Diabetes Case Studies

Situation
A 36-year-old DAKOTACARE member with Type 1 diabetes wrote on the initial diabetes program questionnaire that was sent out to him, “I take care of my own diabetes.”

By looking over his claims, DAKOTACARE's nurses noticed that he hadn’t been in to see a physician for more than three years.

DAKOTACARE sent him an informational packet. After he received the education packet, he called with the intent of quitting the DAKOTACARE diabetes program he was enrolled in.

Solution

A DAKOTACARE nurse talked with him for a while about his diabetes, and he expressed some concern about numbness in his toes. It was also during the conversation that the nurse noted he was using a very old glucometer that was giving him inaccurate blood sugar levels.

DAKOTACARE sent out a new glucometer to him, and he agreed to stay in the program for a few more weeks while he monitored his blood sugars with the new glucometer.

He noticed right away on the new glucometer that his blood sugar readings were very elevated (averaged around 300), so he made an appointment to see his physician and insulin changes were made.

The patient called back six weeks later to let the DAKOTACARE nurse know that his toes were feeling much better and his blood sugars were coming down nicely after insulin changes were made.

He praised the program for being “persistent” with him, and he has decided to remain in the program. Today, he is doing well.

Diabetes Case Study

Situation

A 28-year-old DAKOTACARE member with Type 1 diabetes had high blood sugar levels for a year and had been hospitalized five times during that period for out-of-control diabetes.

When the DAKOTACARE nurse learned of this patient’s condition, she made a push to have this patient on a more regimented program to better control the diabetes.

Solution
After consultations with the doctor and the local diabetes educator, DAKOTACARE approved additional diabetes care, including weekly face-to-face sessions with the local diabetes educator; weekly visits with the doctor; and a referral to an endocrinologist.

The member is now on insulin pump and blood sugar levels that are very good. Most importantly, this patient has had no hospitalizations within the past two and a half years.

The DAKOTACARE nurse and the patient continue frequent telephone contacts to keep the member’s condition in check.