November American Diabetes Month: Action Tips for Physicians

Jim Braibish • Nov 13, 2020

By Betty M. Drees, MD, FACP, FACE, Professor and Dean Emerita
University of Missouri-Kansas City School of Medicine
President 2020, Kansas City Medical Society

Diabetes mellitus is a chronic disease that has a tremendous impact on the lives of the 34 million Americans living with diabetes every day. But in November each year, we take the opportunity to formally recognize this impact and reflect on how we can make a difference. This year, the coronavirus pandemic reminds us of the imperative to continue to improve ways to prevent and treat diabetes. Although people with diabetes are not more likely to catch the SARS-CoV-2 virus that causes the COVID-19 infection, they are much more likely to develop severe illness or die from the infection. Forty percent of the people who have died from COVID-19 had diabetes.

Throughout the year, day-in and day-out, we can make a difference for people living with diabetes and at increased risk of developing diabetes. Here are some suggestions for action :

Prevention : Encourage people to take the diabetes risk test through the ADA https://www.diabetes.org/risk-test or the CDC at https://www.cdc.gov/prediabetes/takethetest/. Most people with prediabetes or metabolic syndrome do not know they have it, and yet are at increased risk of developing heart disease. Lifestyle intervention is both clinically and economically effective. Even though some lifestyle programs are limited right now due to the coronavirus pandemic, we can encourage our patients to eat healthier (limit sugary beverages, increase daily vegetables, and limit highly processed foods), move more, and get enough sleep. Not only may these measures reduce long-term risk of developing diabetes and heart disease, improved metabolic health may reduce morbidity and mortality risk due to coronavirus in the short term.

Clinical Care : For people with diagnosed diabetes, encourage them to continue to seek acute care when needed and not avoid urgent care. Have a sick day plan for patients, especially regarding how to manage medications and when to seek urgent care. Keep up ongoing chronic care, including immunizations, cardiovascular risk management and glucose control. (There was early concern about use of ACE inhibitors during the pandemic, but current guidelines recommend continuing ACE inhibitors and ARBs for blood pressure as safe.) Use telemedicine technology where appropriate. Be alert for depression, social isolation and increased risk of food insecurity during the pandemic.

Advocacy : Physician voice in advocating for people with diabetes is critical for policies for equity, access to care, insurance coverage for COVID-19 and affordable insulin. A quarter of people who take insulin for diabetes ration their insulin. Insulin is a unique medication because it is essential for life for people with type 1 diabetes. Many states have passed legislation capping insulin prices, and more will be considering legislation in 2021.

Volunteer : The Kansas City Medical Society Foundation is the charitable arm affiliated with the Kansas City Medical Society. They coordinate millions of dollars of charitable care annually throughout the metropolitan region, largely provided by physician volunteers. In 2019, there were three dozen cases of eye care for diabetes-related eye disease and over five dozen cases of care for people with diabetes with other conditions. If you are interested in volunteering care for patients in need in our area, please contact Karole Bradford of the Foundation at kbradford@kcmedicine.org , or 913-907-7271.

Physician Self-Care : Higher quality and safer care is provided by doctors and nurses who are healthy themselves, both physically and emotionally. Please take care of yourselves, especially during this pandemic as we all need all of you to be at your best. Eat well, exercise, sleep and stay connected to family, friends and colleagues.

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The theme of this year’s American Diabetes Month from the American Diabetes Association (ADA) is “ We Stand Greater than Diabetes .” I encourage physicians to visit the campaign website for resources and join in activities to improve prevention and treatment for people with diabetes: https://www.diabetes.org/greaterthan

22 Jan, 2024
To Members of the Kansas City Medical Society: Greetings, My name is Greg Unruh , and I am honored to be the President of the Society for 2024. By way of a short introduction, I practice anesthesiology at the University of Kansas Medical Center. I have been involved in and have held leadership positions in local, state, and national societies of organized medicine throughout the years, both in anesthesiology and non-anesthesiology societies. I was an officer in the Wy-Jo Medical Society when we merged with the Kansas City Medical Society and have remained on the Board throughout all of the reorganization. I am very proud of how far we have come, It has put us in position to speak for physicians on both sides of the state line. We have expanded our Leadership Council, and we have passionate members of our Board of Directors. I want to commend our Immediate Past President, Dr. Carole Freiberger for her leadership in 2023. She provided us with an optimistic, can-do Presidency that advanced the Society and the practice of medicine in the KC area, so thank you Carole! In addition, we have welcomed the steady leadership of our executive director, Mr. Micah Flint. We appreciate him keeping us on track and organizing our many activities. Several of the things I mention will be dealt with in more detail throughout this communication, but I wanted to highlight some the several areas the Board has chosen for our work this coming year: Advocacy We want to advocate on both sides of the state line working with both the Missouri State Medical and Kansas Medical Societies (MMSA and KMS) on behalf of physicians. On the Kansas side, the legislature is working on many issues that affect us including scope of practice, vaccinations, Medicaid reimbursement and Medicaid expansion. We are working with KMS to provide testimony and influence our legislative representatives. Support for our Foundation We want to support our crown jewel whole heartedly, the Kansas City Medical Society Foundation which continues to be a model for advocacy and education, as well as our charitable care program which provides immense benefits for our uninsured or under insured patients. The Foundation supported expansion of Medicaid on the Missouri side and is advocating tirelessly for expansion on the Kansas side. Ms. Karole Bradford is our Executive Director. Opioid abuse We have been working to help stem the tide of opioid abuse through education and visibility. We are in the process of putting together TikTok videos about the dangers of opioid abuse produced by local high school students and targeted at high school students at their level and their preferred communication platform. We also have activities targeted to school district officials and several of our Board members and members provide advice around opioid use disorder and school policies. Wellness and Suicide Prevention Our focus has been on removing the stigma that sometimes attaches to physicians help-seeking. We have been advocating for health systems and hospitals to remove credentialing language that could impede a physician from seeking help. Several systems are reviewing their language and are now trying to focus on current, not historical, mental health issues or substance use that could affect safe practice. We are also working to participate in Physician Suicide Awareness Day in September. Welcoming New Members If you are a current member, thank you! I hope you have found our activities to be meaningful for you and your practice. Please consider asking your colleagues to join our collective voices. If you are not a member, please consider joining-we’d love to have you! In conclusion, I’m excited about the year to come and look forward to hearing any and all thoughts and ideas for the Society moving forward. Thanks, and best regards, Greg
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