Description

Diabetes is one of the most common causes of sickness and premature death in the adult population. The MedeSure Diabetes A&M Package will change this outcome within 1 year, and represents one of, if not the best investment in health, future quality of life, and length of life an individual with diabetes could make.

Mechanism of Organ Damage by Diabetes

Sugars are simple (usually sweet) or complex (starch), and come from plants. Starches are broken done to simple sugars during the digestion process as the organs use only simple sugars. Insulin is needed to transport sugar from the blood into the organs. When there is no insulin or not enough insulin in the blood, or the insulin is not working well, the organs become starved and don’t function well, and sugar builds up in the blood, drawing water into the blood (increased thirst) and causing excessive urination and dehydration. Persistently elevated blood sugar also causes damage to the walls of the blood vessels which carry fresh (oxygenated) blood to all organs. The thin, inner lining of the blood vessels become damaged causing sclerosis (corrosion), and narrowing of the lumen restricting the flow of blood. This effect is intensified in the tiny blood vessel branches within the organs. The result is progressive decline in organ function and eventual organ failure. These are inevitable consequences of persistently elevated blood sugar. The heart, kidneys, toes and legs, nerves, and eyes are the most commonly affected causing heart attacks (which can be silent with no chest pain), kidney failure, gangrenous skin ulcers requiring amputations of extremities, nerve pain and other sensations, blindness, increased susceptibility to infections, vaginal yeast infections, erectile dysfunction (men), strokes, dehydration, coma and sudden death.

These changes occur gradually over 5 – 20 years, depending on the level of elevation of the blood sugar, and the presence of other factors such as increased body weight, decreased activity levels, high cholesterol levels, uncontrolled hypertension, smoking and stress. Organ impairment may be halted or its decline may be slowed, but are not reversible. It means therefore that diabetes must be identified and controlled early to ensure good quality of life and long life.

How the Diabetes A&M Package works

The MedeSure Diabetes A&M Package has three main objectives (1) to assess all the organs affected by diabetes, (2) outline a management plan for each affected organ, and (3) obtain blood sugar control within 1 year. The diagnostic tests and disease management protocols are the most current and state-of-the-art available, utilizing an electronic medical records system to which all the medical providers of services have secure online access. The MedeSure member also has secure online access to his/her medical records through a Patient Portal.

The initial encounter with the MedeSure primary care physician will involve a complete medical history and physical examination utilizing protocols that ensure a complete evaluation, and an initial assessment is provided to the member. Written referrals to diagnostic facilities for the diagnostic tests in the package will be provided, as well as for any other condition the physician may consider important. The reason for each referral will be discussed individually. A medical management plan for diabetes will be developed by the physician, and may include medications from the MedeSure Medication Formulary, which are the most efficacious and cost-effective medications available.

The member will be contacted by the MedeSure Nurse Advisor for feedback on the initial physician encounter, and after each subsequent office visit, to discuss the medication(s), including dosing, possible side effects, drug interactions, provide additional information, answer questions, arrange appointments for each diagnostic test/facility and provide specific preparation instructions for each test or procedure when necessary. The member may also call the Nurse Advisor at any time with questions or concerns. The results of laboratory tests, the effectiveness and side effects of each medication, and any other medical concern will be assessed and discussed by the physician on each office visit, and changes and adjustments in the treatment plan will be made accordingly. Each new recommendation will be assessed for effectiveness on the subsequent office visit. Follow up office visits will be scheduled within 2 – 3 months but may be sooner as circumstances dictate.

After 1 year upon completion of the package, a Continuing Care Document will be provided which will include all the medical documentation accumulated over the period. and recommendations for continuing medical care. The member may continue their medical care with the MedeSure physician, or the Continuing Care Document may be provided to any medical provider for continuing medical care.

Product Description

• Complete physical examination,
• Urinalysis,
• CBC, Chem Pac, HBA1C,
• ECG
• 4 follow up office visits, with fasting blood glucose assessments, over 1 year,
• 12 monthly supplies of oral antidiabetic agents from the Medesure formulary. (Price not included in Package price)

This healthcare package provides a 12-month assessment and management of diabetes mellitus. It allows a complete physical examination, a urine test, limited blood tests, an electrocardiogram evaluation of the heart, 4 follow up office visits, with fasting blood glucose assessments, over 1 year, twelve monthly supplies of oral antidiabetic agents from the Medesure formulary.

A physical examination allows the physician to gather information about advanced diabetes mellitus, but in the early years of the disease will provide only limited information about damage to the internal organs. Laboratory and other diagnostic tests of the internal organs are required to assess and manage early disease.

A urine evaluation provides information about the kidneys and urinary system. Diabetes Mellitus produces substances that get into the urine, which are strong indicators of disease status.

The blood tests – CBC, Chem Pac, HBA1C – seek to identify abnormalities of the blood cells, blood chemistry, blood glucose, kidney function, liver function.  Additional tests, not covered by this package, may be recommended by your Medesure Participating Physician, to confirm these conditions or further evaluate abnormalities.

An electrocardiogram or ECG test records the electric current that causes the heart to beat as it passes through the heart. When there is a blockage of any of the very small branches of blood vessels carrying blood to the heart, there is some damage to the heart that often does not cause symptoms and are not noticed during regular activities. The electric current does not flow normally through the damaged portions of the heart, and even small, damaged patches can be picked up on the ECG test.

Follow up office visits are brief visits for a status assessment, review and discussion of laboratory data, to ensure compliance with medications, evaluation of medication side effects or adverse reactions, blood glucose levels assessments. and medication dosage adjustments, additions or discontinuations.

Medications are prescribed from the Medesure Medication Formulary and are dispensed from Participating Pharmacies. Medications will be supplied monthly, at the beginning of each month. The choice of medications is the decision of the doctor and patient.

Payment Terms

Initial downpayment of 50% of the Package price, which may be made in 2 instalments, and the remainder is due in 3 months. The price of this Package does not include medications.  Payments for medications must be received by Medesure Jamaica monthly, 2 weeks in advance of delivery.