How a New Diabetes Program Changed My World
This past fall I was invited to a pilot program aimed at helping to educate patients about diabetes, how to manage it and how to make small changes with big results. Immediately prior to joining the program my hemoglobin A1c, which reflects average glucose readings over three months, was 10.8. This is well above the 5.7 threshold for normal blood sugar levels and well above the 7.5 - 8 threshold where complications from diabetes skyrocket.
Thanks to changing my diet, medications and the support of an amazing care team, my A1c is now a much more manageable 6.9.
My journey started with a meeting with Renee Aiken, RN, a nurse care manager at University of Vermont Health Network. Renee asked about my medications, diet, resources available and my individual health care goals. I missed the person I was when my A1c and weight were lower, when I wasn’t so tired all the time and had energy for activities I enjoyed, like taekwondo. Renee seemed personally invested in helping me and connected me to a variety of resources.
My next meeting was with a diabetes educator – where I learned about changes in diabetes care, reviewed nutrition needs, and again, looked at my personal goals. At the end of the conversation, I asked about getting a continuous glucose monitor (CGM) so I could understand the foods impacting my sugar levels in real time.
My next stop was with the clinical pharmacy team – both a pharmacist and a resident. I learned about the medications I was on, and we added a CGM to my care plan and set an appointment for four weeks later. I was not expecting to learn so much so fast – but the CGM really changed my world. I spent the first weeks experimenting with what I ate and drank – individually and in combination.
Having immediate feedback has educated and motivated me in a new way. I want to see the glucose numbers in my healthy range of 80 – 180. Not surprisingly, things like juice spikes hard and fast. Spaghetti with sauce and sausage? Not so bad, but it ultimately depended on whether I ate the sausage first or second. Prunes? They actually lowered the numbers.
I was eager to go back and discuss what I learned. My care team again walked me through things such as the fiber content of various foods, which is likely what caused the small decrease with the prunes. As I observed, I also learned the order in which I eat matters – not just the content – so I eat my proteins first in meals. From here we changed the timing of certain medications and what form I was taking of another.
The Diabetes Care Management pilot program started in Burlington and has gradually broadened to adult and family medicine primary care sites across UVM Health Network in Vermont and northern New York. It was created by a dedicated group of leaders and health professionals passionate about improving diabetes care. By early fall 2024, the project was able to look at early data on the outcomes for patients in the program, analyzing lab values of blood sugar. Early results looked promising: Most patients working with this team-based approach saw their blood sugar levels decline. I’m excited to be among them.
It has been a fantastic experience. I’m learning to manage my diabetes, my overall health and more broadly how I approach other challenges. We’ve been able to lower my daily insulin needs from 40 units daily to 26. I am starting to have more energy for daily activities again. I am looking forward to more learning, problem-solving and balance as we move my treatment forward. This program is key to my health and success as I look forward to what the rest of 2025 has to offer.
