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High glucose levels need proper diagnosis
Follow-up is key to successful glucose screenings for diabetes. Although resources may prohibit health care institutions from contacting patients directly to make sure they have seen a physician after an elevated glucose test, it’s possible to provide resources for patients.
"If patients have a high glucose level, I tell them to get further testing from their physician, and if they are diagnosed with diabetes, they can come back for one-on-one teaching," says Rita Smith, MSN, RN, coordinator of clinical education at Provena Mercy Center in Aurora, IL. Those with abnormally high blood sugars are escorted to the emergency department so they can receive immediate treatment.
Most of the people screened have a physician, but if they don’t, Smith refers them to a local clinic that provides service on a sliding payment scale. She also makes sure they are aware that Provena Mercy Center has a diabetes support group that is education-based. At each monthly meeting, a different diabetes topic is covered and a team of health care professionals attend, such as a dietitian, pharmacist, and nurse, to answer patients’ questions.
During community screenings conducted by the Specialty Center for Diabetes Care at Saint Joseph’s Hospital of Atlanta, information sheets on people who test positive are set aside for follow-up. "When I get back to my office, I make a note to call those people a week later," says Amparo Gonzalez, RN, CDE, center director. At that time, she checks to see if they have made an appointment to see their physician.
When people who are screened do not have access to health care, they are referred to either the county hospital, which has an excellent diabetes program, or one of its satellite clinics. Gonzalez has assembled a list of resources in order to make referrals for all patients who may have diabetes — whether or not they have health care insurance. "Because Atlanta has a growing foreign population, there are many clinics serving these populations in their own languages with sliding-scale payment, and we keep track of that information," she says.