10C. Shared Integrative Medicine Medical Visits for Type II Diabetes Mellitus: A Case Study Presentation

Focus Areas: Integrative Approaches to Care, Supporting Behavioral Change Diabetes affects approximately 26 million adults and is a leading cause of death and disability in the United States (CDC, 2011). Diabetes disproportionately affects individuals from lower socioeconomic status groups, the same individuals with limited access to healthcare resources (CDC, 2011). Thus, there is a critical need to provide affordable and effective care to these at-risk individuals. In order to meet this need, we developed and implemented a unique integrative medicine (IM) “Shared Medical Visit” approach to diabetes management at a Free Health Clinic. This initiative uses IM techniques and tenants to improve the health and well-being of low-income men and women with Type II diabetes mellitus. The Shared Medical Visit model allows patients to provide and receive social support and learn from others' experiences while receiving high-quality medical care. Visits occur monthly and include 8 to 15 patients, 1 IM physician, and 1 Clinic Primary Care Physician (PCP). The IM physician leads the 90-minute group while the PCP provides individual, private visits as needed. The IM physician's goals are to promote healthy group dynamics, respect, and healthy behavior change. The visits provide several interventions, including nutrition education (eg, whole foods), healthy cooking demonstrations, and food tastings; mind-body stress reduction exercises (eg, mindfulness, breath-work); and physical activity (eg, walking groups). While we did not formally assess outcomes, group members subjectively reported an increased sense of community, appreciation of food tastings, and overall health improvement. One participant reported improved hemoglobin A1C, less medication use, and understanding how stress and sleep contribute to glucose control. The nurse manager reported that participants who attend these visits keep their clinic appointments more often than those who do not. Groups are consistently filled and have been running continuously for 21 months. Plans are underway to formally assess the impact of the group visits on health outcomes.