Diabetes

 Dr. Merideth Norris, 16 Winter Street, Kennebunk, ME 04043.

E-mail address: witchdr910@aol.com.

Chronic disease creates many risks for physician burnout. Seemingly every year we are confronted with yet another set of screening and management mandates, a new collection of target lab values, and of course another crop of brand-new medications that are sure to have an impact this time. In the case of the osteopathic family physician, we are also charged with the coordination of care among the many specialists involved with our patients’ many affected organ systems, while keeping an eye on “the whole person” and maintaining an osteopathic outlook.

Despite our best efforts at vigilance, however, the patient may develop unusual or rare complications that are not on the screening list. Meanwhile, the patient may or may not show any interest in participating in his or her own wellness, and even if they do, we may not have time to educate them on how to do so. How, then, can we maintain the enthusiasm and intellectual curiosity necessary for good patient-centered management?

In this exciting issue of Osteopathic Family Physician, we explore the chronic disease of diabetes from several fresh angles. Deborah Meyer, PhD, RN, and colleagues illustrate the well-kept secret that diabetes outcomes are not necessarily positively correlated with the number of specialists participating in the patient’s treatment—another validation for good primary care!

Kenneth Nelson, DO, FACOFP, and colleagues bring us a novel study in which they attempt to identify unifying osteopathic findings in hyperglycemia. This exploration has the potential of demonstrating closer ties between chronic nonmusculoskeletal diseases and palpatory findings, and reinforces the importance of the osteopathic examination.

Katherine Able, DO, and colleagues present a “zebra” diabetes complication, discussing a unique case of double vision caused by microvascular disease involving cranial nerve III. This case is a good reminder that diabetes impacts the entire circulatory system, and clinicians need to be alert for vascular compromise in all regions of the body.

Amber Healy, OMS, and Frank L. Schwartz, MD, write from a true biopsychosocial perspective that examines the impact of socioeconomic stress on glycemic control. This article addresses the role of stress not only on unhealthy behaviors but on the neuroendocrine pathways that moderate the metabolism of glucose.

In the review article by Dennis L. Eckels, DO, we learn the importance of patient-centered diabetes care and tools for its implementation, including the application of continuous glucose monitoring to enhance patient and clinician understanding of the wide fluctuations in levels some diabetics experience.

This issue of OFP is an opportunity to showcase the diverse talents of the osteopathic family physician: we are endocrinologists, social workers, neurologists, and of course we continue to use our hands and our communication skills as two of our most important diagnostic tools. We are also educators and cheerleaders, roles that mandate an energetic and dynamic approach to our work with patients and in our own education. Enjoy this publication and take pride in our many faces.

DO in the news

A herpes simplex virus (HSV) treatment developed by Domenick J. Masiello, DO, is now available to the general public. Dr. Masiello developed Progenn® in 1996 and has used it successfully with his patients since that time. In 1998, the formula was granted US and foreign patents. Progenn® is an all-natural over-the-counter homeopathic medication for the treatment of symptoms associated with HSV-1 and HSV-2 infections.

Merideth Norris, DO, FACOFP

Associate Editor