My apologies for the tremendous delay in getting Part 2 up and out.
Part 2 of Pioneers in Ambulatory Diabetes Education and Advocacy: We started in Pennsylvania!
Jean Kovaleski: MY JOURNEY IN DIABETES SELF MANAGEMENT IN PENNSYVANIA
My journey began in 1979 when Sayee Sanker MD, Endocrinologist, joined the staff of Carbondale General Hospital, Carbondale, PA. I was appointed to develop a Patient Education Department with a major focus in DM. The patient education included learning about the disease and how to self-manage control with diet, medication, Dextrometer blood sugar and Clinitest urine testing, insulin via injection and Auto Syringe Pump.
Diet was based on the exchange system. Medication included Metformin and
sulfonylureas, insulin Lente, NPH, Regular and multiple injection method Novo Rapid. The team included Nurse Educator, Dietitian, Social Worker and a Cardiac Rehab Nurse.
We had a classroom setup for inpatient and outpatient classes and training, an in house TV channel for additional Diabetes Education with Millner Fenwick videos. Patient Education materials were supplied by pharmaceutical companies or, developed in-house. Family members were included in instruction whenever possible. Insurance reimbursement not available for outpatient DSMT.
In 1980 I attended the Joslin Diabetes Management course. In 1981, PA became a Diabetes Control State. I was appointed to the Governors Diabetes Task Force. PA Dept. of Health Nurses were appointed by region to facilitate Diabetes Management. Peg Adams RN was the Northeast Regional Coordinator. A Diabetes Academy was instituted to provide Patient education materials, Diabetes screenings, and Diabetes Foot Care programs.
In 1982, Blue Cross of Northeast PA agreed to supply RFP (request for proposal) for Outpatient Diabetes Training (a DSMT16 hour program based on the Standard of Care)
Carbondale General Hospital’s DSMT under the direction of Peg Adams submitted a
proposal and was one of the first in the nation to receive a $300.00 reimbursement
for Blue Cross participants in the outpatient program.
Additional timeline:
- 1983 Joined the Mid Atlantic ADA board; Attended AADE national Conference in Philadelphia
- 1983 President of Penn AADE a chapter of AADE covering Mid, Northeast and South
East PA
- 1985 President of the newly formed NEADE, Northeast chapter of AADE .
- 1986 Diabetes Treatment Center Of America established a for profit contract with
Moses Taylor Hospital , Scranton , PA. Two Endocrinologists and 2 Diabetologists
were Medical Directors. I was Program Manager. Staff included full time Nurse
Educator, Dietician, Counselor, Exercise Specialist; classroom with steam table for dietary instruction. Calorie and Carbohydrate counting was replacing Diabetes Exchanges;
insulin pens introduced as an insulin delivery system.
- 1987 CDE was obtained by all staff members .
- 1988-89-90-91 Diabetes Taste In supported by DTCA, ADA, Marywood College
dietetic department and numerous pharmaceutical companies: a 3 hour program
attended by 300 people with diabetes to listen to a panel of professionals address
current Diabetes Care Standards. An actual taste of food prepared for a
Thanksgiving dinner of 1800 calories instead of a the typical 3000 calories meal. Recipes were included in handouts .
- 1989 ADA Capitol Hill Climb, Washington DC. Diabetes awareness, need for
Extended reimbursement.
- 1990 ADA became 1 state 1 board combining Western , Mid Atlantic and Philadephia, PA board into one board . I was appointed Board Secretary.
- 1991 Early conclusion of the Diabetes Control and Complications Trials (DCCT) conducted in Pittsburgh, PA of tight blood sugar control of Type 1 diabetes resulted in decreased heart , kidney, eye disease complications.
- 1993 Managed Care Contacts for Home Health agencies were being approved for in home DSMT reimbursement.
If anyone has more stories to share please send them to me, Bob Rossi or any of your PA/DE LNG leaders or CB members.I find the stories fascinating and inspirational and hope all of you do as well.