Endocrinology eConsult

Diabetes with Hypertension

Diabetes with Hypertension

SPECIALTY
Endocrinology eConsult

CHIEF COMPLAINT
Diabetes with Hypertension

COMMENTS TO SPECIALIST
This is a 59-year-old, new to me this month, with uncontrolled Type 2 Diabetes Mellitus (T2DM) with associated neuropathy, angiopathy, hyperlipidemia and obesity. She has above-knee amputation from poorly controlled diabetes. Her most recent A1C on 4/3/23 was 9.9%, currently taking metformin 1000 mg BID, Jardiance® 10 mg daily, and Lantus ® 30 Units BID, taking atorvastatin 10 mg daily for hyperlipidemia (HLD). She has previously taken Glucagon-Like Peptide 1 Receptor Antagonist (GLP1RA) but did not tolerate d/t nausea. Currently, she is having post-prandial nausea, requiring Zofran ® 1-2 times daily, with no notable weight loss as a result.

Additional chronic medical conditions include hypertension (HTN) with diastolic heart failure (HF), no longer requiring antihypertensives; she also has COPD with chronic respiratory failure, anxiety/depression, chronic pain, and an overactive bladder.
I would appreciate any recommendations for getting better control of her diabetes.

Thank you for your time.

MAIN QUESTION

How do I optimize diabetes management?

diabetes with hypertension containment rates

Common Challenges to Achieve Clinical Quality Goals: Containment

Containment in healthcare involves equipping providers with the appropriate recommendations to effectively manage a patient’s care within their practice without the need for unnecessary referrals or consultations outside of the practice. This is particularly important in ensuring efficient resource utilization and reducing healthcare costs while maintaining high-quality care. Collaboration between the practice and eConsult providers is crucial in this process.

By working closely together, healthcare teams can assess patient needs more comprehensively, share relevant information seamlessly, and leverage specialist expertise when necessary, all while keeping the patient’s care within the primary care setting when possible.

Containment is impacted by:

Specificity of the eConsult request and inclusion of appropriate patient history and testing

One critical factor that impacts containment is the specificity of eConsult requests and the inclusion of appropriate patient history and testing. When healthcare providers submit eConsults with clear and detailed information about the patient’s condition, medical history, and relevant tests, specialists can provide accurate and targeted recommendations. This specificity helps avoid unnecessary procedures, tests, or consultations, reducing healthcare costs and improving efficiency. Additionally, thorough documentation of patient information ensures that healthcare decisions are based on a comprehensive understanding of the patient’s needs, leading to better clinical outcomes and overall satisfaction with care. By emphasizing the importance of detailed eConsult requests and comprehensive patient information, healthcare organizations can enhance containment efforts and optimize resource utilization while delivering high-quality care.

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