Diabetics Risk Early Disability Development

One way retail clinicians can encourage patients to make lifestyle changes is to share some of the risks associated with diabetes, including that the condition is linked with early development of disabilities.

Kristene Diggins, FAANP, CNE, NEA-BC, DNP, DCC, MBA, manager of professional practice at MinuteClinic, previously spoke withContemporary Clinicabout the critical role nurse practitioners and physician assistants play ineducating patients about diabetes.

She argued that even though patients with diabetes may have spoken with many prescribers and other health care professionals about their condition, this does not mean that retail clinicians should be complacent with patient education.

“The advanced practice clinician cannot accept that this patient understands until they really spend time educating them on the risks of their disease. Do they understand that if they don’t take their metformin and they don’t take their drugs as prescribed that their risk for heart attack is going up?” Dr. Diggins asked. “That is the role we ultimately have in the convenient care setting. We are the safety net for primary care providers. …We have the opportunity to inform and educate on each and every visit with our patients.”

Retail clinicians can also help target the 1 in 3 adults who have prediabetes to increase their exercise and adjust their diet in order to avoid the health risks associated with diabetes.

Lead study author Barbara Bardenheier, PhD, MPH, MA, from the US Centers for Disease Control and Prevention’s Division of Diabetes Translation, toldContemporary Clinicthat weight loss counseling is one way retail clinicians can help diabetics avoid disabilities.

“Lifestyle-based weight loss interventions have been associated with a slowing of functional decline and should be encouraged among diabetic patients to avoid developing disability,” she said.

Dr. Bardenheier and her fellow researchers followed about 20,000 patients aged 50 years and older from 1998 to 2012.

In this study, disabilities were defined as difficulties with mobility or daily life activities. Both diabetes and disability status were self-reported.

The results showed that diabetics 50 years or older died almost 5 years earlier and developed a disability between 6 and 7 years earlier. Patients with diabetes also spent around 1 or 2 more years in a disabled state than those without diabetes.

Associations between diabetes status and the number of years without a disability increased with age. In addition, the researchers found that diabetic men spent twice as much of their lifetimes disabled than their peers. Similar associations were seen among women, as well.

“Diabetes is associated with a substantial reduction in nondisabled years to a greater extent than the reduction of longevity,” concluded the researchers, whose findings were published inDiabetes Care.

For diabetics who do develop disabilities, MinuteClinic recently pledged to improve access to its retail clinics for patients with visual, hearing, and other disabilities.

Some services that can be provided to this patient population include arrangements for sign language interpreters and improved methods for measuring the weight of a patient in a wheelchair. MinuteClinic staff members will also be trained to familiarize themselves with availability and use of equipment, aids, and services.