Ending Type 2 Diabetes One Exercise, Nutrition, and Gardening Class at a Time

Where Diabetes Prevention Began at FHCHC: from Individual to Systematic Care Models THE OGTT SCREENING FACTS

In OGTT Screening on August 20, 2010 at 10:10 AM

The patient registry revolutionized the way that the Fair Haven Community Health Center providers were able to treat diabetes. Their first move, equipped with this new culling tool, was to research the number of patients who displayed one or more diabetic risk factor. These included genetic disposition, acanthosis, BMI, and blood sugar levels. Those who had lead the previous diabetes interventions and educational activities at FHCHC then organized the first oral glucose tolerance screening event. Indeed, it was an event. Participants along with their families were invited to the screening, where they received information on their diabetes risk, lifestyle changes that would support their efforts to avoid the disease, and a conversation about food and portion control over lunch when the second set of blood tests were complete. Patients, kids in strollers or teenagers struggling to wake up, would begin arriving as early as 8:30AM.

Little has changed in terms of the screening structure over the past four years. The difference is the buzz. More clinicians and program managers than ever are referring their patients or participants to screenings. Elizabeth and the Diabetes Prevention Program team host up to three screenings per month, one of which is generally on Saturdays, and two of which are in Spanish. The attendance rate remains around 50%, as it was in the beginning. But now, with 40 patients confirmed, the screening is bustling with 20-25 men, women, and children.

When they walk in the front door of the clinic on screening day, those there for the test are directed to our conference room. They are welcomed, and quickly ushered to the vitals station. Soon afterwards, their blood is drawn, which is followed by the glucose drink. The clinician on duty proceeds to conduct formal visits with each individual or family present, while the new patients continue to have their vitals and blood work completed. Around one hour into the screening, the clinician pauses the visits to speak to the whole group. Equipped with a powerpoint and often a child playing at their feet, the clinician conducts the educational portion of the screening. Attendees learn about diabetes, prediabetes, their risk, and ways to prevent the disease, all while they are sitting stationary in anticipation of their next blood drawing.

When the clinician has completed their lecture, the phlebotomists get to work again. Within the next hour they draw the second blood sample from each attendee, and on comes the food. A local restaurant delivers rice, beans, salad, and fruit salad towards the end of each screening. The clinician takes advantage of the attendees’ interest in the food and uses it as a teaching moment. They talk about portion size, fresh fruits and vegetables, and the importance of water versus processed drinks. People leave anywhere between 11am and 12pm, and they are promised a follow-up call with their results in the upcoming week.

Often once the last attendee has made their exit, the clinician and administrators sit around and over the left over lunch, discuss what worked and what didn’t work about that day’s screening.


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