Diabetes Malpractice

Brien Roche

The American Diabetes Association (ADA) has standards as to the care of diabetes.  If these are complied with, they provide the means to bring the blood sugar of most diabetics under control.  Daily testing of blood sugar by the patient is one of the standards.  Regular testing of glycosylated hemoglobin by the doctor is another standard.  These provide the info to allow changes in insulin to bring blood sugar levels as close as can be to that of a non-diabetic.  The failure of a doctor to use this type of routine may be diabetes malpractice.

High Sugar Levels

It is high levels of blood sugar in the small blood vessels that pose the danger.  These vessels serve areas of the body like the kidneys and the nerves in the hands and the feet.  They also serve the retina of the eye.  Patients that are informed of the deadly route of diabetes and the ease within which it can be controlled become faithful to the testing habits.  Therefore the key is getting that info to the patient.  This promotes the well-being of the patient and avoids diabetes malpractice.  Call or contact us for a free consult.

Actos

In a study published in March of 2011 from the University of Texas Health Science Center in San Antonio, a drug named Actos was reported on.  People who took it were less likely to develop diabetes than a like group who was given a placebo.  Actos is from the same class of drugs as Avandia.  The latter had been found to increase the risk of heart attack.  Actos is believed to be safer than Avandia.   However it has been linked to increased risk of congestive heart failure and the FDA is looking at links to bladder cancer.  Questions continue as to whether this drug in fact prevents diabetes.  It may be masking symptoms by decreasing blood sugar levels.

Standards of Care

The ADA has been forthright in stating these basic standards of care.  They urge all doctors to alert patients to enforce them within their own practice.

Any diabetes malpractice analysis is a two-way street.  You not only look at the fault of the doctor but also have to look at the conduct of the patient.

Reducing the Risk of Diabetes Malpractice

Diabetes is sometimes called the lifestyle disease.  Your risk of getting this blood sugar disorder rises if you live an unhealthy lifestyle.  If on the other hand you follow a healthy diet, exercise and control your blood pressure, weight and cholesterol, then the risk is much less.

What to Do

There are many things that can be done in that regard:

• Eating breakfast daily reduces your risk of getting diabetes by 34%.  The logic behind this is that having breakfast helps control your appetite.  It also controls calorie intake for the day.  Some good choices of things to eat early in the morning are peaches, plums and nectarines.  These all have bio-active compounds that help prevent heart disease.
• Increase your intake of fruits and vegetables and decrease your intake of processed meats.  Processed meats are such things as hot dogs, breakfast sausages and luncheon meats.  A Mediterranean-style diet with plenty of fruits and vegetables has been shown to reduce the risk of diabetes.
• Get at least six hours of sleep a night.  People who sleep less than six hours a night have a 60% higher rate of diabetes.  Again, the feeling is that less sleep makes your appetite-regulating hormones go haywire.  This promotes cravings for sweet and salty foods.

Lifestyle Changes

• Get rid of the smoking.  Even if you gain some weight as a result of stopping, the weight gain, assuming that it is less than 10 pounds, is more than offset by the decreased risk of diabetes.
• Exercise.  The exercise does not have to be vigorous but it should be some form of aerobic.  This helps to not only control the cholesterol and blood pressure but also controls the insulin produced.  Try to take at least 10,000 steps per day.  Likewise men should consider lifting weights if appropriate.  Men who lift weights for 150 minutes per week reduce their risk of getting diabetes by 34%.

Call, or contact us for a free consult.

Consulting with a Dietitian

Part of the reason that our healthcare system is so expensive is because the system is focused on dealing with symptoms as opposed to dealing with prevention.  Some dietitians say the system is broken.

That prevention comes in the form of diet control and good exercise.

One of my daughters, Andrea Roche, has a master’s degree in Nutrition from Simmons College in Boston.  She is a Registered Dietitian.

RD Article

What follows is a condensed version of an article that she published in a publication of the Massachusetts Dietetic Association dealing with the issue of including registered dietitians in the Affordable Care Act.

Accountable Care Organizations (ACOs) have become the buzzword in healthcare the passage of the Affordable Care Act (ACA) has set our healthcare system on a new course with ACOs leading the way.    Dietary professionals must get on board.  The Academy of Nutrition and Dietetics (AND) must support ACOs.  They should also take action to insure Registered Dietitians (RDs) are included.  Also they must provide for payment of RDs.  RDs are not listed as providers that can form an actual ACO.  This issue has not been greatly discussed.  In light of this shift, the greater inclusion of RDs in every aspect of health policy is essential.

RDs are Part of the Solution

The ACO framework should include RDs because RDs are focused on prevention and wellness.

An ACO is a group of healthcare providers that agrees to account for the quality and cost of Medicare beneficiaries who are in traditional fee-for-service programs.  The goals of this model are twofold.  First of all, reduce in per-patient cost and disease-related problems.  Finally, increased patient satisfaction, use of resources, transparency and exchange of info.  These goals are based on a shared care model.

In regard to dietetics, all healthcare professionals and RDs should work to provide diet services aimed at prevention, treatment and management of problems.  In addition to their role in critical care, dietitians are also involved in health promotion.  They also help prevent disease, look for wayhs to intervene early, set up links with community services and provide a wide range of research.  RDs’ knowledge, skills, and training equip them to provide services that augment other healthcare providers.

MNT Therapy

RDs are the experts in delivering Medical Nutrition Therapy (MNT).  MNT services for prevention, wellness and disease management have proven to be effective.  In addition the Institute of Medicine has declared that the registered dietitian is currently a single identifiable group of healthcare professionals with standardized education, clinical training, continuing education and national credentialing requirements necessary to be directly reimbursed as a provider of nutrition therapy.

RDs are cost-effective quality care providers.  For example, Massachusetts General Hospital in Boston reported that patients who had received MNT in a 6-month study had a 6% decrease in total cholesterol, including LDL levels.  Furthermore, a cost-savings of $4.28 for each dollar spent on MNT was reported.  The Lewin Group reported that RD MNT results in an 8.6% decrease in hospital use.  There was also a 16.9% decrease in doctor visits for patients with diabetes.  It is clear that bringing RDs in as providers increases quality of care and decreases cost.

The ACO model shows promise as a driver to improve quality and cost control.  The intent of the ACO is to improve quality and control costs.  This can be better realized by including RDs as providers.

Call, or contact us for a free consult. Also for more info on this issue see the Wikipedia pages. Also see the post on this site dealing with malpractice issues.