The New York University College of Nursing’s Nursing Faculty Practice, located at the NYU College of Dentistry, a nurse practitioner (NP) managed primary care practice, launched the Diabetes Care and Lifestyle Center (DCLC) for older adults on January 3, 2011, which includes a comprehensive diabetes management and patient diabetes self-management education and training program (DSME/T). The DCLC was funded by a $130,000 grant from The Fan Fox and Leslie Samuels Foundation.
NYU College of Nursing Dean, Terry Fulmer, a Geriatric Nurse Practitioner and expert in the health care needs of older adults, states “Diabetes ravages older adults and creates untold suffering. The DCLC program helps us to begin to address this monumental issue.”
There are approximately 500,000 adults living in NYC with diabetes, and 38% (195,000) are older adults. Another 33% of all older adults in NYC (900,000) face a considerably high risk of diabetes onset, due to impaired fasting glucose, or pre-diabetes. As a result, the number of older adults affected by diabetes is projected to increase exponentially.
One of the main factors that contributes to effective control of chronic and acute diabetes is patient understanding of and ability to manage this chronic disease. Patient education designed to develop diabetes self-management skills is key to maintaining optimal health. Access to DSME/T programs in New York City is limited; 18 sites currently operate throughout NYC’s five boroughs, and none are strictly dedicated to older adult populations. This is noteworthy, for it shows that taxpayer dollars dedicated to Medicare and Medicaid - programs that help fund DSME/T - are being used inefficiently. Thus, not many older adults either with or at-risk of diabetes take the initiative to receive DSME/T. DCLC is geared towards filling this service gap.
This service gap, states the DCLC Director, Dr. Kelley Newlin, is “related, in part, to a shortage of trained clinicians specializing in diabetes care, especially for the older adult. The DCLC will therefore additionally train annually a cohort of multidisciplinary clinical students from such disciplines as nursing, medicine, podiatry, dentistry, and social work, among others.”
Historically, leading institutional diabetes care teams (IDCT) include the University of Miami, Vanderbilt University, Albert Einstein College of Medicine, and Yale University. However, IDCTs have not focused on the older adult population, and do not include crucial social work services, such as the consideration of economic constraints. The NYU College of Nursing’s NFP design, aims to provide a reproducible, national Diabetes Care and Lifestyle Center model aimed at older adult diabetes self-management and interdisciplinary education. The American Diabetes Association (ADA) recognized the DCLC as a satellite of the NYU Langone Medical Center’s Diabetes Self-Management Education Center (DSMEC).
Now, NYC’s older adults will be able to receive a thorough assessment of their health conditions, and have an algorithm of services developed specifically for each individual. They will have access to services including, but not limited to: diabetes treatment, nutritional advising, social work support, interdisciplinary training programs, and routine monitoring, evaluations, and systematic referral processes with the NYU Langone Medical Center.
DSME/T provides a unique diabetes education by incorporating a collaborative approach to patient care. Patients, families, and health care providers work together in order to achieve ideal diabetes self-management goals, building around knowledge acquisition, skill attainment, and behavioral strategies. This blueprint, combined with the short-term and long-term objectives provided by the DCLC, will allow patients to follow a detailed, realistic method for diabetes treatment and prevention.
About the New York University College of Nursing
NYU College of Nursing is a global leader in nursing education, research, and practice. It offers a Bachelor of Science in Nursing; Master of Arts and Post-Master’s Certificate Programs; a Doctor of Philosophy in Research Theory and Development, and a Doctor of Nursing Practice degree. For more information, visit www.nyu.edu/nursing.