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Volume 29, Number 4 (November/December)

The Patient With Diabetes in Long-Term Care (pages 5-19)

Wendy Kopher-Kilgore, R.N.C., C.D.E.

Health-care providers face many challenges when caring for patients with diabetes in long-term care facilities. The author reviews some of the more common of these challenges, including the difficulties of choosing treatment goals, of recognizing symptoms of hyperglycemia and hypoglycemia, of maintaining consistent blood glucose monitoring, of understanding appropriate treatment options, and of meeting the individual needs of patients. Many helpful tables and examples are provided to illustrate how these challenges can be met in the long-term care setting.
Management strategies and tools
Surgery and hospital care

Disease Registries and Teamwork (pages 20-25)

Edward Shahady, M.D.

The Patient-Centered Medical Home is a primary health-care setting in which prevention and treatment are provided through the close collaboration of physicians, patients, and family members. Patients with diabetes, because of the disease’s high cost and many complications, may benefit particularly from the care offered by a medical home. Dr. Shahady defines the medical home and identifies several barriers to its implementation. He takes as an example the Diabetes Master Clinicians Program in Florida and describes its use of disease registries, practice reports, patient reports, and good teamwork in providing comprehensive diabetes care. Many examples of the practice reports are provided, as well as an example of the patient “report card.”
Health services and insurance
Management strategies and tools

Religion and Spirituality Among Black Americans (pages 26-29)

Kelley Newlin, D.N.Sc., A.R.N.P.-C., C.D.E., and Gail Melkus, Ed.D, A.R.N.P.-C., F.A.A.N.

Black Americans have a higher incidence of diabetes and diabetes complications than the general population. Drs. Newlin and Melkus approach this problem from an unusual angle, by examining the religious and spiritual traditions of black Americans. Through an understanding of these traditions and how they may affect self-management behaviors, the authors draw practical conclusions for improved education and care. Advice on making a religious/spiritual assessment of patients is also given.
Diabetes in specific populationsAfrican-Americans
Management strategies and toolsPsychosocial issues

A School-Based Intervention for Diabetes Risk Reduction (pages 30-31)

Charles A. Reasner, M.D.

Childhood obesity has reached epidemic proportions in the United States. Recent interventions have focused on nutrition and physical activity in schools. The Editor discusses one of the largest of these interventions, which followed more than 4,500 grade-school children in 42 schools, providing half of them with a nutritious diet, increased physical activity, and instruction in goal-setting. The disappointing results of the study underscore the difficulty of addressing childhood obesity.
Childhood diabetes
Complications and comorbiditiesObesity