Diabetes care: It takes a team
Michael Lustro, 52, knew he hadn’t managed his type 2 diabetes well since being diagnosed in 2007. He started to worry he wouldn’t be around for his three young grandchildren.
A phone call to UChicago Medicine’s outpatient location in Orland Park turned his life around.
“Michael first came to us in May 2017, not newly diagnosed, but also not having followed a treatment plan for several years,” said Donna Ellis, RN, APN, diabetes advanced practice nurse. “He just wasn’t feeling well and had decided to take charge of his life and feel better.”
The South Side resident had been seeing his family physician but had never visited a specialist to discuss common health issues that affect people with diabetes. “I was eating what I wanted, I drank alcohol regularly and I just wasn’t living the lifestyle I was supposed to be living,” he said. “So I ended up needing shots of insulin.”
At the Orland Park clinic, Lustro met with endocrinologist Farah Hasan, MD, the first point of contact for new diabetes patients. Following a thorough evaluation, Hasan told Lustro that his blood sugar levels were too high and needed immediate attention.
She quickly set him up with the rest of the diabetes care team: Ellis, the diabetes advanced practice nurse he now sees regularly for follow-up appointments; certified diabetes educator Elvia Ortiz, RN; dietitian Kimberly Kramer, RD, LDN, at the UChicago Medicine Ingalls clinic in Flossmoor; and ophthalmologist Dimitra Skondra, MD, PhD, and podiatrist Paul Lantz, DPM, both at the Hyde Park campus. The team also referred him to a new primary care physician, Stephen Bennett, MD, at Orland Park.
“No one specialist can provide all the care necessary to maintain health in a patient with diabetes,” Hasan said. “With a team approach we’re able to give every patient more time and a more personalized approach.”
Lustro, a parking enforcement supervisor for the city of Chicago, works an overnight shift, making it hard to maintain a good schedule for meals, sleep and monitoring his blood sugar levels.
“I told my UChicago Medicine team that whatever they tell me to do, I’m on it,” Lustro said. The group helped him with daily meal planning, dietary restrictions, an exercise program and adjustments to his medications.
Using advanced imaging technology, Skondra diagnosed Lustro with early signs of diabetic eye disease in his retina that needed prompt, specialized treatment to prevent vision loss.
In less than a year, Lustro lost 30 pounds. His A1C level — a test that measures average blood sugar levels over two or three months — dropped dramatically, from a dangerous 12.5 to 7, his target level.
“I feel like a different person,” said Lustro, who chokes up when talking about the care he’s received. “I don’t think I’d be here if it wasn’t for the team. I’m not a big fan of going to the doctor but now I look forward to it.
“They keep me in check and give me that push. They tell me the truth but they’re also my friends. No one’s ever given me the care they’ve given me.”
Ellis said all patients dealing with diabetes deserve information and good care. “They really need the support,” she said. “It’s not a disease where you can make one office visit. It requires a lot of work on the part of the team and the patient.”
“We are delighted to have Dr. Hasan and her team as part of the University of Chicago Medicine Kovler Diabetes Center,” said Lou Philipson, MD, PhD, the center’s director. “Kovler at Orland fulfills our mission to provide comprehensive diabetes care, education and community outreach.”
Michael Lustro's Diabetes Care Team
- Farah Hasan, MD, endocrinologist (diabetes specialist). Hasan is the first person on the team each patient visits and oversees all care.
- Donna Ellis, RN, APN, diabetes advanced practice nurse and certified diabetes educator.Ellis assists patients with medication, education and follow-up care with other specialists and other needed screenings.
- Kimberly Kramer, RD, LDN, registered dietitian and certified diabetes educator.Kramer advises patients on all aspects of nutrition, from meal planning to carbohydrate counting and an exercise regimen, and how to fit them into their work schedule and lifestyle.
- Elvia Ortiz, RN, nurse and certified diabetes educator.Ortiz talks to patients about their goals for blood sugar control and diet, and teaches them how to use insulin and/or other medications and how to monitor blood sugar.
- Dimitra Skondra, MD, PhD, ophthalmologist and retina specialist with expertise in the management of diabetic eye disease. Diabetes is the main cause of blindness in working-age Americans and early management of eye involvement is crucial for vision preservation.
- Paul Lantz, DPM, podiatrist. Lantz focuses on prevention and treatment of foot problems that are common in people with diabetes, including numbness, ulcers and slow healing.