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Blog 3: Marie’s Story—Getting Help to Gain Control Over Diabetes

(August 31, 2021) – Marie was not the ideal diabetic patient, given the hurdles she would have to overcome to get her condition under control.  But, with some expert help, and support from her family, she became a near perfect patient success.

Marie is the fictional name given to an actual, real-life participant in Veritas Healthcare Management’s personalized program to improve employee health and reduce healthcare costs.  Ernie Vesta, M.D., Chief Medical Officer for Veritas, discussed challenges like Marie’s in a recent Veritas podcast on diabetes.

Dr. Vesta gives a refreshingly honest assessment on the difficulty of getting diabetes–specifically, Type II diabetes–under control:  There is no quick fix.  This is a long journey.  It’s a difficult task.  It took a long time (for the patient) to get there and will likely take a long time to get this under control.

Having helped hundreds of diabetics gain control of their condition, Dr. Vesta and his team understand firsthand just how difficult it is to get a person’s diabetes under control.  The team also knows, though, how rewarding it is to participate in a diabetic’s journey to improved control and health.  Marie’s is the story of one such journey.

An immigrant with her family to the United States from Mexico, 49-year-old Marie was a very hard worker.  She held both full- and part-time jobs to make ends meet for her family.  During a routine biometric screening provided through her employment, a Veritas nurse discovered that Marie had a glucose reading of over 400 mg/dL and a BMI around 44.  Glucose readings are considered normal if below 140 mg/dL.  BMI readings are considered healthy when in the range between 18.5 and 24.9.

Immediately, the nurse arranged for Marie to meet privately with Dr. Vesta to address her health issues.

As is often the case, the visit with Dr. Vesta led to the discovery of multiple issues in need of attention.  In addition to the out-of-control blood sugar and BMI, Marie had developed swollen and cracked feet as well as fungal infections that made walking extremely painful.  She did not have a physician and was very skeptical of the medical community.

The Veritas nurse explained to Marie that she needed an advocate to help her build and stick to a long-term plan. The nurse also convinced Marie that she needed her family to participate in developing her care plan.  Marie agreed, and her family immediately became part of the necessary support system.

The first difficult hurdle along Marie’s journey was to get her to connect with a local physician.  For that important first step, the nurse agreed to attend every appointment with her.  From then on, the nurse would explain to Marie and her family everything the doctor was going to do and why it was important.

The doctor placed Marie on medication and referred her to a foot specialist.  The doctor also explained to Marie that it was important for her to work with the Veritas nurse to make significant lifestyle changes.

The second hurdle to be overcome was Marie’s fear.  She had a strong resistance to pricking her own finger to get a regular glucose reading.  She also feared technology and simply could not be taught how to enter her glucose readings into the scorecard Veritas developed to track her progress.  The scorecard is a critical tool in achieving control over diabetes.

To overcome this second major obstacle, the Veritas nurse trained Marie’s daughter in obtaining the glucose reading and entering the results on the electronic scorecard for her mother.

Getting Marie to agree to a long-term diet that is low in sugar and calories was the third hurdle to overcome.  The nurse realized that she had to make some compromises to gain Marie’s compliance; Marie was not likely to commit long term to a diet requiring her to forgo some foods she loved to eat.

The nurse agreed to permit some unacceptable foods in Marie’s diet if she would agree to cut down on the portion sizes of those foods.  After some negotiation, Marie and her nurse agreed to a customized diet.

The fourth hurdle was developing an exercise program that would be effective and sustainable.  The process of developing the program revealed additional barriers to overcome.  For one, Marie did not have enough money to join a gym or purchase in-home exercise equipment. She also lived in Wisconsin, where it would be difficult for her to exercise outdoors during the winter months.

With a little effort, Marie and the nurse developed an exercise program that could be done in her house without equipment.

Over the next six months, Marie met with the Veritas nurse once or twice a week. They made regular adjustments to the plan they developed and were able to achieve great results.  Marie dropped her BMI to 36, her blood sugars were consistently in the low 100’s and her feet were fully healed.  Marie’s Veritas nurse said it was a moving experience to celebrate this accomplishment with Marie and her family.

Moving forward, Marie needed less frequent meetings with the nurse because she became more disciplined at following the plan.  As a result, she continued making progress in her health, as she could see by recording all her clinical markers on the scorecard Veritas created for her.

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