Diabetes treated with expertise at G.C. Hospital


Dr. Manuel Flores had a great time when he went skiing with his family in Canada last December, but two weeks later he suffered from severe fatigue, and he could not understand why. Then he bit his tongue during dinner in his Glen Head home. The pain was so unbearable he was unable to eat or drink and became dehydrated which increased his fatigue.

“When I went to urgent care I crashed right there,” Flores, 58, said. “I was anemic, and my blood pressure went down.”

He was sent to Glen Cove Hospital’s emergency room where doctors found his lungs were filled with fluid and Flores also had kidney failure. He was diagnosed with ANCA Vasculitis, a rare autoimmune disorder causing him to create antibodies that attacked his lungs and kidneys, triggered by the medication hydralazine, which he had been taking for three years to treat hypertension.
Doctors recommended Flores take the steroid corticosteroids to lower the inflammation. But this caused him to develop diabetes. 

“That’s very common. As a diabetes specialist, I know firsthand the challenges and complexities of managing this complex condition,” said Dr. Barbara Keber, chairperson of the medical board of family medicine at Glen Cove Hospital. “The steroids raise the blood sugar dramatically and then it has to be managed in a hospital setting with insulin.” 

Flores returned home after three weeks of treatment. He continued his treatment and is currently being weaned off the steroid. People often no longer have diabetes after they go off of steroids, which is what Flores is hoping will be the case for him.

Glen Cove Hospital is known for their exemplary care for diabetes. The hospital received national recognition for the first time on March 20 from the American Diabetes Association and The Leapfrog Group as one of 17 hospitals honored with the designation of “Recognized Leader in Caring for People Living with Diabetes.” 

“These hospitals are leading the nation in dedication to people with diabetes,” Dr. Robert Gabbay, the ADA’s chief scientific and medical officer, said. “Safe, effective, patient-centered care from hospital admission through a patient’s return home lowers risks of serious health complications and improves outcomes for people living with diabetes.”  

The Leapfrog Group, an independent national watchdog for patient safety, evaluates hospitals based on their care for patients with diabetes during admission, stay and discharge. The group’s objective is to counter the heightened safety risks faced by approximately 8 million people living with diabetes who are hospitalized each year.

Dr. Bradley Sherman, chair of medicine at Glen Cove Hospital, said a great deal of effort is spent to keep the hospital’s diabetes program stellar.
“I think the key for us is a very strong, organized program, which continues to look at how we can continue to improve,” Sherman said. “There’s monthly meetings from the diabetes team and we continually are working on projects that improve the care. I think we’ve become a nationally recognized leader in diabetes care for all of the work that’s been done.”

Glen Cove Hospital screens for diabetes among hospitalized patients, particularly those undergoing surgery, protocols are in place to minimize the incidence of hypoglycemia, and there is much care given to optimizing the medical management of patients that come in with diabetes, Sherman added.

“We have a number of diabetes champions, usually nurses who have gone through the protocol of learning to be expert in diabetes care, to be able to teach others about that,” he said. “Diabetes is becoming an epidemic, given the fact that there’s such a high incidence of diabetes in the community.”

Keber said the hospital has been working since 2007 to put in place a diabetes program, which works directly with patients to educate them on how to manage their diabetes after they leave the hospital. And the hospital assists the uninsured as well as the insured.

“We have programs set up for the uninsured with our family medicine center,” she explained. “We are equitable about the care we provide for both, and this makes us stand out more.”

It’s about teamwork, she added, which includes nurses and ambulatory physicians. Many patients who come to the hospital for another issue find out they have diabetes or learn their diabetes is out of control.

“We have specialty physicians for diabetes, our pharmacists, case managers who all work together to help patients when they are discharged,” she said. “Over 90 of our nursing staff are specially trained to educate patients for care when they go home. Interdisciplinary is the key. We work as a team with our inpatients and outpatients which is unusual.”

Flores is a dean at a medical school in the Caribbean — the University of Health Sciences. He would travel there in the past but now works from home. He is required to wear a mask everywhere and is unable to go out in public places as he once did until he recovers. Although he misses going out to dinner with his wife and visiting friends, he’s encouraged that he is getting stronger, he said.
Flores has nothing but positive memories of his care at Glen Cove Hospital.

“It was a very, very good team I had there. They went the extra mile for me,” Flores said. “They really care about their patients. One of the topics I’ve always taught in medical school is doctor-patient relationship. It’s very important to me.”
His wife Magda said she appreciated the care doctors and nurses took to speak to her whenever she needed clarification. They were comforting.

“They were very empathetic,” she recalled. “There were times they didn’t know what they were dealing with. My husband has a very rare autoimmune disorder. So there were times they’d say, we don’t know how this is going to go but this is what we think may happen. They were honest with us.”

And Magda said she appreciated that the doctors, nurses and staff were positive. “He wouldn’t be here if it wasn’t for them,” she said.