Treatment models from the International Diabetes Center: advancing from oral agents to insulin therapy in type 2 diabetes
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OBJECTIVE: To discuss treatment models used at the International Diabetes Center (IDC) and present strategies for transitioning patients with type 2 diabetes from orally administered medications to insulin therapy. METHODS: The experiences of the IDC in developing and improving patient care and educational programs are reviewed. In addition, clinical outcomes and economic results are highlighted. RESULTS: In the management of chronic conditions such as diabetes, the patient is a crucial member of the health-care team. Therefore, patients must understand and endorse treatment goals. Key components of the patient-centered IDC treatment model are group instruction focused on behavioral change, worksite education and coaching programs, and treatment algorithms to help clinicians identify treatment priorities and initiate appropriate therapeutic strategies, including early and more effective use of insulin therapy. CONCLUSION: The IDC patient-centered team model aimed at helping patients live well with diabetes has been shown to improve achievement of glycemic, lipid, and blood pressure goals, and it is economically viable. One approach to helping more patients with type 2 diabetes reach glycemic targets is for clinicians to become more comfortable with, and therefore more aggressive in, initiating and adjusting insulin therapy.
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