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Published in CenterView on November 21, 2011
Clockwise from bottom left, Kelly Land, Dr. Valyncia Green, Paul Robertson, Lorraine Findley and Bonnie Carminati
Clockwise from bottom left, Kelly Land, Dr. Valyncia Green, Paul Robertson, Lorraine Findley and Bonnie Carminati

UMMC launches group approach to multidisciplinary diabetic education

By Matt Westerfield

Should a person with Type 2 diabetes ever eat chocolate? That was one of the questions posed to a classroom full of diabetes patients recently that drew a flurry of conflicting responses - "yes," "no," "sometimes."

"You can have 'a little bit?'" said nurse practitioner Bonnie Carminati, replying to one patient's answer. "Yes, but how much is a little bit?"

Learning about the right foods - and how much of them - to eat was one of the major concerns patients had during the group education class at the University Physicians Pavilion at the University of Mississippi Medical Center. Combining a group approach with multidisciplinary educators to teach diabetes patients how to manage their disease was an idea hatched earlier this year by nurse practitioners Carminati and Kelly Land, both certified diabetes educators at the pavilion's internal medicine clinic.

The two-hour class has been offered every second and fourth Friday of the month since February. Each session includes an overview of the disease, lessons by a nutritionist, physical therapist and pharmacist, blood sugar checks and lots of Q and A.

Carminati and Land had both worked in previous diabetes clinics at the pavilion and at the Jackson Medical Mall Thad Cochran Center. After those clinics closed, they wound up working together in internal medicine with Dr. Marion Wofford.

Concerned about the sudden absence of diabetes education, the nurse practitioners began brainstorming ways to reach out to patients.

"It just seemed like, in this whole institution, there needed to be something for these patients. So the need was there," Carminati said. "Since we had that background, we felt like something needed to be provided."

The classes begin at 8:30 a.m. with a check-in process that includes taking each patient's history. Many of the patients are new to Carminati and Land, and they represent a wide spectrum, ranging from the newly diagnosed and pre-diabetic to some who have been living with the disease for a decade.

Mississippi has the second-highest rate of overall diabetes in the nation, according to the state Department of Health. More than 270,000 adults in the state have Type 2 or adult-onset diabetes.

"We want to control complications over time," Carminati explained to a class earlier this month. "The complications of high blood sugar over time can be heart attack and stroke - that's the main problem. The main thing we want to keep safe is the heart."

By involving nutritionist Paul Robertson to discuss healthy foods and portion control, physical therapist Nelson Ware to give advice on exercising, and pharmacist Dr. Valyncia Green to answer questions about medications, Carminati and Land developed a multidisciplinary approach that they hope will have a lasting impact.

"The goal is to put them behind the steering wheel and give them the information that's going to help them, because this is not easy," Carminati said. "The more you can help somebody do that, the better their lifestyle is and their quality of life."

Land, who completed her certified diabetes educator course last summer, said she was working in the Division of Clinical Immunology and Allergy years ago when she volunteered to see diabetes patients one day a week at the former medical mall clinic.

"I really enjoyed working with those patients because I felt like I could really help them change their life outcome," she said. "So much of it depends on what they do. They don't realize they just need to change something simple about their lifestyle."

Carminati said they do some one-on-one patient education in their diabetes clinic within internal medicine, and some patients prefer that.

"This is more fun," she said. "I enjoy this because you can reach a real smattering of patients from different backgrounds."

The group approach also allows patients to learn from others' questions and to share frustrations with peers who are struggling with similar issues of changing their diets or trying to become more physically active.

"My problem is, it doesn't take but just a little something to get on my nerves, and I get so aggravated until it just looks like I can't do anything right," said DeLois Trigg during a portion of the class discussing the pitfalls of frustration.

After class, Trigg heaped praise on the program.

"The group was very, very helpful. I know how to cook, but there was a lot I didn't understand about how much you need to eat and when," she said. "The only thing is, I wish we could do this more than once."