Medford Transcript

March 17, 2011

By Nell Escobar Coakley

In 2010, nearly 19 million people over the age of 20 were newly diagnosed with diabetes. The Centers for Disease Control and Prevention estimates that nearly seven million more went undiagnosed in the same year.

Those numbers, say health officials, are staggering. And, they add, the epidemic is spreading.

“There is a greater awareness of the problem because it’s being reported more,” said Dr. Sunita Schurgin, chief of endocrinology at Lawrence Memorial Hospital. “The numbers are definitely up from what they were even 20 or 30 years go.”

That’s why Hallmark Health has joined forces with Jolsin Diabetes Center in Boston to become one of the world-renowned organization’s 42 affiliate locations in the United States. On March 23, Hallmark will cut the ribbon on its new location at Lawrence Memorial Hospital in Medford.

“We’ve had a certified program for 10 years,” said Terry Giove, Hallmark’s vice president of ambulatory services. “The program has been growing and growing and we still knew that we had not tapped all of the community’s needs.”

Giove said Hallmark ended up purchasing a portion of a private practice that was getting ready to give up its endocrinology and diabetes specialties. The organization then turned the practice into a diabetes center, which it opened last year.

Then six months ago, she added, someone met someone else at a function and soon everyone was talking about the possibility of Joslin and Hallmark joining forces on the diabetes front.

“It was basically a win-win for everyone,” Giove said. “Over the past several months, Joslin has met with us and our physicians. They gave a presentation to the Medical Executive Committee. There was a vote before it went to the Board of Trustees. Everyone voted on it.”

Schurgin said everyone is very excited about the affiliation because it opens so many avenues for not only the patients, but also doctors looking to be on the cutting edge of diabetes research.

“It’s a field that’s constantly changing, as far as treatment options,” she said. “We have brand new medications that seem to be coming out every six months with good results for our patients.”
And it doesn’t hurt to have the Joslin name either.

“I sometimes find that my patients are not listening,” said Dr. Sybil Kramer, another Hallmark endocrinologist who practices mainly at Melrose-Wakefield Hospital. “This might help add a little more respect to my title and maybe having the Joslin name behind me will give me a little more clout.”

Kramer added being affiliated with Joslin also allows her to meet other doctors nationwide and see what they’re doing.

“And they have great materials,” she said. “I am incorporating the material into what Hallmark Health already has.”

Diabetes is the seventh leading cause of death in the U.S. and a leading contributor of heart disease, stroke, limb amputation, kidney failure and new cases of blindness. Because of this, both Kramer and Schurgin say it’s important for patients to be involved in their own care.

“Patients need to change their psychology,” Kramer said. “They’re used to going to get pills and being told what to do. They need to take charge and be responsible for their disease because it’s within their power to change the course of their lives.”

Kramer blamed the explosion of the disease not only on the sedentary lifestyle many people lead these days, but the refusal of many to cut back on the junk food and get out of the house.

“Diabetes actually starts about 10 years before you start to see some of the effects,” she said. “That’s why it’s important to catch it early before it becomes serious.”

Schurgin agreed.

“One of the things we like to do is have our patients see a diabetes educator, someone who is accredited in providing that sort of information,” she said. “[Patients] often have another whole world open up to them. Often times, they come in with a chip on their shoulder, but after meeting with the educator, they often feel better. They have a magical way of dealing with patients.”
Schurgin said patients often feel as if someone is preaching at them, but meeting with a diabetes educator helps them see their disease in a very real way.

“The educators have a way to get down to the day-to-day struggles they have,” she said. “There’s an overwhelming sense of too many choices out there and an educator really helps them get down to the reality of their lives.”

Schurgin added there are many pitfalls diabetes patients face on a daily basis, and that’s why it’s important for them to receive not only education, but access to information. The Joslin affiliation does just that.

“Sometimes people have very mild symptoms, like feeing draggy or having a dry mouth, and sometimes those are not even very noticeable,” she said. “But we always recommend they receive a screening, especially if there is any family history, because your chances [grow exponentially] depending on if it’s a parent or sibling.”

It’s also not the end of your world if you are diagnosed with the disease, Schurgin added, because there are so many treatment options.

“People often imagine diabetes as something their grandmother had, and that isn’t the case,” she said. “There are things our patients can do to avoid complications and change the course of their own disease.”

From a physician’s standpoint, Schurgin and Kramer said there are both oral and injectible medications far beyond just insulin. For example, one drug that’s injected and is not insulin is GLP1 agonist.

“It’s revolutionized the way we manage diabetes,” Schurgin said. “The benefit is that it helps with weight loss and still reduces blood sugar. There are people who really try to lose weight, but sometimes the medication they’re on actually contributes to their weight gain. We want to give them every big of help we can because even losing a few pounds can help them tremendously with their diabetes.”

Although Hallmark Health currently has its diabetes center in operation, the Joslin name will soon help the organization re-brand and re-launch itself.

Giove said this opportunity has really helped the hospital stand out in that Hallmark is the only provider north of Boston that provides Joslin-level services. That mean no more trips to Boston for patients tired of fighting traffic and finding parking.

“It definitely gives us some cache,” Giove said with a laugh. “But we now can give our patients the same level of care they’d receive at Joslin with easy access. We’re always exploring new affiliations that will enhance the quality of care for our patients. There are still a lot of opportunities out there.”

And, doctors add, there’s no real downside to these affiliations, especially with organizations like Joslin behind them.

“I don’t see any,” said Kramer. “Sometimes our patients have been confused because of the Joslin name, but we’ve explained that they can still come here and know they are receiving the same care by their Hallmark physician, but that it will be augmented by the Joslin affiliation.”

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