NCMS Morning Rounds 1-7-21

Happy Thursday! Enjoy your NCMS Morning Rounds!

Jan. 7, 2021

Connecting Patients with Community Health Programs

In keeping with the NCMS’ commitment to help you connect patients to community resources to enhance their health, we alert you to an organization helping to do just that – Healthy Aging NC. This statewide resource seeks to bridge the gap between physicians and PAs and the evidence-based community health programs they support statewide.

Healthy Aging NC connects people to programs and agencies that improve
community health, increases the capacity of providers to offer these programs,
maintains a website with program information and an online registration system,
and analyzes data to report results. Healthy Aging NC’s partners include the 16 NC Area Agencies on Aging, which are often able to leverage federal funding to offer these programs at low or no-cost to participants.

Evidence-based programs include chronic pain management, living with a chronic disease, diabetes self-management, balance and fall prevention classes. Learn more about the Healthy Aging NC programs and how you can refer patients here.

Rare and Atypical Diabetes Study – Do Any of Your Patients Qualify?

The University of North Carolina School of Medicine has been selected as a site for a study funded by the National Institute of Diabetes and Digestive & Kidney Diseases (NIDDKD). The RADIANT study will evaluate rare and atypical diabetes to discover new genes and phenotypes.

Do you have an ‘unusual’ case that does not quite fit standard type 1 or type 2 diabetes or has atypical features? After informed consent, the RADIANT study will invite the most promising cases to screen for autoantibodies and, if negative, undergo whole genome sequencing. Participants will be provided genetic counseling if abnormalities are found and additional phenotyping may be obtained.

Three ways patients may get into RADIANT
1. They can contact John Buse, MD, PhD at jbuse@med.unc.edu or the study coordinator Rachel Fraser at rachael_fraser@med.unc.edu, 984-974-3011.
2. They can enroll and consent online here.
3. You, the patient’s physician or PA, can email their contact information and the study staff will contact them on your behalf.

The following criteria or phenotypes will be considered as “atypical” participants:
• Type 2 diabetes diagnosed at a time when the individual was prepubertal or non-obese
• Mendelian pattern, especially with early onset (<18 years old)
• Syndromic (multiple systems involved)
• Lipodystrophic
• Extremes of BMI
• “Mitochondrial” characteristics (e.g., myopathy, hearing deficits)
• Non-progressive
• Rapidly progressive (“fulminant”)
• Low insulin requirements (<0.5 u/kg/day)
• Cyclical hyperglycemia with periods of remission
• Lean persons with polycystic ovarian syndrome (PCOS)
• History of gestational diabetes (GDM) when lean
• Lean insulin resistant persons
• If islet autoantibodies and beta-cell function parameters have been measured (where “A” = islet cell autoantibodies, “B” = beta-cell function):
o A-B- (i.e., lacking islet autoimmunity makers and lacking beta cell function)
o A-B+ with unprovoked DKA at initial presentation (i.e., lacking islet autoimmune markers, with preserved beta-cell function, but presenting with unprovoked DKA)
o A-B+ of very young onset (pre-pubertal) (i.e., lacking islet autoimmune markers, with preserved beta-cell function, but very early onset T2DM-like phenotype)

Exclusions:
• Those with high likelihood of typical type 1, typical type 2, known monogenic, or other known secondary forms of diabetes
• Refusal of consent for genetic testing
• Islet autoantibody positive (participants who are islet autoantibody positive but present with additional atypical features i.e. syndromic, strong linear family history of diabetes may not be excluded)
• Women who are currently pregnant

Congrats to These Grads!

Last month, three physicians became the inaugural class of Campbell University’s Master of Health Professions Education (MHPE) degree program. This program, which includes faculty from the NCMS staff, provides education in leadership, change management, curriculum design and teaching skills. Open to clinicians of all disciplines, the degree program is designed to prepare health care professionals as teachers and leaders in training the next generation of health care providers. Learn more here.

Congratulations to the following graduates: Nancy Finnegan, DO, Thomas Motyka, DO and Monica Stanton, MD.

The MHPE is the School of Osteopathic Medicine’s newest degree program and the curriculum will be delivered entirely online beginning in January 2021.

In the News

New COVID Vaccines Need Absurd Amounts of Material and Labor, Scientific American, 1-4-21

Learning Opportunity

The Medicaid Managed Care Fireside Chat Series, featuring Chief Medical Officer for the NC Division of Health Benefits Shannon Dowler, MD, continues tonight, Jan. 7 from 5:30 to 6:30 p.m. with a focus on Behavioral Health (Standard Plans).

The agenda will cover:
• Behavioral health services and changes for beneficiaries (standard plans vs. tailored plans)
• What behavioral health providers need to do to get ready for July 2021 launch
• Network adequacy
• Special populations, including pediatric and opioid (how to opt in or out of a tailored plan).

Register here.

Future Fireside Chat topics include the Advanced Medical Home Tier Support Tool, COVID-19 Vaccine Administration and NC Medicaid Transition to Managed Care.

If you have policies you’d like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!

 
 

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