Brunswick Novant’s mission finds many people are unaware of diabetes

By Amy Myers
Special to the Beacon
BOLIVIA—One in three American adults are at risk for developing Type 2 diabetes, yet many don’t realize it because the debilitating, potentially deadly disease often shows few early symptoms, according to the American Diabetes Association.
Brunswick Novant Medical Center has confronted this dilemma with an aggressive early diagnosis and education program that is identifying and informing hospital patients who have diabetes—or are at risk of contracting the disease.
During the last 20 months, Brunswick Novant Medical has administered a test measuring the blood sugar levels of most patients admitted to the hospital for any reason. For those with elevated levels—a sign of diabetes—the hospital’s staff have alerted the patients and their physicians and suggested community resources that can help patients learn the diet, exercise and other steps that help combat the disease.
The results of Brunswick Novant Medical’s “search-and-rescue” mission are sobering: Between September 2010 and April 2012, 92 people previously undiagnosed with Type 2 diabetes were found to have the disease. During the same time period, more than 3,050 patients were identified and alerted in 11 hospitals operated in the Carolinas by Brunswick Novant Medical’s nonprofit parent organization, Novant Health. Some had blood-sugar levels so high they needed immediate attention before they left the hospital.
“Diabetes is one of the most common health issues locally in Brunswick County, and it has become an epidemic in our country,” said Dr. David Koenig, medical director for Brunswick Novant Medical Center’s hospitalist program. “The disease can have devastating effects, but if detected early and managed correctly, the disease can easily be managed.”
“While the diabetes testing was originally considered a pilot program, the test is now is part of the regular patient screening process,” Koenig said.
Physicians, nurses and staff across Novant Health are hoping more hospitals in the nation adopt this type of bold detection program.
“We are very proud of this program, as it is one way in which we are truly able to improve the health of our community,” Koenig said.
Of nearly 26 million Americans—8.3 percent of the population—who have diabetes, one quarter or 7 million do not realize they have the disease, according to the American Diabetes Association. Another 79 million have prediabetes, which usually develops into diabetes within two to 10 years and generally occurs without symptoms but is easily detected through tests.
“Too often prediabetes is dismissed as ‘a touch of the sugar’ or too borderline to take seriously,” said Dr. Jim Lederer, vice president of clinical improvement for Novant Health. “But early diagnosis is critical to reduce chances of developing devastating complications later.”
If not diagnosed and treated, diabetes can cause blindness, kidney disease, amputations and many other complications. Diabetes causes more deaths a year than breast cancer and AIDS combined, according to the American Diabetes Association. Two out of three people with diabetes die from heart disease or stroke.
Diabetes often goes undiagnosed because many of its symptoms seem relatively harmless, such as cuts or bruises that are slow to heal, blurred vision or recurring skin, gum or bladder infections. Frequently people with Type 2 diabetes have no symptoms. Lifestyle changes such as weight loss and increased physical activity can substantially reduce the development of Type 2 diabetes and significantly improve patients’ quality of life.
Nine out of 10 of diagnosed patients in the U.S. have Type 2 diabetes, which usually begins when the body’s cells don’t properly use insulin, a hormone created by the pancreas.
It is normally associated with older age, obesity, physical inactivity and a family history of diabetes or gestational diabetes during pregnancy, among other factors. (Type 1 diabetes usually strikes children and young adults, though can occur at any age.)
Under Brunswick Novant Medical’s initiative, patients admitted for any reason (except in maternity, where gestational diabetes risk already is closely monitored) received a hemoglobin A1C test. Patients whose measures were 6.5 or greater were alerted they may have the disease, and their primary care physician received a letter reporting the test results.
“Most patients are initially stunned by the results,” said Angie Fisher, RN, Brunswick Novant Medical’s director of clinical improvement. “We want them to understand the seriousness of the results so that they will take action, but we also try to ease their fears by sharing the many community resources available to assist them.”
Amy Myers is director of marketing and community relations as Brunswick Novant Medical Center in Bolivia.