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Winter 2009 |
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Online Only
P
E R S P E C T I V E S
Diabetes testing, incontinence treatment and a letter for patients
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Don Lane Photo |
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Dr. Susan King |
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Blood glucose
monitoring in diabetics; incontinence treatment; planning
ahead for routine appointments.
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By Dr. Susan King |
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Hello colleagues. Another year gone by
and we’re all likely a bit pudgier after the Christmas splurges. Not
great for the waistline or the blood glucose. I’m sure that you,
like me, have lots of diabetes patients who, if they remember to
bring in their sugar level book, have it sparsely populated. Well,
maybe now we can relax a little about glucose monitoring.
Ever heard of the Canadian Agency for
Drugs and Technologies in Health? CADTH, as it is known, is an
independent, not-for -profit agency that provides credible
evidence-based information about the effectiveness and efficiency of
drugs and other health technologies. It recently reviewed
self-monitoring of blood glucose levels. Their research reveals that
routine testing of stable diabetics who do not use insulin is not
required! Of course, during changes in medication, changes in activity,
during illness or for those who may be at increased risk of
hypoglycaemia (e.g. Patients on secretogues like glyburide) monitoring
is required. They estimate that $150 million can be saved each year,
without negative impact, if we changed our protocols to reflect the
evidence. For more information about this and other research, check out
the
CADTH website.
Incontinence treatment
I had an interesting chat with an Obs-Gyne
resident recently. He told me that, in addition to Nurse Continence
Specialists, there is also a physiotherapist affiliated with the Women’s
Health Center who has advanced training in treatment of incontinence
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an important addition to the treatment of this life-impacting issue.
He also advised me that fecal incontinence
is more common than we think and often not volunteered by women. Good to
have an additional resource that at least some of our population can
access.
Planning ahead for routine appointments
Boy, I sure am finding it difficult to run
an efficient practice these days. With the increasing complexities of
care and the natural aging of my patient population, my patients now
have to wait longer than ever for a routine follow-up appointment, even
with me.
We keep appointments every day to fit in
patients with urgent and unexpected illness. Unfortunately, more and
more of these appointments are filled by patients with routine issues,
despite explanation by staff. This means that other patients with urgent
matters cannot be accommodated and those who had made routine
appointments have to, unfairly, wait. My patients just aren’t yet in the
habit of booking their follow-up appointment on the way out because they
never had to.
I recently developed a letter for staff
to give to patients who were added in for urgent care. I found this to
be very helpful. The letter advises them about what I am able to do
during that particular appointment and is a reminder for them to get
into the habit of planning ahead for appointments. I would be happy to
provide this to anyone interested. Please contact the
NLMA and I can provide it for you.
Well here we are, another year older
ourselves… hopefully wiser! Wishing all of you and your staff and
families the very best of health and happiness for 2010.
Dr. Susan King is a family physician
at the Newfoundland Drive Medical Clinic in St. John’s. Tips and hints
may be emailed or faxed to (709) 726-7525.
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