite receiving diabetes education, some patients continue to have a sustained A1c above 9.0%, and some high-risk individuals face consistent challenges managing diabetes on their own. Many of these patients have missed appointments with their diabetes care team and/or stopped making future appointments.
The Solution: Diabetic Coaching
The Care Coach Program was developed in collaboration with Shields Health Solutions. Patients receive frequent touchpoints with a personal diabetes coach to administer the care plan developed by their endocrinologist and/or nurse practitioner.
Coaches engage with patients frequently and serve as the go-to resource for all of their diabetes needs, including:
- Managing medications (medication changes, refills & financial assistance)
- Blood sugar management (personalized approaches to stay within target range)
- Encouraging improved lifestyle habits (exercise motivation & nutrition plans)
- Identifying gaps & social determinants and providing resources when applicable
- Collaboration with the primary care physician and diabetes educators to address concerns between visit
The Results: Lower A1c
Patients experienced an average drop in their A1c of greater than 2.2% consistently at their six, nine and twelve month visits. The data shows total hospitalizations were reduced for the participants and diabetes related hospitalizations and ER visits were reduced following participation in the program. This success was a result of better adherence to medications (95% vs. almost zero), direct contact and frequent touchpoints with coaches, and successful lifestyle changes. There was also a reduction in diabetes related distress as measured by the Problem Areas in Diabetes questionnaire score. Preliminary data may suggest a decrease in hospitalizations.
The Care Coach Program, piloted by endocrinologists Richard Haas, MD, and Vrushali Shah, MD, is now being implemented across the UMass Memorial Diabetes Center of Excellence.