December 23, 2022 – 12:47
“It’s important to see the patient as a whole, with all their conditions.”
Earlier this year, Ciro, a specialist knowledge and care center for people with complex chronic pulmonary or heart failure, set up a special diabetes team. People with chronic lung disease often have comorbidities. For example, diabetes occurs above average in this group of patients. To better treat these patients, Ciro has set up a diabetes clinic. Internist Nicole van Loon and diabetes nurse Maud Verberne have now guided more than 40 patients. And the results don’t lie.
Nicole van Loon explains: “There are also big differences within the group of people with lung disease and diabetes. Both when it comes to the severity of the disease and the use of medications, as well as knowledge of the disease. We see patients who are very well prepared and know exactly what to do when. But there are also people for whom this does not apply. In the meantime, we have made progress with our approach for many patients: for some, the drug has been halved or even stopped, and complaints such as headaches, excessive sweating or many hypos may be partially resolved. Plus, with more knowledge and personalized advice, people stay much better within their glycemic ‘target range’ – the ideal value for the person in question.”
Measure and know
Maud Verberne has recently completed her higher professional education in diabetes nursing and will soon begin further training in diabetes care. She is thrilled: “Then I can also prescribe medication myself. It’s so helpful. But we can often achieve a lot with lifestyle advice. More exercise and different food choices really help, especially with type 2 diabetes. It is important for the patient to know what influence food and exercise have on their glucose level. Then you also know what to watch out for and what to do. Like whether or not you should eat something before exercising, for example.” Measurement is important here. Nicole: “We’ve started to place more emphasis on 4-point full day curves. This gives a better picture. And for ICU patients with a sensor, we can monitor the patient and their blood glucose readings online. For patients who do not have a sensor and are struggling with interrupted blood glucose readings, we have two internal sensors as standard. This allows us to continuously monitor the glucose level for two weeks.”
Comprehensive diabetes care
With the new approach, Ciro patients receive a full-fledged diabetes cure, entering the transdisciplinary specialist treatment. Complete with, among others, evaluation of the kidneys and feet and attention to weight, nutrition, use of medications and possibly. further complaints. Maud: “I also work one day a week at the diabetes clinic in Laurentius. Very nice and also nice to exchange knowledge and experience. Because diabetes is a complex and impactful disease”.
The future
In the long term, the diabetes team wants to further expand their work. Nicole: “We want more attention for our patients in the pre-diabetic stage. We see and talk about them already, but we would like to take the treatment a step further. We also want to broaden the consultations with cardiovascular risk management. All with the aim of doing better for and with the patient. Because of course it really depends on someone’s situation and personal goals, which approach is more helpful. We must look at the patient as a whole: with all his ailments, desires and circumstances ”.
Bron: Ciro