For 25 years, the Q.E.H.C. Diabetes Program has offered the services of a registered nurse two days per week to support and counsel people living with diabetes. All diabetes clients are seen by an endocrinologist and the services of a Nurse Clinician are free of charge due to the generous support from the public and the Q.E.H.C. Foundation.
The Medical Specialist Clinic staff and nurse in the past few years had to adapt the Diabetes Program services according to the ongoing threat of the Covid-19 virus and variants. Fortunately, with vaccination programs and safe practice guidelines in place, the services have continued without interruption.The Diabetes Program has continued to follow many clients virtually due to their increased vulnerability for poorer outcome from Covid illness and/or their own personal preference.
2021-2022 annual follow up visits in the program totalled n=921 which is consistent with pre-pandemic years. There were less missed appointments and re-scheduling this past year as clients perhaps felt more protected and familiar with the medical system for booking pre-visit tests and optional virtual appointments. Approximately 80% of follow up visits occurred virtually. Although a move to in-person office visits remains in progress. An increase in return to office visits is expected as Covid risk lessens.
Health protection and the well-being of our clients and staff remains a top priority.Telephone interactions (n-1549) show a consistent increase, averaging 17 calls daily between the nurse and diabetes patients regarding health related issues. This demand has increased as clients now communicate more freely through email, telephone and remote data sharing devices. The diabetes nurse continues to work collaboratively with the multidisciplinary team and on a daily basis consults with members of the Q.E.H.C. Complex and community.Communications with pharmacy occur on a daily basis (n-422 or 5/day) and close partnering with MD or RN,C.H.S.L.D./C.L.S.C. long term care homes, residences and C.L.S.C. remain an important nurse role to help advocate for clients and coordinate their care.Many more clients comfortably use flash or continuous blood glucose monitoring devices. These systems reduce the need for finger prick blood glucose testing and provide detailed interactive web-based reports clients can share with their health care providers. These blood glucose reports are especially beneficial during a time of mainly virtual visits. The increased client usage of these devices is shown as the nurse performs an average of 1 new start teaching weekly and receives an average of 4 individual blood glucose downloads daily for review and guidance on self-management.
Many clients are on intensive drug regimens for management of their diabetes, blood pressure, cholesterol or other concurrent illness. Over 70% of client visits are with individuals using insulin therapy. The diabetes nurse performs an average of 5 insulin teachings daily for either new start insulin instruction or a comprehensive review of diabetes management with clients using multiple daily injection of insulin regime.
Support and education continues to be in demand to help clients living with diabetes adapt to new therapies, technologies and achieve better outcomes. The Medical Specialists team is committed to staying up-to-date with communications and evidence-based guidelines and adapt the Q.E.H.C. Diabetes Program as necessary to help and protect those living with diabetes.
We applaud this fine program which has helped so many individuals living with diabetes and appreciate the on-going support of the Q.E.H.C. Foundation.