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Iowa City IA 52242
(319) 335-6660; fax (319) 384-4638

Release: Feb. 12, 2001

UI Intensive Insulin Therapy Clinic is offering comprehensive diabetes care

IOWA CITY, Iowa -- Health care professionals have long recognized the importance of good blood glucose control for people with diabetes. However, successful control for each affected individual depends on finding and adhering to the appropriate combination of diet, exercise and insulin therapy.

The UI Intensive Insulin Therapy Clinic helps people with established diabetes meet this challenge by bringing together physicians, nurses and dieticians in one care center. Since opening last October, the clinic has been helping people ages 16 and older gain and/or maintain control of their diabetes, especially type 1 diabetes. A major goal of the clinic is to help people take advantage of diabetes treatment advances.

People with diabetes either do not make insulin, or the insulin they make does not work the way it should to help glucose enter cells and provide energy. As a result, people with diabetes can have too much glucose in their blood. Chronically elevated blood glucose can damage blood vessels and cause serious complications leading to blindness, kidney disease, lower limb amputation, and stroke or heart disease.

"Good blood glucose control requires structured dietary and exercise therapy along with intensive insulin therapy," said Gregory Doelle, M.D., UI associate professor (clinical) of internal medicine. "Intensive insulin therapy can mean multiple daily insulin injections or the use of an insulin pump. Good control also requires many health care providers who are involved on an ongoing basis with patient management."

The clinic helps people already using or who want to use an insulin pump, a newer method of insulin delivery that substitutes for multiple daily needle-stick injections. The device is about the size of a deck of cards and is often worn on the belt or in a pocket. The pump delivers a continuous infusion of short-duration insulin through a tiny catheter inserted into the abdomen. The device also can be used to provide extra insulin before meals or to correct high levels of blood glucose.

"The pump system allows more precise insulin dosage and gives people who use it more flexibility," said Vicki Kraus, UI advanced registered nurse practitioner in internal medicine and one of the clinic staff members. "People who use the pump can more easily deal with altered meal times or content. The device also is very accommodating for people with highly variable levels of daily activities, such as construction workers or people who work two shifts."

People who choose to use the pump are initially closely followed with weekly or more frequent clinic visits. Telephone check-ins then help patients as they learn to work with the device to maintain good blood sugar.

Newer technology also helps the clinic professionals assess patients for possible use of the pump or for the need for changes in their insulin dosages. An implantable 72-hour glucose sensor, which monitors blood glucose sugar every five minutes, provides a detailed pattern of highs and lows so that insulin use can be more easily and accurately be adjusted.

In addition to Doelle, UI physicians serving the clinic are Robert Spanheimer, M.D., associate professor of internal medicine, and William Sivitz, M.D., associate professor of internal medicine. Spanheimer is also a staff physician at the Veterans Affairs Medical Center in Iowa City; Sivitz is both a staff physician and researcher at the VA center. The UI clinic staff also includes Barbara Bezoni, Rhonda Fruhling and Jennifer Long, nurse diabetes educators, and Sydney Carlson, a dietician who can help people plan meals with the appropriate balance of carbohydrates, protein and fat.

The UI Intensive Insulin Therapy Clinic serves people ages 16 and older with established diabetes. For more information, call UI Health Access at (319) 384-8442 or 1-800-777-8442.

People who are interested in finding out whether they have diabetes should also call the above numbers but ask for information about free diabetes screenings.

University of Iowa Health Care describes the partnership between the UI College of Medicine and the UI Hospitals and Clinics and the patient care, medical education and research programs and services they provide.