Joslin Diabetes Center (Joslin) is well-renowned for its diabetes education programs and research efforts. When Vanessa Nemeth told us about her experience with Joslin’s Why WAIT weight loss management program, she also mentioned another one of Joslin’s offerings, the Diabetes Outpatient Intensive Treatment (DO IT) program, and I wanted to learn more. I turned to Program Coordinator Joan Beaton for more information about the course.
Joan has been with Joslin for 15 years, and coordinating the DO IT program for 13. “It’s been a challenge and a delight,” she said.
The DO IT program is a four-day multi-disciplinary outpatient program that combines diabetes management tactics with diabetes education and behavioral health techniques. A typical session includes eight to 12 participants, who are involved in activities from 7:30 a.m. to 4 p.m. each day. Each group typically includes both those living with type 1 diabetes and type 2 diabetes, with a median age of 45-55.
Participants enroll in the program for a variety of reasons. “When people call or email for information, I do an initial screening to get an idea about what’s going on with their diabetes and why they would want to participate in our program,” Joan said. “Oftentimes it’s to get back on track with their diabetes management. Sometimes it’s just to find out what’s new in diabetes, and we have many patients who come back every two or three years for this reason. Education in diabetes is always evolving.”
Others enroll for more personal reasons. “It’s very touching when patients come in who have had diabetes for a while and then they have a grandchild and now they have a new incentive to get a better handle on their health,” she said.
Patients are personally invested in the program, and come from all over the country. “They’ve made a big commitment to travel to Boston and make their own hotel accommodations,” she said. “Usually they’ll take a week off from work. I think that commitment lends to the success we see in the program. The common thread that I hear on Thursdays when they’re leaving is they wish they had known about this program long ago.”
The program also allows participants to bring guests to attend the sessions. “We encourage everyone to bring a guest,” she said, “whether it’s a family member or a friend, anyone who’s really involved in their diabetes care, to participate in the program. We think it’s important. There’s no charge for the guest to attend the program, other than meals. They can come as often as their schedule will allow but we do encourage them to come for all four days.”
The first day, the participants meet for an individual evaluation with members of the DO IT team, comprised of an endocrinologist, an exercise physiologist, a registered dietitian, nurse educators and a social worker, all of whom are Certified Diabetes Educators® (CDEs®). They do lab work and attend an introductory session with the social worker to begin the behavioral health portion of the program.
The remaining days the participants attend a series of classes with each of the specialists. “Participants also exercise each day in our fitness center, to see what influence exercise has on their blood glucose,” she said. “The attending physician also meets with them one-on-one each day to counsel them about their blood sugar number. Oftentimes it’s to get their number in a better range. Since we do lab work on the first day, the physician is able to counsel them based on the results.”
Participants also learn about new diabetes research. “We incorporate a research lecture in the program, conducted by one of our investigators,” she said. “The patients love that portion. It’s sort of a Q&A so they’re able to ask their questions and find out what’s new in the research world. We also give them a tour of one of our labs and they find that fascinating and hopeful as well.”
At the end of the program, participants receive a letter listing any changes made to their diabetes care regimen and any other significant findings. “One of the educators is assigned as their case manager,” Joan said. “There’s a connection after those four days and I think that’s very important. We give them a plan, then the case manager follows up and sees how they’re doing with that plan.”
Six times during the year Joslin conducts programs only for those living with type 1 diabetes. “Those sessions often attract kids going back to college,” she said. “This is an adult program so they have to be 18 and over. Once in a while we’ll find a patient who has never encountered another individual with type 1 diabetes. These might be people who have lived with diabetes for 15 or 20 years and they didn’t go to camp or they’ve just never known anyone else who’s had type 1.”
Part of the benefit of the program is the camaraderie and learning among participants. “We often say as much as they learn from us, the patients learn from one another,” Joan said. “They bring a wealth of experience to the table and there’s a lot of group discussion during downtime. They have their breakfast, lunch and snacks here throughout the day so when they sit down together, they share each other’s experiences. The group dynamic is very important.”
I find the idea of a group of people gathering together with a common goal of improving their health very inspiring. I can only imagine how empowering and supportive the vibe there must be. Many thanks to Joan for sharing an inside look at the DO IT program.
All the best,
Disclosure: Joan Beaton received no compensation for this post. All opinions contained in this post reflect those of the interviewee, and not of Sanofi US, its employees, agencies or affiliates.
“Certified Diabetes Educator” and “CDE” are certification marks owned and registered by the National Certification Board for Diabetes Educators (NCBDE). NCBDE is not affiliated in any way with Sanofi US. NCBDE does not sponsor or endorse any diabetes-related products or services.