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Washington Diabetes Center Helps Patient to Better Manage His Condition

February 04, 2014

 Center Offers the Tools and Support Needed to Manage Diabetes Effectively

In June 2013, Chandra Shekar-Reddy decided to attend a health fair held at Tesla Motors, where he works. Conducted by health-care professionals from Washington Hospital, the event changed his life.

"I decided to have a blood test," he recalls. "The test results showed I had a blood sugar level of 300. Since I had just had a drink of Gatorade, the nurse asked me to come back in about two hours to repeat the test. The second test showed a blood sugar level of 320, so the nurse recommended that I see a doctor for further testing to see if I had diabetes. The results surprised me because I'm only 34, and I didn't have any noticeable symptoms of diabetes. I did have a family history of diabetes, though. Both my grandfather and my father had diabetes."

The nurse who tested Shekar-Reddy that day was Vida Reed, RN, CDE, a certified diabetes educator and Program Coordinator of the Diabetes Program at Washington Hospital. Vida states that testing done at a health fair by finger-stick is not considered a definitive diagnostic screening for diabetes, and patients should always follow up with their doctors.

A "fasting" blood sugar test measures blood sugar after the person has not eaten for at least eight hours and is the most common laboratory test used to screen for diabetes. Pre-diabetes is diagnosed when the level is 100 to 125 milligrams (mg) per deciliter (dL), and the risk for type 2 diabetes increases if changes in lifestyle are not implemented. A blood sugar level of 126 mg/dL or higher most often means the person has diabetes.

"I followed the nurse's advice and went to see Dr. Michael Parmley, a primary care physician with Washington Township Medical Foundation," says Shekar-Reddy. "He ordered comprehensive blood tests, as well as the A1C test to evaluate my blood sugar levels over a longer period of time. My A1C level was 9.6 percent. My triglycerides also were high at 561, and my total cholesterol level was borderline high at 191. I also was diagnosed with abnormal thyroid hormone levels."

The A1C test, which measures how much glucose is stuck to red blood cells, also can be used to diagnose diabetes, but it is most often used to assess the risk for developing unhealthy complications in a person with diabetes. The A1C test calculates the personÕs average blood glucose level over the past two to three months. Diabetes is usually diagnosed for an A1C level of 6.5 percent or greater.

Normal levels of triglycerides are below 150; levels above 500 are considered very high. The ideal range for total cholesterol is below 200 mg/dL.

"Dr. Parmley put me on a diabetes medication to help lower my blood glucose and treat the high triglycerides and cholesterol," Shekar-Reddy notes. "He also referred me to Dr. Prasad Katta, an endocrinologist with the Washington Township Medical Foundation."

Both doctors recommended that Shekar-Reddy enroll in the outpatient diabetes education program at Washington Hospital to learn how to self-manage his diabetes.

"The classes I attended taught me a lot about how the medications work and the importance of diet and exercise," he explains. "I also learned about things such as controlling food portions and how to read food labels. I was born in India, and I love Indian food, which often has a lot of carbohydrates. As a result of what I learned, I have made changes such as reducing the amount of white rice in my diet and avoiding other starchy foods and fried foods.

"One of the best parts of attending the classes was meeting with other patients: some of whom had been diagnosed with diabetes for a long time," he adds. "The other patients shared their experiences of what worked and what didn't work for them. They inspired me."

The classes Shekar-Reddy attended are offered through Washington Hospital's Outpatient Diabetes Center, which is recognized by the American Diabetes Association as a program providing evidenced-based self-management education.

"Our diabetes self-management training program typically provides about 10 hours of education during four sessions, in addition to an individual 30-minute session for each patient with a dietitian and a nurse with specialized training in diabetes," Reed explains. "We have classes in the mornings, evenings and on Saturdays to accommodate people's schedules. We also offer individual instruction for people with language barriers or work schedules that preclude attending the group sessions."


The diabetes self-management training program at Washington Hospital includes instruction in the seven self-care behaviors recommended by the American Association of Diabetes Educators (AADE). The AADE7 Self-Care Behaviors include:

* Healthy Eating: Making healthy food choices, understanding portion sizes and learning the best times to eat.

* Being Active: Determining appropriate levels of exercise to improve blood sugar and lipids control, enhance weight loss and reduce blood pressure and stress.

* Taking Medication: Learning how various diabetes medications work, including their actions, side effects, efficacy, toxicity, proper dosage and timing of administration.

* Monitoring: Daily self-monitoring of blood glucose levels and regular checks of blood pressure urine ketones and weight.

* Problem Solving: Developing problem-solving skills to make rapid, informed decisions about diabetes management, overcome obstacles and develop coping strategies.

* Reducing Risks: Learning about effective risk-reduction behaviors such as smoking cessation, blood pressure monitoring and having regular eye, foot and dental examinations.

* Healthy Coping: Identifying motivations for changing behavior, setting achievable behavioral goals, and overcoming various obstacles Ð learning what you can control and ways to cope with what you cannot control.

"I was lucky to find out early about my high blood sugar levels before any symptoms developed," Shekar-Reddy says. "It's good to get blood sugar levels checked every year, especially for people who have a family history of diabetes like I do. I now do my own blood sugar test at least once a day and go in once every two months for more comprehensive tests with my doctors."

In addition to diabetes self-management training, the Outpatient Diabetes Center offers free monthly "Diabetes Matters" classes on the first Thursday of each month (except July) from 7 p.m. to 9 p.m. The first hour features expert speakers who provide science-based information about diabetes. The second hour features group discussions about managing diabetes. The next Diabetes Matters class on February 6 will focus on "Diabetes and Heart Disease," featuring cardiologist Dr. Sanjay Bindra as the guest speaker.

"For people with diabetes, I highly recommend the classes at Washington Hospital," Shekar-Reddy emphasizes. "They will get valuable information about diabetes. The group discussions are very helpful, too. I learned a lot from other people's mistakes and successes. My A1C has come down to 6.2 percent. My triglycerides and cholesterol have come down, too. I'm not as hungry as I used to be, and I am much more energetic. It feels great!"

To learn more about the programs available through the Outpatient Diabetes Center at Washington Hospital, visit www.whhs.com/diabetes/.