Health1

Rico Long, a film critic for WOSU-AM radio, gives his diabetes treatment team at OSUMC four stars.

“I’m fighting the battle and I think I’m winning,” says Rico Long, regarding the daily care needed to live a healthy life with type 2 diabetes. The retired OSU motion picture producer and adjunct professor stays busy serving as a volunteer film reviewer with his wife, Joyce, for WOSU-AM. The duo has been providing listeners with film critiques for 22 years and has no plans to retire anytime soon.

Long, a Worthington resident, partnered with his physician Fred Miser, MD, more than 10 years ago to manage his diabetes.

“Rico takes care of himself, and he has good control of his diabetes,” says Dr. Miser. “Individuals like Rico are able to enjoy their lives instead of having diabetes control their life.”

Long enjoys an active and interesting life, while managing his diabetes effectively. “I take oral medication for my diabetes; it keeps it under tight control,” says Long, whose most recent Hemoglobin A1C test, which measures average blood glucose control for the past 2 to 3 months, was 6.1 percent, well below the 7 percent target for most diabetics.

Risk factors and complications
Diabetes can be prevalent in people who are overweight, have high blood pressure and high cholesterol. Nine out of 10 people with newly diagnosed type 2 diabetes are overweight and at least 40 percent of people with diabetes also have high blood pressure. Studies show people at risk for developing type 2 diabetes can cut their risk in half simply by shedding excess pounds (5 to 7 percent of their current weight) and walking for half an hour at least five days a week.

Diabetes can also be linked to sleep apnea, a potentially serious sleep disorder in which breathing repeatedly stops and starts. About 40 percent of all men who have type 2 diabetes also have sleep apnea. OSU researchers are investigating the connection and have found that treating sleep apnea can improve the glucose levels of type 2 diabetes patients.

More than medication
Long is quick to note that the medication alone does not manage diabetes. “Watch your diet. Watch your alcohol intake. And, get a good exercise program going and stick with it,” says Long. “You’ll be able to play golf and do whatever you want to do, really.”

Leon McDougle, MD, MPH, assistant professor in the Department of Family Medicine, agrees. “If a patient doesn’t change his or her lifestyle, it is very difficult to control their diabetes,” says Dr. McDougle. “Treatment of diabetes is a triad, consisting of medication, diet and physical activity. You have to do all three. I think that sometimes people rely too heavily on medication alone.”

Your Advocate Linda Strout, DO Q: What is the difference between type 1 and type 2 diabetes? A: Type 1 diabetes is caused by too little insulin as a result of destruction of the insulin-producing beta cells of the pancreas. Type 1 diabetes is treated with insulin therapy. Type 2 diabetes occurs when the pancreas cannot produce enough insulin or when certain tissues in the body become resistant to normal or even high levels of insulin. Treatment of type 2 diabetes includes a healthy, low carbohydrate diet, appropriate weight loss, oral medications and occasionally insulin treatment. Schedule an appointment at OSU Internal Medicine at Morehouse or with Dr. Strout by calling 1-800-293-5123.

“We are hoping that the social support will undergird the diabetic patients and help them to adhere to recommendations for a healthy lifestyle,” says Dr. McDougle. “I think this changes the paradigm of the doctor-patient relationship. It is no longer just the doctor and patient; now there is also the community and their environment. Whatever we can do to influence their environment once they walk out the door is the key to improving their lifestyle and their diabetes.”

“The vast majority of care for diabetic patients is self-management. Diabetic patients make their own decisions about diet, medication and exercise,” says Dr. Miser. “If you know each person, their family, the community in which they live, it goes a long way toward helping them take control of their treatment. We at Ohio State make that effort to get to know each patient and provide care personalized just for them.”

Certified specialists
The National Committee for Quality Assurance Diabetes Physician Recognition Program recently certified many offices in the OSU Primary Care Network. Only those physicians with established track records of excellent diabetes care earn recognition through the program. “This certification assures the patient that the diabetes care they receive is high quality,” says Dr. Miser.

“We are unique as a network to achieve it,” explains Dr. Miser. There are about 324,000 primary care physicians and nearly 4,000 diabetes specialists in the United States. Of these, only about 1 percent have earned the recognition.

Long is one of an estimated 5,000 patients with diabetes whose primary care physician is in the OSU Primary Care Network. While he can thank his doctor for part of his success, the praise goes to him for his commitment to three workouts a week and making healthy choices every day.

“Golf season is over, so now I’ll be shoveling snow instead,” says Long with a laugh. “That’s good exercise too!”

It Takes a Team
Thanks in large part to Kwame Osei, MD, and a team of dedicated professionals, comprehensive diabetes care has become a focal point at University Hospital East’s Ambulatory Care Center (ACC). According to Sandy Squeo, RN, BSN, charge nurse with cardiovascular services, a committee evaluated ambulatory care centers around the country and incorporated the best practices to serve patients at the ACC when it opened in August 2007.

The team includes all practitioners that diabetic patients may need to visit, under one roof. “We tried to get everyone on board,” says Squeo, referring to the group of endocrinologists, podiatrists, cardiologists, ophthalmologists, vascular clinicians, dietitians and pharmacy assistants available at the ACC. “Patients and family members love the convenience of having the ability to see every type of physician they need.”