Affiliate at SUNY Upstate Medical University

3229 East Genesee Street I Syracuse, NY 13214 I 315 464-5726 or 800 668-4536 I www.upstate.edu/uh/joslin

Joslin Education Programs at UpstateOur education program is nationally recognized by the American DiabetesAssociation. We offer education in all the content areas of diabetesself-management.

Living with Diabetes 3 sessions Comprehensive Program to complete program

1. Getting Started2. Staying Healthy 2-3 hours per session3. Eat Right and Keep Moving

Pump Orientation for Adults 3 hour sessionand Children

Insulin Pump Initiation for Adults 2 day sessionand Children 2-3 hours per session

Personal Continuous Glucose Monitoring Initiation 1.5 – 2 hour session

IPRO- Professional Continuous 2 day sessionGlucose Monitoring System 1.5 – 2 hour session

Carbohydrate Counting 1 hour session

WAY Less Program: Weight 12 session weight managementAchievement for You with program is available to Joslin Lifestyle Skills and Support patients

Questions?Please don’t hesitate to call your JoslinCare Team at 315-464-5726 if you have any questions or concerns.

Welcome To JoslinCare™

at the JOSLIN DIABETES CENTER at Upstate Medical University in Syracuse

Since 1996, the Joslin Diabetes Center at Upstate Medical University has been an affiliate of the Joslin DiabetesCenter in Boston, MA, the world’s preeminent diabetes research and clinical care organization.

Meeting the Ever-ChangingChallenges of Diabetes andRelated Diseases for Adult and Pediatric Patients

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get started on a treatmentplan. This plan may require areferral to our educationprograms or other specialists.

The Core Team • YoUYou are the most importantpart of your JoslinCare plan!We have the medical andeducation experts, but no oneknows you or your child aswell as you do. JoslinCarephysicians and educatorsprovide their clinical expertise,but to develop the right plan,we ask you to share yourexpertise with us. To achievebetter glucose control, youmust be an active participantin your treatment program. Todo so, it is important to learnthe skills to manage yourdiabetes, and we plan to helpyou do just that!

• A JosliNCArE PArTNErYour JoslinCare partner (anurse, educator, dietitian, orexercise specialist) helpsidentify the things you need todo daily to improve glucosecontrol. You and your teampartner will review what isworking, what may not beworking, and what you can doto overcome hurdles. Yourpartner will keep an open lineof communication with you,both during and betweenvisits.

• A JosliNCArE PhYsiCiANOur physicians (who aresubspecialty-trained,board-certified and on thefaculty of Upstate Medical

University) are at theforefront of clinical care andresearch on diabetes and itscomplications. Your or yourchild’s JoslinCare physicianwill do a complete medicalevaluation and identify anyproblems. The physician willalso assess risk levels,monitor for early signs ofcomplications, prescribediabetes medications andhelp you set goals.

• A NUrsE PrACTiTioNEr (NP)or PhYsiCiAN AssisTANT (PA)A nurse practitioner orphysician assistant withadvanced clinical training indiabetes may also be involvedin your or your child’s care.Their special training andcertification enable them todiagnose and manage acuteand chronic diseases andadjust and prescribemedications. They emphasizehealth promotion andmaintenance and preventionof diabetes complications.

• A JosliNCArECoordiNATorYour JoslinCare coordinatorschedules your appointments,answers your phone calls anddirects your questions to theappropriate team member.They make sure youunderstand where yourscheduled appointments are,whether at Joslin or atUpstate University Hospital.

• A diAbETEs EdUCATorIn addition to yourindividualized visits with your

JoslinCare partner, you haveaccess to diabetes educationgroups taught by our diabeteseducators, all of whom offerone-on-one consultations.Studies show that groupeducation is the mosteffective setting for masteringnew skills and developingstrategies to manage diabetes.A list of all Joslin groupprograms and classes can befound in the back of thisbooklet. There are alsospecial ‘transition’ programsavailable for children who areplanning to leave the securityof the home.

Diabetes educators arenurses, dietitians, and exercisephysiologists with extensiveknowledge and experiencecounseling patients withdiabetes. Like coaches, theyinspire patients to do whatkeeps them healthy. Forexample, diabetes educatorsprovide guidance on how tomonitor and respond tochanges in blood glucoselevels, make appropriate foodchoices, and how toincorporate more physicalactivity into your or yourchild’s life. They also provideinstruction on how to takeinsulin or other medications,and help you solve self-management problems.

• AN EYE CArE sPECiAlisT(oPhThAlmologisT,oPTomETrisT)Joslin recommends anannual, dilated eyeexamination to identifycomplications. Early, effectivetreatment can lead to

What is JoslinCare? JoslinCare is all about you.

JoslinCare is an innovative,specialized approach to help you or your child stay healthy withdiabetes. It incorporates the medicalguidelines of our experts and theeducational approach of our diabeteseducators to help you care foryourself or your child and stayhealthy with diabetes.

Learning to manage diabetes is thebest defense against complications.Optimum glucose control reducesthe risk for the development orprogression of complications andwill help ensure that you or yourchild will live a long and healthy life.

With your JoslinCare team membersas your partners, you will learndiabetes management skills andproblem-solving techniques step bystep. You need to know how tomanage your or your child’s diabetesbecause you—not your healthcare

provider—are the one who will bemaking care decisions at home, atwork and at play. Think of JoslinCareas your personal recipe for health.Here are some of the key ingredients:

• Your JoslinCare Team • Your JoslinCare Partner • Your Diabetes Management Plan

Your JoslinCare Team:There When You NeedThemDiabetes can be a complicateddisease to manage and requires amultidisciplinary approach tooptimum care.

You will see your JoslinCare partnerand other team members regularly(usually every three to six months).Whether you see one member of theteam or three, we will try tocoordinate appointments for yourconvenience. Initially, you may need tosee us more frequently to help you

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The Joslin Diabetes Center at Upstate MedicalUniversity is one of 38 national affiliates of theworld-famous Joslin Diabetes Center in Boston, MA,which, in turn, is affiliated with the Harvard MedicalSchool. Through this partnership, and with more than100 years of trailblazing diabetes care to support us,the Joslin Diabetes Center in Syracuse is uniquelyequipped to offer progressive state-of-the-artdiabetes care for adults and children.

The Joslin Diabetes Center at Upstate: The Power of Partnership

of heart attack or stroke). The ABI can beperformed at the Joslin Diabetes Center. Ifindicated, more specialized tests andinterventions can be performed by Upstate'svascular specialists. If you already have aprivate vascular specialist, we will workclosely with that individual.

What to Expect at Your visitConsider each visit as a checkpoint to see how things are going. We will ask thefollowing questions:

• What’s working well? What isn’t? Are you oryour child meeting your JoslinCare goals?

• What are your concerns? Do you have anyquestions about the care received or yourself-management plan?

• Are you getting too much or too little helpfrom your family?

• Are you feeling stressed?• Have you had any specific problems,including problems with medications?

At each visit, your JoslinCare team willidentify your or your child’s diabeteschallenges and work with you to resolve them.

There are certain signs on the path to optimalhealth. JoslinCare experts have determinedoptimal goals for each of these signs, whichwe individualize to your needs. At each visit(or as often as your JoslinCare teamrecommends), we monitor the following:

• blood glucose levelsThis is an important measure of whether your diabetes is under control.

The monitoring of blood glucose (BG) is doneat home with a glucose meter which measuresthe glucose level in the bloodstream at thatmoment. Keeping blood glucose levels withina specific target range is a major step tocontrolling diabetes.

Since blood glucose is determined by foodintake, physical activity, medications and overallhealth, looking at patterns in BG levels allows

us to help you make adjustments in all theseaspects of your treatment plan. It is essentialthat you bring your blood glucose records fromthe past two weeks and your meter to each visitso that you and your JoslinCare team canreview them together.

• A1CThis is another way of measuring bloodglucose control. The A1C test (which, likemonitoring your BG levels, requires afingerstick to obtain blood) provides asnapshot of blood glucose levels over the past two to three months. We recommend an A1C test two to four times a year.

• lipids (Cholesterol and Triglycerides)These are usually checked annually or moreoften if you take medications to lowercholesterol. Cholesterol levels are importantfor maintaining cardiovascular (heart andblood circulation) health.

• blood PressureBlood pressure (BP) is usually checked at allvisits because control of blood pressure isextremely important to maintainingcardiovascular health.

• WeightFor most people with diabetes, maintaining a healthy weight is a critical component oftreatment and can also have a positive impact on BP, lipids and BG control.

healthy living goalsYour healthy-living goals concern lifestyle,frequency of monitoring blood glucose,healthy eating habits and becoming moreactive, and contain tools to help patientsachieve these goals. Specifically, for adults, it includes your blood pressure goal (foradults usually less than 130/80), your A1C goal(generally less than 7 percent), and goals forlipids (LDL-cholesterol less than 100 mg/dl;less than 70 mg/dl in the presence of heartdisease).

preserved vision. If you do notcurrently see an eye care provider,we can refer you to one at UpstateUniversity Hospital who specializesin preventing, diagnosing and treatingall eye problems related to diabetes.

• A KidNEY sPECiAlisT (NEPhrologisT)Kidney disease can be a complicationassociated with diabetes. Earlydiagnosis of kidney problems andaggressive treatment can helppreserve kidney function.

As part of JoslinCare, we do a urinetest at least once a year to monitorfor signs of early kidney disease. We also measure overall kidneyfunction.

• soCiAl WorKEr sErviCEsAn experienced licensed medicalsocial worker is available to assistpatients and families with financialor insurance challenges, mentalhealth concerns, transportationneeds, and so much more.

• PodiATrisTPeople with diabetes are vulnerableto foot problems because diabetescan damage nerves and reduce bloodflow. It is estimated that one in fivepeople with diabetes who seekhospital care do so for footproblems. By taking proper care ofyour feet, you can avoid mostserious health problems associatedwith diabetes. If foot problems doarise, your JoslinCare provider willrefer you to an affiliated podiatristfor an assessment and treatment.

diabetes & Your heartThe most life-threateningcomplications of diabetes are heartdisease and stroke, which occur inpeople with diabetes twice as often.

The diagnosis of diabetes as an adultpresents the same risk as alreadyhaving one heart attack. More than 65 percent of deaths in diabetespatients are attributed to heart andvascular disease.

The Joslin Diabetes Center stressesthe optimum management of riskfactors to prevent heart attack andstroke. In addition to blood glucosecontrol, we stress goals for bloodpressure (<130/80 mmHg); LDLcholesterol (<100 mg/dl or <70 mg/dlif vascular disease is present);smoking cessation; lifestyle changes(weight management and exercise);and the use of low dose aspirin ifappropriate. This approach issometimes referred to as preventivecardiology.

At the Joslin Diabetes Center,patients can be evaluated forperipheral arterial disease (PAD).Individuals with PAD have anincreased risk for heart attack andstroke. PAD occurs when bloodvessels in the legs are narrowed orblocked by fatty deposits. Anestimated one out of three peoplewith diabetes over the age of 50 havethis condition. The ankle brachialindex (ABI) is the test mostcommonly used to diagnose PAD.This test compares the bloodpressure in your ankle to that in yourarm. If the blood pressure in thelower part of your leg is lower thanin your arm, you may have PAD.

An expert panel of the AmericanDiabetes Association hasrecommended that people over theage of 50 have an ABI to test for PAD.People with diabetes younger than50 may benefit from testing if theyhave other PAD risk factors (smoking,high blood pressure, abnormalcholesterol levels, or a family history

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referrals &AppointmentsThese include recommendededucation programs, appointmentsand referrals to specialists.

our WebsitesOur websites have a wealth ofinformation. You’ll find the latestadvice and research results ondiabetes and all of its complications,as well as links to our education andphilanthropy options. You can alsogo to www.upstate.edu/joslin tolearn more about the specificclinical, educational and researchclinical trial offerings available at theJoslin Diabetes Center at Upstatethrough its clinical practice inSyracuse (across from NottinghamHigh School) and through UpstateMedical University and UpstateUniversity Hospital.

For information about ongoingresearch trials or about becoming aresearch volunteer, call the clinicalresearch team at 315-464-9007.

On www.joslin.org, click on “LearnAbout Diabetes” for our Beginner’sGuide and a comprehensive librarywith articles that cover diabetestreatment, monitoring, nutrition,exercise, foot care, complications,mental health and Joslin’s ClinicalGuidelines, among many other topics.

Through the Boston Joslin.orgwebsite, we offer pedometers,guidebooks on diabetes self-care(such as the newly updated JoslinGuide to Diabetes Care), videos (suchas Joslin’s Keep Moving…KeepHealthy with Diabetes video), and avariety of cookbooks with tasty andhealthy recipes.

EPiC/mY ChArTPatients of Upstate UniversityHospital and the Joslin DiabetesCenter can now sign up, for free,with the completely secure, on-linetool, MyChart, in order to gain accessto their medical information, asrecorded by Upstate/Joslin providers.MyChart allows members to: • Communicate with their healthcare providers as well as familymembers

• Obtain advice • Access their medical history,including allergies, immunizationsand flu shot history

• Access information about theirmedications and test results

• Learn about preventive caremeasures applicable to them

• Refill prescriptions • View, request and cancelappointments

Heading South (Mattydale & South) on Rt. 81 Take 81South Exit onto Rt. 690 E, then exit at Teall Ave. Turnright and onto Teall Ave. Teall will become Columbusas you cross Erie Blvd E. Turn left onto E. Genesee St.Continue on E. Genesee to 3229. Joslin is on the left.Nottingham High School is across the street.

Heading South (Cicero & North) on Rt. 81 Take 81South to 481 Dewitt exit 3W. Take E. Genesee Streetabout 2 miles to 3229. Joslin is on the right.Nottingham High School is across the street.

Heading North on Rt. 81 Take Exit 16A off Rte 81 N to481 N. Continue along 481 N to Dewitt Exit 3W. Followoff ramp onto E.Genessee Street. Continue onE.Genesee Street about 2 miles. Joslin is on the right.Nottingham High School is across the street.

Heading East on Rt. 690 Exit at Teall Ave. Turn rightand continue on Teall. Teall becomes Columbus asyou cross Erie Blvd E. Turn left onto E. Genesee St.Continue on E. Genesee to 3229 (on the left).Nottingham High School is across the street.

Heading West on Rt. 690 Exit at Teall Ave. and turn left and continue on Teall. Teall becomesColumbus as you cross Erie Blvd E. Turn left ontoE.Genesee St. Continue on E. Genesee to 3229 (on the left). Nottingham High School is across the street.

Heading East on the NYS Thruway (I 90) Take exit #39.Take 690 E to Syracuse and exit at Teall Ave. Turnright and continue on Teall. Teall becomes Columbusas you cross Erie Blvd E. Turn left onto E. Genesee St.Continue on E. Genesee to 3229. Joslin is on the left. Nottingham High School is across thestreet.

Heading West on the NYS Thruway (I90) Take exit#34A. Take 481 South to Dewitt Exit 3W. Turn right onto E. Genesee Street and go to 3229 on the right.Nottingham High School is across the street.

Centro Bus Route:Take the "Westcott #530" bus. If you are returning to downtown, take any "Downtown" bus or the"Fairmount #78" bus.

Affiliate at SUNY Upstate Medical University

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