Diabetes Management. for River Valley Ranch Health Services. Reviewed by Camp RN If the participant has been diagnosed with diabetes and is under the age of 18, …
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Center for Diabetes and Endocrinology at Saint Marys Health Care
Expanding the Specialized Care Team
By Patrice Mindock
A major expansion of specialized care services and medical staff is underway at the Center for Diabetes and Endocrinology at Saint Marys Health Care in Grand Rapids Two new physicians will be joining Philip W Tate, MD, MS, on the diabetes treatment team Dr Tate is the current medical director for the center and is board certified in internal medicine, endocrinology and metabolism With approximately 18 million Michigan residents and almost 20 million people nationwide diagnosed with diabetes, Dr Tate says theres a growing need for specialty care Diabetes in particular has become increasingly complicated, due in part to new classes of drugs with which to contend, he says Theres greater understanding of the various mechanisms regulating energy balance in the body, such as glucose control We now have new tools we can apply to that Some of the insulin analogues are dramatic improvements over the old NPH insulin The thiazolidinediones or TZDs and the incretins, such as the GLP-1 agonist and DPP4 inhibitors have also been effective adjunctive therapies
As physicians, we are continually educating ourselves on where and how to apply this new technology as it becomes available DRS ROOD AND COLLINS JOIN THE PRACTICE One of the two new physicians coming to the Saint Marys Center for Diabetes and Endocrinology is Robert S Rood, MD, a diabetologist with an extensive background in endocrinology When I first started practicing, we basically had two drugs, Dr Rood adds There was
Joining the practice in August, endocrinologist Emilie Collins, MD, will focus on womens endocrine issues and diabetes
Center for Diabetes and Endocrinology
Specialty Services at a Glance: Diabetes Diabetes and Pregnancy Gestational Diabetes Intensive Insulin Therapy Insulin Pump Program Continuous Glucose Monitoring High Blood Fat Disorders Thyroid Disorders Calcium Abnormalities Pituitary Dysfunction Hirsutism Osteoporosis Saint Marys is also widely recognized for specialized care for unusual and rare endocrine conditions affecting the thyroid, pituitary, and adrenal glands and ovaries, testes and pancreas
PHOTO COURTESY OF DR EMILIE COLLINS
insulin and the sulfonylureas to stimulate the pancreas to make more insulin There was nothing to help
impact insulin resistance like the TZDs The ongoing research into new medications is vital to helping the increasing number of people being diagnosed with diabetes Dr Rood says one of the main reasons he decided to affiliate with the Saint Marys diabetes program is the multidisciplinary clinics ability to provide a range of necessary patient services from dilated eye examinations to nutritional counseling You can inform a patient that they need an eye exam for macular edema or a consultation with a nutritionist, but half the time, they wont follow through on those recommendations, he says Having those options available in one center makes it easier to reach target glycemic goals and avoid some of the medical complications that can result from uncontrolled diabetes At Saint Marys, specialized care is offered for patients adolescent and older Type 2 diabetes accounts for about 90 to 95 percent of all diagnosed cases of diabetes, according to the FDA The team treats the range of complications associated with diabetes mellitus, the development of diabetes during pregnancy, hypertension, hyperlipidemia and impaired glucose intolerance Programs are individualized to treat most endocrine
or metabolic disorders Other specialized care patient groups include those with kidney failure, diabetic peripheral neuropathy, cardiovascular disease related to diabetes and visual impairment The Saint Marys Diabetes Program is National Committee for Quality Assurance NCQA certified, recognized by the American Diabetes Association of West Michigan and certified by the Michigan Department of Community Health
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PHOTO BY ANTHONY DUGAL PHOTOGRAPHY
Robert Rood, MD, left diabetologist, will soon join the Center for Diabetes and Endocrinology at Saint Marys Health Care Philip Tate, MD, right is medical director for the practice
Dr Rood is expected to be available to begin seeing Center patients in July Regarding his title as a diabetologist, he says, There is no board certification in diabetology yet, although it is a recognized specialty Diabetes became his major focus, in part due to a family history of the disease and the influence of his private practice association with the clinic founded by his mentor, the late Keats Vining, MD Dr Vining was considered an expert in diabetes in west Michigan and he always believed that blood
sugar control mattered, long before the rest of the field embraced the concept, he explains People scoffed at his insulin injection routines, and it turned out that he was right Dr Rood is a member of the International Diabetes Federation and has studied extensively in Europe with experts Dr Tate palpates the thyroid of a patient on the cutting edge of diabetes research I intend to continue studies on inhaled insulin and the GLP products, including polycystic ovarian syndrome PCOS Its characterized Dr Rood states In the works is a once-per-week injection that helps with insulin resistance similar to diabetes, fertility issues, hirsutpeople lose weight and lowers their blood sugar I think many patients ism and central obesity, she adds I find treating the physiologic are going to want to try that and cosmetic aspects of PCOS interesting Other interests include The second new physician — joining the team in August — is osteoporosis caused by low estrogen levels in post-menopausal Emilie Mennel Collins, MD, currently a Fellow in the Division women, osteomalacia in adults related to vitamin D deficiency of Metabolism, Endocrinology and Diabetes at the University of and low bone
mineral density as a result of chronic renal disease Michigan Health System Saint Marys caught my attention as it In addition, Dr Collins sees the rising rate of obesity in the US seemed to have a good mix of general endocrinology and diabete 
s, as one of the factors for challenges she will face in treating Type 2 she says I am looking forward to having the opportunity to discuss diabetes in the near future interesting cases with Dr Tate and Dr Rood, as well as interacting She also hopes to explore potential research and teaching opportuwith the team of NPs, RNs and support staff For me, interacting nities There are a number of new medications under investigation with colleagues is what makes medicine exciting I feel the Center at which may have an impact on insulin resistance, weight loss and other Saint Marys will be a good work environment with an intense focus issues surrounding diabetes, Dr Collins adds Saint Marys ongoing on positive patient outcomes epidemiology projects and the new MSU medical campus in Grand Dr Collins personal interests include womens endocrine issues, Rapids may also provide new avenues of research or teaching I would enjoy giving didactic endocrine
lectures to Dr Rood has the patient perform the Phalens test, an indicator of diabetes first or second year medical students or to work with third or fourth year students on their clinical rotations ADVANCES IN TECHNOLOGY The most promising advances in diabetes treatment are coming in the form of insulin pump technology, according to Dr Tate The manufacturers are now in the process of linking glucose level in tissue fluid to the infusion pumps, he says Its essentially a closed loop for regulating insulin levels, since patients wont have to adjust dosage to actual blood sugar readings The more sophisticated devices will do that automatically and may become the standard of care within the next decade Dr Rood is also anticipating the newer models The pumps currently read the blood sugar levels, but the patient still has
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PHOTOS BY ANTHONY DUGAL PHOTOGRAPHY
has to react to that, he notes The newer sensor models will perform like an artificial pancreas and thats exciting There is such solid evidence that improving glucose control decreases the frequency of long term complications such as vascular disease, neuropathy and kidney
problems, Dr Tate stresses A MULTIDISCIPLINARY TEAM APPROACH The multidisciplinary team at Saint Marys includes nurse practitioners specializing in diabetes, pharmacists, certified diabetes educators and registered dietitians Along with the focus on patient education, there are also optometrists involved at the center On-site resources include the consumer information library, classrooms, and a demonstration kitchen Diabetes patients have A member of the multidisciplinary team, Chanel Kerschbaum, RD, is an educator who works with convenient access to the comprehensive patients dietary issues management and education program at Saint Marys Health Care, which works to coordinate treatments with the Philip W Tate, MD, MS, graduated from the Medical College of Wisconsin primary care physicians or any specialists for better long-term outand completed post-graduate training in internal medicine and endocrinology comes After-hours and weekend call are provided to offer Center also at the Medical College of Wisconsin Dr Tate also received an MS in clinipatients and other health care professionals consultation on matters cal research design and statistical analysis from the University of
Michigan in pertaining to their endocrine or metabolic disease Saint Marys also 1991 Dr Tate came to Grand Rapids in 1983 and entered private practice at partners with the Michigan Athletic Club to offer Diabetes Wellfit Saint Marys In 1991, he took an opportunity to move to Saudi Arabia for two classes These group classes focus on physical exercise and education years Upon his return, Dr Tate joined Butterworth Hospital now Spectrum specifically for patients with diabetes Health internal medicine faculty, eventually becoming the program director for We often hear diabetes referred to as an epidemic, Dr Tate says the internal medicine residency Dr Tate joined the Wege Center for Diabetes While the numbers of diagnosed diabetes cases are on the rise, it and Endocrinology in 2000 should also be noted that health care providers can now screen more accurately for diabetes and metabolic disorders The advances in Robert S Rood, MD, is a 1974 graduate of Michigan State University College technology related to endocrinology also allow us to find more thyof Human Medicine He did his internship at Blodgett Memorial Medical Center roid disease, thyroid nodules and cancer In addition, better
imaging and his internal medicine residency at both Blodgett and Saint Marys Hospitals options can locate tumors in the pituitary gland and increase the opin Grand Rapids Dr Rood completed his fellowship in diabetes at the Harvard portunities for treating our patients more effectively affiliated Elliot P Joslin Clinic at New England and Deaconess Hospital in Boston He has maintained a private practice as part of Grand Rapids Associated Internists Janette Buhl, nurse practitioner, exams the foot at each visit since 1978 and is an assistant clinical professor of internal medicine at MSU Emilie Mennel Collins, MD, is currently completing her fellowship in metabolism, endocrinology and diabetes at the University of Michigan Health System She completed her internal medicine internship and residency at U of M and received her MD from the University of Texas Southwestern Medical School in Dallas Dr Collins received her MS in clinical research design and statistical analysis from the University of Michigan in 2007 She is presently working on an investigation into the relationship of hepatitis C virus genotype 1 infection and hepatic insulin resistance
For more information:
The Center for
Diabetes and Endocrinology is located in the Peter M Wege Center and may be reached at 616-732-3098 For further information on Saint Marys Health Care, visit http://wwwsmhealthcareorg/ or call 616-752-6090 Saint Marys Health Care is a member of Trinity Health
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Source:smmmc.org
