A Novel Clinic For Adults Dealing With Type 2 Diabetes - “Diabetes 360”

The "3600 Diabetes Clinic" at the Endocrine Institute, Sheba Hospital, is a unique healthcare model designed for Type 2 diabetes adults over the age of 60. The clinic operates the "Integrated Patient Unit" model, aiming to assess and address various aspects of the patient's health through a comprehensive evaluation. Patients undergo a 6-hour meeting with a team includes: Physical therapist, dietitian, endocrinology MD, psychologist, and nurse. The goal is to determine the patient's risk to functional decline. The assessment Outcome Measures includes 1. Physical Condition Assessed through physical capacity tests (6min walk test, 30 sec sit-to-stand, grip strength, etc.), risk of falls (Timed up & go test, 10m walk test, etc.), and adherence to physical activity recommendations. 2. Nutritional status Assessed by evaluating protein consumption, BMI, etc. 3. Medical Indices: Including HbA1c, blood pressure, and other relevant medical measures. 4. Cognitive & Emotional Status: Evaluated through various assessments. The Interventions includes Case manager summary that provide the patients with a list of recommendations for intervention. Patients requiring intervention receive nutritional counselling, tailored physical activity training, fall prevention programs, medical monitoring, and cognitive therapy. FOLLOW-UP RESULTS: Health Improvements: Over nearly two years, improvements include a 0.9% decrease in average HbA1c, a 30% improvement in fasting glucose levels, and enhanced physical capabilities (evidenced by improved TUG test and grip strength). Nutritional Indicators: Positive changes observed, such as a 35% increase in protein consumption and a trend towards lower BMI among overweight/obese patients. Emotional Well-being: Significant improvement noted in emotional indices according to PHQ9 and WHO5 questionnaires. CONCLUSION: The clinic's model has proven successful in improving the health status of adults with diabetes. The positive outcomes and the clinic's unique approach make it an inspiration for other healthcare clinics in Israel. The integrated approach, involving multiple health professionals and comprehensive assessments, appears to contribute to the success of the clinic's model.