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Case Study: Care Coordination and Case Finding of Undetected Depression in a 72-Year-Old Man With Type 2 Diabetes

The first 300 words of the full text of this article appear below.

	Presentation

 
In 2001, M.G., a 72-year-old white man, enrolled in a diabetes management program sponsored through his health benefits program. This is a voluntary program that includes periodic telephone assessment of diabetes self-management. In addition to self-reported information, the program also utilizes claims and lab data made available through the health plan. After each assessment, the program mails summary reports to participating patients and their physicians. These reports support better communication between patients and physicians regarding information gathered during program assessments that falls outside the recommendations of the American Diabetes Association (ADA).

In addition to asking the assessment survey questions, the program staff also provides patient education materials based on the ADA’s current clinical practice recommendations and support patients and their practitioners with care coordination and diabetes management supplies. Between assessments, participants can access the program staff through a toll-free telephone number 24 hours a day, 365 days a year.

M.G.’s case history
At enrollment, M.G. provided demographic information and medical history indicating that he is single, elderly, living alone, and responsible for his own self-care. M.G.’s type 2 diabetes was diagnosed 5 years before he enrolled in the program and is controlled by diet and activity alone.

In addition to diabetes, he has been treated for other conditions, including chronic back pain, hyperlipidemia, coronary artery disease, neuropathy, arthritis, and cancer. Several physicians share responsibility for his medical care; some are from a large multi-physician group, and others are from a Veterans Affairs clinic. M.G. complains that his care is fragmented and that the advice and recommendations of his doctors frequently clash. He often feels caught in the middle of these disagreements and sometimes does not know whose advice to follow. This has frustrated him tremendously and caused him to lose faith and trust in the health care system.

Lab data confirm that M.G. . . . [Full Text of this Article]

Change of health status
Epilogue

	Questions

 

	Commentary

 
Prevalence of depression as a comorbidity of diabetes
Barriers to early detection and treatment of depression in diabetes

	Clinical Pearls

 

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