Oct
07
Demystifying Diabetes: Q&A with Mandy Micheaux
Posted by DwagenerComment
 
 
Mandy Micheaux, PA-C

Mandy Micheaux, CPAS, PA-C

To 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 Mandy Micheaux, CPAS, PA-C, a PA in family practice in Dallas.

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

I’ve been a PA for eight years. I work at a family practice clinic called Mi Doctor in Dallas, Texas.

My past work experience includes three years at rural health clinic in Gonzales, Texas, three years at an endocrinology clinic in Houston, Texas, and the other two years in research and family practice clinics.

How are you involved in diabetes care?

I am directly involved and in the “line of fire” providing care. I diagnose, treat, educate and counsel patients with pre-diabetes and diabetes. I also educate children and adults about diabetes prevention and the importance of diet and exercise.

I spend 30-40 percent of my day providing diabetes care. I manage diabetes medications, discuss their side effects and aim to get patients to their diabetes goals.

Can you give some tips for recognizing and treating diabetes?

1) Always be on the look-out and ready to screen for diabetes—especially in a family practice setting. For example, I often see patients come in for skin infections (tinea pedis/cruris or staph infections or abscesses) and determine they have diabetes. Another example is patients complaining of fatigue or trouble losing weight, or those who have a dark line around their neck called acanthosis nigricans.

2) When treating patients with diabetes, PAs should spend time going over their medications and side effects and start to build a trusting relationship. Give them a copy of their medication list, go over their labs in detail and encourage them to reach their diabetes goals (i.e., A1c. cholesterol, blood pressure, weight goals).

(3) In a similar vein, find out what patients are doing to manage their diabetes. Ask them about their concerns, fears and disbeliefs or denial about their disease. Talk about their most challenging lifestyle modification, and point them to resources either by referral (to a dietician) or to a community program (YMCA health programs). Diabetes cannot be managed alone. Find out what the patient needs and put a team together to address their needs.

Are there limits to PAs treating diabetes?

PAs are able to treat diabetes efficiently and provide great care. The limitations are minimal.

A few limitations I encounter:

  • Time! Of course it seems like there is never enough time, especially when patients are noncompliant and/or their diabetes is complicated by several other co-morbidities.  We need more time with these patients to educate them and help them find resources.  This is why an established diabetic team is so important.
  • Resources. Sometimes my patients have limited access to needed equipment such as  continuous glucose monitoring devices or insulin pumps.

What are good resources to learn more about this disease?

The Diabetes Initiative launched at AAPA’s annual meeting in May will become a great resource to educate PAs at the primary care level about confidently managing and treating patients with diabetes, with numerous information at your fingertips and a central online location.

Numerous CME activities are already available out there, but getting hands-on experience and finding a dynamic course that provides detailed and interactive education is the best source. Some of the materials for Diabetes Leadership Edge were created specifically for the initiative by PA experts, but the initiative also utilizes many great resources for other professional sources.

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

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

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