Extended Reach
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!
References
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.
Dr.
Kolade 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.
Ready
to do a book review of your own? If you recently read/reviewed a book, please
contact us so that we can consider publishing it on our blog!! kimberly@aiamc.org