Clinic helps people with diabetes find the right combination of diet, exercise, and insulin therapy

Since opening last October, University of Iowa Health Care's Intensive Insulin Therapy Clinic has been helping people ages 16 and older gain and/or maintain control of their diabetes, especially type 1 diabetes.

The clinic, which brings together physicians, nurses and dietitians in one care center, helps people take advantage of diabetes treatment advances.

"Good blood glucose control requires structured dietary and exercise therapy along with intensive insulin therapy," said Gregory Doelle, M.D., associate professor (clinical) of internal medicine. "Intensive insulin therapy can mean multiple daily insulin injections or the use of an insulin pump. Good control also requires many health care providers who are involved on an ongoing basis with patient management."

The clinic helps people already using or who want to use an insulin pump, which substitutes for multiple daily needle-stick injections.

"The pump system allows more precise insulin dosage and gives people who use it more flexibility," said Vicki Kraus, A.R.N.P. "People who use the pump can more easily deal with altered meal times or content. The device also is very accommodating for people with highly variable levels of daily activities, such as construction workers or people who work two shifts."

People who choose to use the pump are initially closely followed with weekly or more frequent clinic visits. Telephone check-ins then help patients as they learn to work with the device to maintain good blood sugar.

Newer technology also helps the clinic professionals assess patients for possible use of the pump or for the need for changes in their insulin dosages. An implantable 72-hour glucose sensor, which monitors blood glucose sugar every five minutes, provides a detailed pattern of highs and lows so that insulin use can be more easily and accurately be adjusted.

In addition to Doelle, the clinic's staff includes two other internal medicine physicians, three nurse diabetes educators, and a dietitian.

For more information, call UI Health Access and ask for the Intensive Insulin Therapy Clinic. If you want to find whether you might have diabetes, call UI Health Access and ask for information about free diabetes screenings.

Barbara Bezoni, R.N., teaches diabetes care to patient Travis O'Toole of Centerville, Iowa.