Dr Jaime Davidson Discusses Challenges of Access for Patients With Diabetes

With more than 30 million patients with diabetes and only 6000 endocrinologists, that primary care doctor is playing a crucial role in seeing diabetics, said Jaime A. Davidson, MD, FACP, MACE, professor of medicine, Touchstone Diabetes Center, The University of Texas Southwestern Medical Center.

Transcript

What are the challenges that social determinants of health present in diabetes management?

Well one of the challenges is actually to get the patients to be seen on a timely basis. At least in endocrinology we have about 6000 endocrinologists. But not every endocrinologist is willing to see patients with diabetes. We have over 30 million patients with diabetes. So, they need to be seen by the primary care [doctor], and you know in primary care today they actually need to see 40, 50 patients a day. You cannot be fair to a patient with diabetes on a 5-minute visits, because it’s not just glucose—it’s lipids, it’s hypertension, it’s looking at the eyes, looking at the feet. So, the system has to change and allow more time to a doctor who sees patients with diabetes. And that’s one of the big challenges.

The other big challenge is medications that change on a yearly basis, sometimes more than once a year. Supplies that change and they cannot get them. For example, if someone is taking an SGLT2 inhibitor called one name, and all of a sudden, they get to the pharmacy and their care plan doesn’t cover that anymore, it covers something else, the patient gets confused. Sometimes we don’t get a call until 2 months later. So, for a period of time, the patient may not be able to take the medications properly. In insulin, that’s very common.