Demystifying Diabetes: Q&A with Chris Sadler
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Christopher Sadler, PA-CTo learn more about CME diabetes education, visit AAPA’s Diabetes Leadership Edge page.

Diabetes is a national health crisis: 25.8 million Americans have it—or 8.3 percent of the U.S. population. Of these, 7 million don’t know they have the disease.

Because of diabetes’ complications, PAs will encounter diabetic patients in almost all practice settings. But the good news is you’re in an excellent position to identify the disease and help patients manage the condition.

In the coming months, the American Academy of Physician Assistants will roll out a nationwide initiative, the Diabetes Leadership Edge, to support PAs in fulfilling a vital role as champions of diabetes care. The initiative will give PAs the resources to become expert care providers in diabetes and keep patients on track with their treatment.

As part of this initiative, AAPA is profiling PAs with diabetes expertise to share their experience and offer some advice to PAs interested in learning more.

Today, PAsConnect sits down with Chris Sadler, MA, PA-C, CDE, a PA in endocrinology in San Diego.

How long have you been a PA, and where do you practice?

I’ve been a PA for 17 years, and I’ve been working exclusively in endocrine practice for that time here in La Jolla, Calif. I’m with a group of endocrinologists at a private practice. We do diabetes as well as general endocrinology.

How did you get started?

I have a master’s in exercise physiology. I started off in cardiac rehab back in 1985, and then I got drafted into the diabetes department because they wanted a part-time exercise physiologist to help with exercise prescriptions for people with diabetes. So I actually started out working with diabetes patients in 1986, and I became a certified diabetes educator [CDE]. I’ve been a CDE now for almost 25 years. So that’s what got me interested in diabetes.

I became so involved with diabetes that the endocrinologist, who was my medical director, said, “Chris, go get a license and come work with me.” The practice helped co-sign a loan and get me through [PA] school. I’ve been working here ever since.

I had a passion for diabetes because I saw that if people knew what they were doing, and they were educated properly, they could dramatically improve their quality of life. That stuck with me.

Why is diabetes an important issue for PAs?

PAs are interested in the prevention of disease and education. And diabetes is a disease where education really matters. Lifestyle education is critical to managing diabetes.

PAs and NPs are also generally good at educating patients about their diseases and how to manage them.

We’re uniquely positioned to help, and I think sometimes patients feel more comfortable talking to us. They may say things or reveal things about what they’re really doing that can help us guide them.

What are some tips for PAs in treating diabetes?

A key thing to remember is that patients with diabetes—especially Type 2—are loaded with guilt. They come to our offices feeling like failures—that they haven’t kept up with their diet or exercise, or maybe they haven’t been checking their blood sugar.

We can either give them a good tongue-lashing and leave them feeling beat up, or we can partner with them and really help support them and say, “How can I help you manage your diabetes better? Let’s look at ways we can do this.” And you can do it without focusing on the negatives or the things they’re not doing. Encourage them in what they are doing and how they can manage the disease.

I think a lot of PAs get that: Don’t berate patients, but partner with them for a successful outcome.

Are there limits on what PAs can do in treating diabetes?

There are limits in terms of your expertise. For example, if you don’t have experience with insulin management, you’re probably not going to put someone on an insulin pump.

The education is critical before you step into certain areas. You can get your patients into trouble if you don’t get the right education and skills—especially with insulin, which has a very small therapeutic window. If you administer too much, they’re hypoglycemic. If you give too little, they’re hyperglycemic.

But if PAs are educated well, they can be an excellent resource and coach for patients. There’s no reason they should shy away from diabetes. Just make sure you know what you’re doing.

Where would be some good places for them to start learning?

I’m excited about AAPA’s Diabetes Leadership Edge. It will expand into learning modules and also has some mentoring aspects to it. That’s critical with diabetes.

There’s so many nuances, and people with good clinical experience can pass on a lot of clinical pearls and through case histories, they can teach people and bring them up to speed so they really understand those nuances.

In addition, there’s a great organization called Taking Control of Your Diabetes. It’s run by an endocrinologist here in San Diego and is a national program. They give very good lectures on diabetes management and have a radio show and website. It’s mainly for patients, but they have a very good provider program, too.

And then, of course, the American Diabetes Association [ADA] and the American Association of Clinical Endocrinologists [AACE] have very good resources. AACE has an algorithm for managing diabetes and ADA has guidelines for treatment.

I truly believe that PAs can make a difference with diabetes patients. This is a ubiquitous disease: No matter what practice you work in, you’re going to see diabetes—from pediatrics all the way through geriatrics and every specialty in between. So it’s something that we need to be good at. And we need to be well versed in all the complications and be able to refer or manage patients.

Stay tuned for the next installment of “Demystifying Diabetes” on PAsConnect.

To learn more about CME diabetes education, visit AAPA’s Diabetes Leadership Edge page.

See also: Demystifying Diabetes: Q&A with Mandy Micheaux

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