Member Satisfaction
Diagnosis: Diabetes, hypertension, hyperlipidemia
Background:
Patient had multiple issues, including poorly controlled diabetes (finger sticks elevated to 180), hypertension, hyperlipidemia, chronic back problems, obesity, bronchitis, and sleep apnea. Despite having medication prescribed for diabetes and having been told by his doctor that he needed to monitor his finger sticks daily, he denied ever being told he was a diabetic. He demonstrated a poor understanding of dietary recommendations for managing his medical conditions. He was obese, but was not modifying his diet to promote weight loss and did not exercise. He was smoking one pack of cigarettes daily.
Interventions:
CM provided comprehensive educational material on diabetes management, which included information on meal planning and carbohydrate counting. CM suggested that the patient begin to take steps to help achieve a healthier weight. CM provided comprehensive educational material on exercise and on dietary considerations to help promote weight loss safely. The patient had been smoking cigarettes most of his adult life and admitted his doctor has warned him to quit.
CM provided information on medications and techniques for smoking cessation and provided support and encouragement as the patient worked to quit. CM had noted a knowledge deficit regarding the need to avoid hidden sources of dietary sodium (important for managing blood pressure). CM provided comprehensive educational material on blood pressure management including the DASH diet.
Results:
The patient started exercising 3-5 days a week and now states he "feels like a new man". He was a runner in his youth and now reports he is running again for exercise and enjoyment. His weight is down to 301 lbs, representing a 34 lb weight loss since his assessment 5 months ago. There was an improvement to his blood pressure, where his last reading was normal, at 122/70. The patient reports his A1C is now 6.4, he is no longer on Januvia for glucose management, and only needs to take Actos.
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