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Diabetes Care and Education

-by Dee Meerdink, Diabetes Care Coordinator
There are lots of new technologies (and commercials!) for diabetes these days. Sometimes, these are helpful to make people aware of options they may not have seen before. Sometimes, they are just confusing – CGM, GLP-1, SGLT2 – sounds like alphabet soup! Let’s try to break down some of this information. One of the most exciting new technologies is CGM – Continuous Glucose Monitors. These devices are inserted into your body (arm or abdomen usually) and they check your blood sugar continuously – without a finger stick. Amazing for those people who have had diabetes for years and are tired of those pokes! A sensor is inserted into interstitial tissue (the layer of tissue under the skin) and this sends a signal to a receiver and blood sugar readings are available. Depending on the device, this sensor is worn for 10-14 days and then changed. Each product has different features. Sounds great, right? Why doesn’t everyone have one of these? Well, cost and insurance coverage are some of the obstacles. We have seen some improvements with coverage. Medicare now covers CGMs if certain criteria are met: diagnosis of diabetes, need to inject insulin three times a day, frequent insulin adjustments and a face to face meeting with provider every six months for diabetes care. If you have private insurance, coverage depends on your carrier, but I feel like it never hurts to check and see if a CGM could be covered. The other options is self-pay. Some CGMs brands have programs to get your out of pocket cost per month to about $75. A prescription is still needed. Contact your provider or your diabetes educator/care coordinator with questions.

GLP-1 are a group of medications for diabetes. The commercials frequently seen are for Ozempic, Bydreon, Rybelsus and Trulicity. These commercials tout lower blood sugars and weight loss. Have we seen this in our office? Yes. Is it for everyone?
No. But it is an exciting class of medications. This class of medications do typically require a once a week injection, though there is now a daily oral version too (Rybelsus). GLP-1 work in three ways: slows down how food moves through the stomach, decreases the amount of sugar released from liver and increases insulin from pancreas when blood sugars are high. Common side effects are nausea, vomiting, constipation, diarrhea. Early research shows a benefit to heart health and kidney function.

You can check with your provider if this medication is indicated for you and what product is covered by your insurance.

SGLT-2 are another group of medications that you are seeing commercials about. Brand names are Jardiance, Farxiga and
Invokana. These meds have shown promise for lowering blood sugars by eliminating extra sugars through the urinary systems. Common side effects include urinary tract infections and yeast infections. Research has shown beneficial cardiovascular outcomes. These include a reduced incidence of cardiovascular death and heart failure hospitalization in people with and without diabetes, and those with and without prevalent heart failure.

It is an exciting time in the world of diabetes care. Technology and new meds are great but some of the basics of diabetes care have not changed – eating a healthy diet, staying active, taking your medications as ordered, monitoring your blood sugar levels and seeing your provider regularly. Diabetes Care education is here to help you with this sometimes overwhelming diagnosis of diabetes. You don’t have to do this on your own. Reach outto your partners in health – Orange City Area Health System.

Click here for information about our Diabetic Eye Exams

Jerry’s story

Jerry established care at the Orange City Area Health System in May 2022.  He had been dealing with Type 2 diabetes for years. He stated he was frustrated with his diabetes care and felt like he was “getting nowhere.” His A1C was 9.1%. “I was in danger of losing a job I love” as a school bus driver for Sheldon schools. He decided he needed a “fresh set of eyes” on his diabetes care. Jerry was seen in our Hospers Family Medicine Clinic by Dr. Millard and was referred to Dee in our Diabetes Care Clinic. According to Dee, “We were able to update his insulin regimen by checking his insurance coverage and offering meds that better worked with his lifestyle as a school bus driver. He also started to use a CGM (Continuous Glucose Monitor).”  

“Using the Libre (CGM), helped me understand my blood sugar numbers,” reports Jerry. Over the year, Jerry began to walk his dog. “At first, I couldn’t get very far without getting short of breath but Tucker (my dog) was relentless.”  Now they walk 2-3 times a day, up to 1 ½ miles each time. He also noticed he was losing weight and keeping it off.  “I really find I can eat anything I want in moderation.” 

In four months, Jerry’s A1C was down to 6.8%. A year later, his A1C is at 6.5%. “I feel better, have more energy. Working with Dee has changed how I look at my diabetes- there is hope.”

Orange City Area Health System is your partner in diabetes prevention, management, and care. Our Outpatient Diabetes Education Program is proud to offer comprehensive educational programs for those with diabetes. In addition to individual sessions with our diabetes care coordinator and/or registered dieticians, we offer the following education opportunities. Click here to register.

Diabetes Self-Management Education and Support:

Taught by Orange City Area Health System’s highly trained diabetes education team; these 2 hour group classes are designed for newly diagnosed diabetics or for those who are looking for a refresher course. Topics covered include: Overview of diabetes, blood glucose monitoring, carbohydrate counting, food label reading, exercise, medications, complication prevention, sick day care, and stress management.

Gestational Diabetes Group Classes:

Orange City Area Health System’s Outpatient Diabetes Education Program offers group classes to women diagnosed with gestational diabetes. With this class, expectant mothers learn the skills for managing their blood sugar through healthy eating, increased activity, blood glucose monitoring, and stress management.

Pre-diabetes Group Classes:

Concerned about Pre-diabetes? This 2 hour group class teaches you about healthier eating and exercise habits to improve your health and reduce your chance of having Type 2 Diabetes. Research has shown that losing weight and exercising most days of the week may prevent or delay the onset of type 2 diabetes and reduce the risk of cardiovascular disease, a serious medical condition that develops more frequently in this population. Taught by Orange City Area Health System’s highly trained diabetes education team.

Support Groups:

In conjunction with Orange City Area Health System’s Outpatient Diabetes Education Program, we offer a “Sweet Talk” Diabetes Support Group for the community.

Insulin Pump Management:

Pumps can help some people achieve better control and some people prefer this continuous system of insulin delivery over injections. Contact the diabetes care coordinator for more information.=

Continuous Glucose Monitoring can be used by type 1 and type 2 diabetes patients who would like better glucose control to improve the health and quality of their lives. Contact our diabetes care coordinator for more information or click here.

Diabetes Care Coordinator Dee Meerdink, RN, CDCES, is part of a team that works closely with your family medicine provider, nurses, support staff, and our dietitians to help you navigate your healthcare and manage your diabetes … seamlessly and with less stress.