DIABETES A new approach: Hospital changes tactics against Delta Killer

By BOB DARDEN Staff Writer Greenwood Commonwealth: Health and Fitness

Diabetes has been called the silent killer. Greenwood Leflore Hospital, with the assistance of Dr. Joseph Assini and others, is aiming to take on diabetes in a major way in the next three to six months with a new, multi-disciplinary approach to treating it and an expansive educational component to help people prevent it.

“The Delta is the epicenter in the country for patients having diabetes. ” said Assini, 58, a New York podiatric medicine physician and surgeon, who came to Greenwood 11 months ago.
About six months ago, Assini met with the hospital’s board of trustees, physicians and Jim Jackson, the hospital’s administrator, in a far reaching effort to begin combatting diabetes in a coordinated way.

Diabetes in the Delta, Assini said, is at “endemic levels” now —–  meaning it is regularly found among people or in a certain area. Soon, he said, diabetes will reach the pandemic or epidemic level in the region.

Already, he said, one in three hospital patients have diabetes in their medical histories. At the same time, many people aren’t even aware they have diabetes.

The on-going discussions at the hospital have been encouraging as the group forms a multi-disciplined approach to the problem of diabetes.“Since diabetes really affects many systems of the body, the eyes, the kidneys, the feet, circulation, the neurological system, we need to give the patient the very best of care. To educate the patient, we need to put together a multi-disciplined team approach to the problem,” he said.

Prior to the adopting of this team approach, discovering and treating diabetes was often a haphazard affair, Assini said.“Before, you would see an internist, who would really not coordinate his findings with a neurologist or a cardiologist or a gastrointerologist — diabetes affects all these systems. We found the best way to prevent and to help the quality of life, is to have a multi-disciplined approach to the problem,” he said.

Too often in today’s field of medicine, “One hand doesn’t know what the other one is doing,” Assini said.

A Key Piece Already in Place

One of the first components to the coordinated response to diabetes will be fully utilizing the hospital’s Diabetic Education Center, which has been operational since 1996.
The center — one of only two in the Delta — was accredited by the  American Diabetes Association in August 2011.
The center, under the supervision of Medical Director Dr. Henry Flautt, receives referrals from physicians and nurse practitioners. Patients referred to the center can receive general diabetic training, insulin dependence training and monitor training by a registered nurse.
It also provides educational courses for those living with diabetes.

Assini said all the components of the program are similar to spokes on a wheel with the patient at the center, or hub. “Since it affects every organ in the body, we need to involve every discipline in the care of the patient,” he said.

“When you have a coordinated effort, all under one roof, with these specialists in constant dialogue. We feel this is going to ultimately  decrease the disease to a significant extent and ultimately the end-stage disasters that happen so often, like amputations and kidney disease that requires dialysis and transplantation,” Assini said.

“If we can coordinate this, it could mean significant savings to the healthcare system,” he said.
Assini said that the effort will yield fruit.“We feel that through this approach, we would be doing a tremendous service, not only for the people of Greenwood, but for the whole Delta region,” he said.

A New York State of Mind

Assini, knew that diabetes was prevalent in the Delta long before he first set foot in Greenwood.“Certain regions of the country have bits and pieces of this. When I came here, I had this dream,” Assini said, of creating a comprehensive approach to combatting diabetes.
“I come from New York and yes, there’s some of this up there, but the disease here is so far advanced that we have people in their 40s with strokes and amputations. Up north, that may not happen until they are in there 70s and 80s,” he said.
There’s a disconnect in families dealing with diabetes. ‘My grandfather had it, so I’ll have it.’ It doesn’t have to be a fait accompli,” Assini said.
“I had a person in my office not too long ago, a 13-year-old man, and he’s almost 400 pounds. That sets off red flags. The grandfather had diabetes, the father had diabetes,” Assini said. Breaking that intergenerational cycle of hypertension and obesity in families is key to beating back diabetes, he said. Assini said obesity is the No. 1 precursor for developing diabetes. He also said education is the No. 1 way to stop the spread of the disease.

Prevention Not Treatment

Assini said the ultimate goal of the coordinated approach is to educate the public about what they can do lessen the chances of developing diabetes. Whether it’s eating healthy or exercising more, every little bit can help.“It’s a real pro-active approach, as opposed to having someone come in with the problem and then having to treat the problem,” he said.
The combined approached, coupled with that diabetes education “cog in the wheel,” makes a lot of sense, Assini said. Education is critical component in the hospital’s plans, Assini said.
“Education is power and motivation for success in anything.

This multi-disciplined team approach understands that. We can go out and fish net the people. I’m a doctor. I want to make a difference in someone’s life,” he said. While learning healthy lifestyles may be difficult, it can soon become “second habit” to those who understand the dangers and then can avoid them, Assini said. Assini is ready to do missionary-like work to get his message across, adding, that he plans on going to schools to preach his message.

Assini said he hopes that the new marketing plan for the combined effort with be something along the lines of “Greenwood Leflore Hospital — The Delta’s Diabetic Center of Excellence.” Again, Assini used the wheel analogy.
“When you have everybody turning the wheel at the same time, it will make a tremendous improvement,” Assini said.

He said the hospital will have an open door policy.
“We’re not going to turn down anyone that has diabetes regardless of insurance or the ability to pay. We want to provide this service to the people of the Delta. We have to make this a standard of care issue,” Assini said.
Contact Bob Darden at 581-7239 or bdarden@gwcommonwealth.com.