An aggressive form of insulin management, arranged by her Marshfield Clinic team of caregivers, is helping to make a big difference in quality of life for Mary Olson.
This 46-year-old woman was younger than many patients when she was diagnosed with diabetes five years ago by Kathryn Krohn-Gill, M.D., a family physician at Marshfield Clinic Merrill Center.
Olson was determined to fight her diabetes. “I knew I was healthy enough to still do things and I couldn’t be slowed down,” said Olson, who lives in Wausau and works as child care director at the YWCA, in addition to pursuing a master’s degree.
“I’ve just got too many things I want to do in this world.”
Diabetes is a complicated disease involving blood glucose, or sugar, and insulin. Insulin is a hormone that helps the glucose get inside cells to use it for energy and keeps the blood sugar level in the normal range.
Dr. Krohn-Gill started Olson on insulin and found her to be a model patient, checking her sugars regularly and reporting in to the doctor’s office.
She was an ideal candidate for a more aggressive form of insulin management involving two different forms of insulin, one of them short-term and the other long-term.
“She can alter her dose of the short-acting insulin, based on how she’s eating and her activity level. She can take this insulin for what she thinks she will need,” Dr. Krohn-Gill said.
She also takes a long-acting insulin twice daily that provides some effect all day and night.
The short-acting insulin covers the peak periods when she needs more insulin, and helps avoid the valleys that can occur when blood sugar levels get too low.
Olson’s regular monitoring shows blood sugars nicely controlled. More importantly, she’s avoided the many serious complications from diabetes that can result in hospitalizations.
Her treatment plan is an excellent example of Marshfield Clinic’s quality initiatives aimed at reducing costs while improving outcomes.
The Clinic has been recognized by federal authorities for its success in this area, but nobody says it’s easy.
“Sometimes people will say they can’t manage their diabetes because their life varies so much, but she’s really taken control of what she’s eating, and adjusting her insulin constantly,” Dr. Krohn-Gill said.
“This wouldn’t be right for everybody, but for somebody who’s motivated and has a varying day-to-day schedule – even shift work – this program can work very well.”
Olson is matter-of-fact about it and said the doctors and nurses can’t do their jobs if she doesn’t give them accurate information.
While she’s generally upbeat, she admits the diabetes can get her down, especially around the holidays when sweet temptations are everywhere.
“But there is good support at the Clinic if I’m really struggling or stressing about something,” she added.
“By doing what I can, I know that I feel better, I’m healthier, and I’m eating more nutritious foods.”
Dr. Krohn-Gill said she gave “a little guidance” but credits Olson as well as the diabetes educators at Merrill Center for keeping Olson’s diabetes under control.
“You can’t rest on your laurels with diabetes,” Dr. Krohn-Gill said.
“People can do everything perfectly and insulin resistance can increase with time, so you can’t just give someone a prescription and say ‘I’ll see you in a year.’ It requires careful adjustment and tight follow-up, paying attention to it multiple times per day, and Mary does it very well.”