Victor O. Kolade, MD (AIAMC Roles: Member of Board of Directors & Programming Committee)
Did you just have a well-attended Grand Rounds session presented by an outside speaker on a unique approach to a common problem? That likely happens often. What if the speaker has given your institution a copy of his book on the subject for each attendee? How do you diffuse the information further?
You review the book for a journal1 – or encourage a team member to. My opportunity came when I got The Diabetes LifeMap: Data-driven Diabetes Care for the 21st century, written by Dr. David Bleich2, professor and chief of endocrinology at Rutgers Medical School. In his presentation and book, Dr. Bleich challenged our contemporary practice of patients with diabetes checking their blood sugar levels with little or no regard for physiologic variations in levels based on timing of meals (or time of wakefulness in shift workers) – and clinicians not effecting changes in such testing patterns. He recommends that at a minimum, patients collect glucose data sufficient for ‘trend analysis’ - at wake-up time and two hours after each meal, two to three times a week. The LifeMap promotes ‘active management’ - seven or more tests a day: before and two hours after each meal, before and after snacks, and at bedtime. This data collection frequency may reveal important patterns of hyper- and/or hypoglycemia before it is time to get a traditional test such as hemoglobin A1c. Adopting this or a similar method of glucose monitoring may enable clinicians to predict and optimize A1c values as part of ambulatory quality improvement. A full review is posted here: https://journals.stfm.org/familymedicine/2022/january/br-jan22-kolade/
Why do I deem this book important? It describes a cloud based LifeMap with patient and provider portals. Although integration with electronic medical records is not promised, I welcome this paradigm shift in diabetes management and am introducing the concept to my patients and trainees. The author believes: ‘our future for chronic care delivery will embrace cost-saving technologies that improve outcomes’ (p. 180). This is consistent with the prediction by an AIAMC member and colleagues that technology is becoming an integral member of the health care and education teams.3 We anticipate that there will be more initiatives like the LifeMap in the near future, and that the AIAMC will continue to proclaim innovation!
1. Kolade V. The Diabetes LifeMap: Data-Driven Diabetes Care for the 21st Century. Fam Med. 2022;54(1):64-5. https://journals.stfm.org/familymedicine/2022/january/br-jan22-kolade/
2. Bleich D. The Diabetes LifeMap: Data driven diabetes care for the 21st century. Morgan James Publishing. New York. 2021.
3. Simpson D, Sullivan GM, Artino AR Jr, Deiorio NM, Yarris LM. Envisioning Graduate Medical Education in 2030. J Grad Med Educ. 202012(3):235-240. doi: 10.4300/JGME-D-20-00292.1. Erratum in: J Grad Med Educ. 2020 Aug;12(4):506.
is Interim Co-Chief for Quality, Wellness & Research, Sayre Internal Medicine, The Guthrie Clinic, and Clinical Professor of Medicine & Regional Clerkship Director for Internal Medicine, Geisinger Commonwealth School of Medicine.