SlideShare a Scribd company logo
1 of 32
Efficacy  of  Group  Visits  in  Outpatient  Management  of Diabetes Nicholas  Urbanczyk,  DO Peter  Farago,  MD, Patricia  West,  PhD Department  of  Family  Medicine St.  John  Hospital Detroit,  MI October 17, 2011
1999 Obesity Trends* Among U.S. Adults BRFSS,   1990, 1999, 2009 (*BMI   30, or about 30 lbs. overweight for 5’4” person) 2009 1990 No Data  <10%  10%–14%   15%–19%  20%–24%  25%–29%  ≥30%
Number and Percentage of U.S. Population with Diagnosed Diabetes, 1958-2008  CDC’s Division of Diabetes Translation.  National Diabetes Surveillance System available at   http://www.cdc.gov/diabetes/statistics
Diabetes:  The  Epidemic ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
There is Hope
Patient  Centered  Medical  Home ,[object Object],[object Object],[object Object],[object Object],[object Object]
Group  Visits ,[object Object],[object Object],[object Object],[object Object]
Group Visits ,[object Object],[object Object],[object Object],[object Object],[object Object]
DM Group Visit ,[object Object],[object Object],[object Object],[object Object],[object Object]
Literature ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Literature
The  Study
Purpose  ,[object Object]
Methods ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Methods ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Methods ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Results
 
Medications  at  Baseline
After  6  months…
HbA1c  Pre- and Post-Intervention p = 0.026
Individual  HbA1c  Change  from  Pre- to Post-Intervention Intervention HbA1c  (%)
Diabetes  Knowledge Test Score  Pre- and Post-Intervention p = 0.001 23 Questions
Weight  Pre- and Post-Intervention p = 0.044
Systolic Blood Pressure  Pre- and Post-Intervention p = 0.005
Patient  Satisfaction  Survey ,[object Object],[object Object],[object Object],[object Object],[object Object]
Patient  Satisfaction  Comments ,[object Object],[object Object],[object Object]
Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Conclusions ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Acknowledgements ,[object Object],[object Object],[object Object],[object Object]
References ,[object Object],[object Object],[object Object],[object Object]

More Related Content

What's hot

ADA 2019 DIABETES AMERICAN DIABETES ASOCIATION
ADA 2019 DIABETES AMERICAN DIABETES ASOCIATION  ADA 2019 DIABETES AMERICAN DIABETES ASOCIATION
ADA 2019 DIABETES AMERICAN DIABETES ASOCIATION Leonel Ernesto
 
Allied healthevalnewmodelscare
Allied healthevalnewmodelscareAllied healthevalnewmodelscare
Allied healthevalnewmodelscareNatPor
 
Conversations about Weight Loss can Promote Behavior Change in Patients
Conversations about Weight Loss can Promote Behavior Change in PatientsConversations about Weight Loss can Promote Behavior Change in Patients
Conversations about Weight Loss can Promote Behavior Change in PatientsMedical Transcription Service Company
 
Final drs nutritionppt
Final drs nutritionpptFinal drs nutritionppt
Final drs nutritionpptwangdin
 
Week 3 management program2
Week 3 management program2Week 3 management program2
Week 3 management program2SNikki
 
Apc a-00120-time 2 self-ident not-diabetic
Apc a-00120-time 2 self-ident not-diabeticApc a-00120-time 2 self-ident not-diabetic
Apc a-00120-time 2 self-ident not-diabeticDr. Robert Rutledge
 
The American Gastroenterological Association Obesity Practice Guide
The American Gastroenterological Association Obesity Practice GuideThe American Gastroenterological Association Obesity Practice Guide
The American Gastroenterological Association Obesity Practice GuideDr. Robert M. Webman
 
Evidence for a new category of diabetes care reversal
Evidence for a new category of diabetes care reversalEvidence for a new category of diabetes care reversal
Evidence for a new category of diabetes care reversalJames McCarter
 
Diabetes Patient-Centered Care: Everyone Has a Role to Play
Diabetes Patient-Centered Care: Everyone Has a Role to PlayDiabetes Patient-Centered Care: Everyone Has a Role to Play
Diabetes Patient-Centered Care: Everyone Has a Role to PlayMedavie Blue Cross
 
The Top Myths About Ketosis Debunked by Clinical Trials
The Top Myths About Ketosis Debunked by Clinical TrialsThe Top Myths About Ketosis Debunked by Clinical Trials
The Top Myths About Ketosis Debunked by Clinical TrialsJames McCarter
 
Sickle cell and depression final
Sickle cell and depression finalSickle cell and depression final
Sickle cell and depression finalKimberly Reger
 
Effectiveness of Continuous Remote Care and Nutritional Ketosis for Type 2 Di...
Effectiveness of Continuous Remote Care and Nutritional Ketosis for Type 2 Di...Effectiveness of Continuous Remote Care and Nutritional Ketosis for Type 2 Di...
Effectiveness of Continuous Remote Care and Nutritional Ketosis for Type 2 Di...James McCarter
 
Continuous Care Intervention in Type 2 Diabetes
Continuous Care Intervention in Type 2 DiabetesContinuous Care Intervention in Type 2 Diabetes
Continuous Care Intervention in Type 2 DiabetesJames McCarter
 
Ijsrp p11062 (manuscript)
Ijsrp p11062 (manuscript)Ijsrp p11062 (manuscript)
Ijsrp p11062 (manuscript)salindap
 
Perspectives of Education in Diabetes- Crimson Publishers
Perspectives of Education in Diabetes- Crimson PublishersPerspectives of Education in Diabetes- Crimson Publishers
Perspectives of Education in Diabetes- Crimson PublishersCrimsonPublishersIOD
 

What's hot (20)

Jurnal 2263
Jurnal 2263Jurnal 2263
Jurnal 2263
 
ADA 2019 DIABETES AMERICAN DIABETES ASOCIATION
ADA 2019 DIABETES AMERICAN DIABETES ASOCIATION  ADA 2019 DIABETES AMERICAN DIABETES ASOCIATION
ADA 2019 DIABETES AMERICAN DIABETES ASOCIATION
 
STFM_CPI_Poster
STFM_CPI_PosterSTFM_CPI_Poster
STFM_CPI_Poster
 
Allied healthevalnewmodelscare
Allied healthevalnewmodelscareAllied healthevalnewmodelscare
Allied healthevalnewmodelscare
 
Conversations about Weight Loss can Promote Behavior Change in Patients
Conversations about Weight Loss can Promote Behavior Change in PatientsConversations about Weight Loss can Promote Behavior Change in Patients
Conversations about Weight Loss can Promote Behavior Change in Patients
 
Final drs nutritionppt
Final drs nutritionpptFinal drs nutritionppt
Final drs nutritionppt
 
diaclincd22as01.pdf
diaclincd22as01.pdfdiaclincd22as01.pdf
diaclincd22as01.pdf
 
Week 3 management program2
Week 3 management program2Week 3 management program2
Week 3 management program2
 
Apc a-00120-time 2 self-ident not-diabetic
Apc a-00120-time 2 self-ident not-diabeticApc a-00120-time 2 self-ident not-diabetic
Apc a-00120-time 2 self-ident not-diabetic
 
The American Gastroenterological Association Obesity Practice Guide
The American Gastroenterological Association Obesity Practice GuideThe American Gastroenterological Association Obesity Practice Guide
The American Gastroenterological Association Obesity Practice Guide
 
Cdea 2020
Cdea 2020Cdea 2020
Cdea 2020
 
Evidence for a new category of diabetes care reversal
Evidence for a new category of diabetes care reversalEvidence for a new category of diabetes care reversal
Evidence for a new category of diabetes care reversal
 
Diabetes Patient-Centered Care: Everyone Has a Role to Play
Diabetes Patient-Centered Care: Everyone Has a Role to PlayDiabetes Patient-Centered Care: Everyone Has a Role to Play
Diabetes Patient-Centered Care: Everyone Has a Role to Play
 
The Top Myths About Ketosis Debunked by Clinical Trials
The Top Myths About Ketosis Debunked by Clinical TrialsThe Top Myths About Ketosis Debunked by Clinical Trials
The Top Myths About Ketosis Debunked by Clinical Trials
 
Sickle cell and depression final
Sickle cell and depression finalSickle cell and depression final
Sickle cell and depression final
 
Effectiveness of Continuous Remote Care and Nutritional Ketosis for Type 2 Di...
Effectiveness of Continuous Remote Care and Nutritional Ketosis for Type 2 Di...Effectiveness of Continuous Remote Care and Nutritional Ketosis for Type 2 Di...
Effectiveness of Continuous Remote Care and Nutritional Ketosis for Type 2 Di...
 
Continuous Care Intervention in Type 2 Diabetes
Continuous Care Intervention in Type 2 DiabetesContinuous Care Intervention in Type 2 Diabetes
Continuous Care Intervention in Type 2 Diabetes
 
Indication of health
Indication of healthIndication of health
Indication of health
 
Ijsrp p11062 (manuscript)
Ijsrp p11062 (manuscript)Ijsrp p11062 (manuscript)
Ijsrp p11062 (manuscript)
 
Perspectives of Education in Diabetes- Crimson Publishers
Perspectives of Education in Diabetes- Crimson PublishersPerspectives of Education in Diabetes- Crimson Publishers
Perspectives of Education in Diabetes- Crimson Publishers
 

Viewers also liked

Shilpa Saxena, Leveraging Time: The Power of Group Visits
Shilpa Saxena, Leveraging Time: The Power of Group VisitsShilpa Saxena, Leveraging Time: The Power of Group Visits
Shilpa Saxena, Leveraging Time: The Power of Group VisitsCleveland HeartLab, Inc.
 
03.05.09(c): Treatment of Diabetes
03.05.09(c): Treatment of Diabetes03.05.09(c): Treatment of Diabetes
03.05.09(c): Treatment of DiabetesOpen.Michigan
 
Hypoglycemia unawareness slide share
Hypoglycemia unawareness slide shareHypoglycemia unawareness slide share
Hypoglycemia unawareness slide share Mohamed BADR
 
Amy l. Doneen: Imaging & Inflammation: Applying the Evidence to Clinical Prac...
Amy l. Doneen: Imaging & Inflammation: Applying the Evidence to Clinical Prac...Amy l. Doneen: Imaging & Inflammation: Applying the Evidence to Clinical Prac...
Amy l. Doneen: Imaging & Inflammation: Applying the Evidence to Clinical Prac...Cleveland HeartLab, Inc.
 

Viewers also liked (6)

Shilpa Saxena, Leveraging Time: The Power of Group Visits
Shilpa Saxena, Leveraging Time: The Power of Group VisitsShilpa Saxena, Leveraging Time: The Power of Group Visits
Shilpa Saxena, Leveraging Time: The Power of Group Visits
 
03.05.09(c): Treatment of Diabetes
03.05.09(c): Treatment of Diabetes03.05.09(c): Treatment of Diabetes
03.05.09(c): Treatment of Diabetes
 
Hypoglycemia unawareness slide share
Hypoglycemia unawareness slide shareHypoglycemia unawareness slide share
Hypoglycemia unawareness slide share
 
A quick review of available insulin products
A quick review of available insulin productsA quick review of available insulin products
A quick review of available insulin products
 
Amy l. Doneen: Imaging & Inflammation: Applying the Evidence to Clinical Prac...
Amy l. Doneen: Imaging & Inflammation: Applying the Evidence to Clinical Prac...Amy l. Doneen: Imaging & Inflammation: Applying the Evidence to Clinical Prac...
Amy l. Doneen: Imaging & Inflammation: Applying the Evidence to Clinical Prac...
 
Diabete Mellito
Diabete MellitoDiabete Mellito
Diabete Mellito
 

Similar to Aach group visit

A correlation study to determine the effect of diabetes self management on di...
A correlation study to determine the effect of diabetes self management on di...A correlation study to determine the effect of diabetes self management on di...
A correlation study to determine the effect of diabetes self management on di...Kurt Naugles M.D., M.P.H.
 
Manuscript GNUR741 Diabetes group visit in a primary care
Manuscript GNUR741 Diabetes group visit in a primary careManuscript GNUR741 Diabetes group visit in a primary care
Manuscript GNUR741 Diabetes group visit in a primary careSelma Mujezinovic
 
Prof-Dennis-Yue-Kellion-Lecture.ppt
Prof-Dennis-Yue-Kellion-Lecture.pptProf-Dennis-Yue-Kellion-Lecture.ppt
Prof-Dennis-Yue-Kellion-Lecture.pptvictorgolubev97
 
Team as Treatment: Driving Improvement in Diabetes
Team as Treatment: Driving Improvement in DiabetesTeam as Treatment: Driving Improvement in Diabetes
Team as Treatment: Driving Improvement in DiabetesCHC Connecticut
 
TRFrame AACP Final Poster
TRFrame AACP Final PosterTRFrame AACP Final Poster
TRFrame AACP Final PosterJuanita Draime
 
download5fa7ed36a05f68739c53ff0000b8561d.pptx
download5fa7ed36a05f68739c53ff0000b8561d.pptxdownload5fa7ed36a05f68739c53ff0000b8561d.pptx
download5fa7ed36a05f68739c53ff0000b8561d.pptxtuan nguyen
 
diabetes self management in rural community
diabetes self management in rural communitydiabetes self management in rural community
diabetes self management in rural communitymuskrahatain
 
CMI/Compas Endocrine Today Focus on Diabetes
CMI/Compas Endocrine Today Focus on Diabetes CMI/Compas Endocrine Today Focus on Diabetes
CMI/Compas Endocrine Today Focus on Diabetes CMI_Compas
 
Diabetic nursing visits for better A1C control in patients Discussion.pdf
Diabetic nursing visits for better A1C control in patients Discussion.pdfDiabetic nursing visits for better A1C control in patients Discussion.pdf
Diabetic nursing visits for better A1C control in patients Discussion.pdfsdfghj21
 
VA Diabetes Education Research Project
VA Diabetes Education Research ProjectVA Diabetes Education Research Project
VA Diabetes Education Research ProjectDavid Donohue
 
PICOT Question and literature.docx
PICOT Question and literature.docxPICOT Question and literature.docx
PICOT Question and literature.docxstudywriters
 
Binge Eating Disorder-Presentation.pptx
Binge Eating Disorder-Presentation.pptxBinge Eating Disorder-Presentation.pptx
Binge Eating Disorder-Presentation.pptxchiogb1
 
Diabetes Evidence Based Practice Paper.pdf
Diabetes Evidence Based Practice Paper.pdfDiabetes Evidence Based Practice Paper.pdf
Diabetes Evidence Based Practice Paper.pdfsdfghj21
 
Diabetes Prevalence Presentation.pdf
Diabetes Prevalence Presentation.pdfDiabetes Prevalence Presentation.pdf
Diabetes Prevalence Presentation.pdfsdfghj21
 
My STSH Scholary Article about TREATMENT of PRE-DIABETES with SSDD
My STSH Scholary Article about TREATMENT of PRE-DIABETES with SSDDMy STSH Scholary Article about TREATMENT of PRE-DIABETES with SSDD
My STSH Scholary Article about TREATMENT of PRE-DIABETES with SSDDDr. Sutanu Patra
 
The 2nd Diabetes Attitudes, Wishes & Needs (DAWN2) study: objectives and meth...
The 2nd Diabetes Attitudes, Wishes & Needs (DAWN2) study: objectives and meth...The 2nd Diabetes Attitudes, Wishes & Needs (DAWN2) study: objectives and meth...
The 2nd Diabetes Attitudes, Wishes & Needs (DAWN2) study: objectives and meth...Primary Care Diabetes Europe
 
download10a5ed36a05f68739c53ff0000b8561d.pptx
download10a5ed36a05f68739c53ff0000b8561d.pptxdownload10a5ed36a05f68739c53ff0000b8561d.pptx
download10a5ed36a05f68739c53ff0000b8561d.pptxanamsaeed32
 

Similar to Aach group visit (20)

A correlation study to determine the effect of diabetes self management on di...
A correlation study to determine the effect of diabetes self management on di...A correlation study to determine the effect of diabetes self management on di...
A correlation study to determine the effect of diabetes self management on di...
 
Manuscript GNUR741 Diabetes group visit in a primary care
Manuscript GNUR741 Diabetes group visit in a primary careManuscript GNUR741 Diabetes group visit in a primary care
Manuscript GNUR741 Diabetes group visit in a primary care
 
Prof-Dennis-Yue-Kellion-Lecture.ppt
Prof-Dennis-Yue-Kellion-Lecture.pptProf-Dennis-Yue-Kellion-Lecture.ppt
Prof-Dennis-Yue-Kellion-Lecture.ppt
 
Team as Treatment: Driving Improvement in Diabetes
Team as Treatment: Driving Improvement in DiabetesTeam as Treatment: Driving Improvement in Diabetes
Team as Treatment: Driving Improvement in Diabetes
 
Improving Diabetes Care ELDEP
Improving Diabetes Care ELDEPImproving Diabetes Care ELDEP
Improving Diabetes Care ELDEP
 
My Eposter
My EposterMy Eposter
My Eposter
 
TRFrame AACP Final Poster
TRFrame AACP Final PosterTRFrame AACP Final Poster
TRFrame AACP Final Poster
 
download5fa7ed36a05f68739c53ff0000b8561d.pptx
download5fa7ed36a05f68739c53ff0000b8561d.pptxdownload5fa7ed36a05f68739c53ff0000b8561d.pptx
download5fa7ed36a05f68739c53ff0000b8561d.pptx
 
diabetes self management in rural community
diabetes self management in rural communitydiabetes self management in rural community
diabetes self management in rural community
 
CMI/Compas Endocrine Today Focus on Diabetes
CMI/Compas Endocrine Today Focus on Diabetes CMI/Compas Endocrine Today Focus on Diabetes
CMI/Compas Endocrine Today Focus on Diabetes
 
Diabetic nursing visits for better A1C control in patients Discussion.pdf
Diabetic nursing visits for better A1C control in patients Discussion.pdfDiabetic nursing visits for better A1C control in patients Discussion.pdf
Diabetic nursing visits for better A1C control in patients Discussion.pdf
 
VA Diabetes Education Research Project
VA Diabetes Education Research ProjectVA Diabetes Education Research Project
VA Diabetes Education Research Project
 
PICOT Question and literature.docx
PICOT Question and literature.docxPICOT Question and literature.docx
PICOT Question and literature.docx
 
Binge Eating Disorder-Presentation.pptx
Binge Eating Disorder-Presentation.pptxBinge Eating Disorder-Presentation.pptx
Binge Eating Disorder-Presentation.pptx
 
Diabetes Evidence Based Practice Paper.pdf
Diabetes Evidence Based Practice Paper.pdfDiabetes Evidence Based Practice Paper.pdf
Diabetes Evidence Based Practice Paper.pdf
 
Diabetes Prevalence Presentation.pdf
Diabetes Prevalence Presentation.pdfDiabetes Prevalence Presentation.pdf
Diabetes Prevalence Presentation.pdf
 
My STSH Scholary Article about TREATMENT of PRE-DIABETES with SSDD
My STSH Scholary Article about TREATMENT of PRE-DIABETES with SSDDMy STSH Scholary Article about TREATMENT of PRE-DIABETES with SSDD
My STSH Scholary Article about TREATMENT of PRE-DIABETES with SSDD
 
Ajp mrecs dsme
Ajp mrecs dsmeAjp mrecs dsme
Ajp mrecs dsme
 
The 2nd Diabetes Attitudes, Wishes & Needs (DAWN2) study: objectives and meth...
The 2nd Diabetes Attitudes, Wishes & Needs (DAWN2) study: objectives and meth...The 2nd Diabetes Attitudes, Wishes & Needs (DAWN2) study: objectives and meth...
The 2nd Diabetes Attitudes, Wishes & Needs (DAWN2) study: objectives and meth...
 
download10a5ed36a05f68739c53ff0000b8561d.pptx
download10a5ed36a05f68739c53ff0000b8561d.pptxdownload10a5ed36a05f68739c53ff0000b8561d.pptx
download10a5ed36a05f68739c53ff0000b8561d.pptx
 

Recently uploaded

Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls JaipurCall Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipurparulsinha
 
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...vidya singh
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...astropune
 
Chandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableChandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableDipal Arora
 
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...CALL GIRLS
 
VIP Call Girls Indore Kirti 💚😋 9256729539 🚀 Indore Escorts
VIP Call Girls Indore Kirti 💚😋  9256729539 🚀 Indore EscortsVIP Call Girls Indore Kirti 💚😋  9256729539 🚀 Indore Escorts
VIP Call Girls Indore Kirti 💚😋 9256729539 🚀 Indore Escortsaditipandeya
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...perfect solution
 
Call Girls Mumbai Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Mumbai Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Mumbai Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Mumbai Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsBangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsGfnyt
 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Servicevidya singh
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...chandars293
 
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Dipal Arora
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Dipal Arora
 
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...Arohi Goyal
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...chandars293
 
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 

Recently uploaded (20)

Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls JaipurCall Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
 
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
 
Chandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableChandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD available
 
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
 
VIP Call Girls Indore Kirti 💚😋 9256729539 🚀 Indore Escorts
VIP Call Girls Indore Kirti 💚😋  9256729539 🚀 Indore EscortsVIP Call Girls Indore Kirti 💚😋  9256729539 🚀 Indore Escorts
VIP Call Girls Indore Kirti 💚😋 9256729539 🚀 Indore Escorts
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
 
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
 
Call Girls Mumbai Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Mumbai Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Mumbai Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Mumbai Just Call 9907093804 Top Class Call Girl Service Available
 
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsBangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
 
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
 
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
 
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
 
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
 

Aach group visit

  • 1. Efficacy of Group Visits in Outpatient Management of Diabetes Nicholas Urbanczyk, DO Peter Farago, MD, Patricia West, PhD Department of Family Medicine St. John Hospital Detroit, MI October 17, 2011
  • 2. 1999 Obesity Trends* Among U.S. Adults BRFSS, 1990, 1999, 2009 (*BMI  30, or about 30 lbs. overweight for 5’4” person) 2009 1990 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
  • 3. Number and Percentage of U.S. Population with Diagnosed Diabetes, 1958-2008 CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics
  • 4.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 13.
  • 14.
  • 15.
  • 16.
  • 18.  
  • 19. Medications at Baseline
  • 20. After 6 months…
  • 21. HbA1c Pre- and Post-Intervention p = 0.026
  • 22. Individual HbA1c Change from Pre- to Post-Intervention Intervention HbA1c (%)
  • 23. Diabetes Knowledge Test Score Pre- and Post-Intervention p = 0.001 23 Questions
  • 24. Weight Pre- and Post-Intervention p = 0.044
  • 25. Systolic Blood Pressure Pre- and Post-Intervention p = 0.005
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.  
  • 31.
  • 32.

Editor's Notes

  1. I have been passionate about the notion of Group Visits, since my residency training. I always felt that a better educated patient, equaled a healthy patient. My resident research project focused on group visits for Pediatric obesity. I wanted to carry the group visit idea into my practice. And then as faculty physician at St. John I had some help from the residents I was teaching. So really this research project is a large collaboration with residents giving lectures during their community medicine rotation. Residents are so eager to get involved and we set up each resident with a topic to facilitate during the DM Group Visit. So I was able to harness that energy to move forward this research pilot study.
  2. Behavioral Risk Factor Surveillance System performed by CDC, The data shown in these maps were collected through the CDC&apos;s Behavioral Risk Factor Surveillance System (BRFSS) , on the basis of self-reported weight and height. Each year, state health departments use standard procedures to collect data through a series of monthly telephone interviews with U.S. adults. Prevalence estimates generated for the maps may vary slightly from those generated for the states by the BRFSS as slightly different analytic methods are used
  3. Methodology Number and percent of the U.S. population with diagnosed diabetes were obtained from the National Health Interview Survey (NHIS, available at http://www.cdc.gov/nchs/nhis.htm ) of the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC) for years. Conducted continuously since 1957, the NHIS is a health survey of the civilian, noninstitutionalized population of the United States. The survey provides information on the health of the United States population, including information on the prevalence and incidence of disease, the extent of disability, and the utilization of health care services. The multistage probability design of the survey has been described elsewhere (1,2). Estimates for years 1958-1979 were obtained from published data (3) and estimates from 1980 forward were derived directly from the NHIS survey data. References 1. Massey JT, Moore TF, Parsons VL, Tadros W. Design and estimation for the National Health Interview Survey, 1985-1994. Hyattsville, MD: National Center for Health Statistics. Vital and Health Statistics 1989;2(110). 2. Botman SL, Moore TF, Moriarity CL, Parsons VL. Design and estimation for the National Health Interview Survey, 1995–2004. National Center for Health Statistics. Vital and Health Statistics 2000;2(130). 3. Harris MI: Prevalence of noninsulin-dependent diabetes and impaired glucose tolerance. Chapter VI in Diabetes in America , Harris MI, Hamman RF, eds. NIH publ. no. 85-1468, 1985.
  4. Data from the 2011 National Diabetes Fact Sheet (released Jan. 26, 2011) Total prevalence of diabetes Total: 25.8 million children and adults in the United States—8.3% of the population—have diabetes. Diagnosed: 18.8 million people Undiagnosed: 7.0 million people Prediabetes: 79 million people Cost of Diabetes $174 billion: Total costs of diagnosed diabetes in the United States in 2007 $116 billion for direct medical costs $58 billion for indirect costs (disability, work loss, premature mortality)
  5. This article states “The future of family Medicine”, but this article is from 2004, and so the future is already the past. But in this report, the committee supported the PCMH concept. And mentioned Group Visits as 1 tool to provide higher quality and better access at a lower cost to the health care system
  6. Quality measures – patient disease registries, establish core performance measures, test result tracking Patient experience – increased access to care, same day appointments, email, support patient self management through motivational interviewing, group visits
  7. Dr. Andrew Davis published a Review article in clinical diabetes 2008. There has been much research in Group Visits, starting from late 1990s
  8. Group visit setting is a superb time to catch up on preventive health maintenance, immunizations, labs, etc.
  9. We did have several patients who made dramatic positive change in HbA1c which may have affected our results