Successes in diabetes care

Photography by Nate Smith

Excerpted from page 56 of the November/December 2022 edition of AOA Focus.

Ansel Johnson, O.D., is eager to talk about his vision for caring for patients with diabetes. It is rooted in a holistic approach: the latest technology (OCT); a standard of care informed by his training and the latest research (such as the AOA diabetes guideline); collaboration with a patient’s primary care physician, a dietician and a pharmacist; and patient education.

Patients can even learn from each other, says Dr. Johnson, who practices in Illinois.

His philosophy? It all works together.

What is crucial is being in a patient’s corner with all those tools at his disposal.

A member of the Association of Diabetes Care & Education Specialists (ADCES) for more than two decades, Dr. Johnson says: “You’ve got to be patient-centered and see what their barriers are.”

Dr. Johnson is one of only six doctors of optometry among ADCES’ 12,000 members.

You and Paula Newsome, O.D., started a program a few years ago called KNOC^TM (Knowledge-Nutrition-Ocular Health-Coaching). Describe this holistic philosophy.

Even professional athletes, who may know what drills they need to do, have their trainers. They have a strength coach. They may have a speed coach. They may have a psychologist to talk to. They have different people to help them be better.

From where does your passion for providing diabetes care derive?

Family. I have family living with diabetes. I have family members who passed away from complications from diabetes. I am a poster child for Type 2 diabetes because I am living with diabetes myself. Like most people, I ignored the warning signs. I’m a busy professional, running my own practice, with a high stress level, until I had a catastrophic health incident and had to be hospitalized because it had gotten out of control.

Does your own diabetes story help you relate to your patients with diabetes?

Professionally, in practice every day, I see people living with diabetes. I am able to relate my own story to them. I talk to them about my own struggles and day-to-day decisions I have to make to live a better-quality life. I am also really big on patient education.

You’ve talked about providing patients with “nuggets” of education. What are those?

We all know, intellectually, how to take care of ourselves if we’re prediabetic or diabetic. But we also have our own human frailties and struggles. I ask patients, “What’s your plan?” I challenge them to be specific. If they mention their diet, I ask them “How are you going to eat differently?” Are they going to start eating from smaller plates, decreasing the amount of meat they eat? I try to give people specifics or tips that are motivational and achievable.

What kind of commitment does it take to provide this level of care?

Not every doctor can be out of their office for a prolonged period. But I am certified by the Centers for Disease Control and Prevention in diabetes prevention. That’s a two-day seminar—Diabetes Prevention Program lifestyle coach—which is a much lower bar to manage. Optometry can make a big difference in terms of public health and health care disparities.

Access AOA’s valuable diabetes resources

To raise public awareness about diabetes and support doctors’ of optometry integral role in detecting the disease, the AOA has a collection of valuable resources including:

• The AOA’s evidence-based clinical practice guideline, Eye Care of the Patient with Diabetes Mellitus, Second Edition, contains 31 recommended actions to enhance care of patients with diabetes. Listen to the podcast on the guideline.
• Members-only online courses can be accessed at EyeLearn Professional Development Hub including AOA Diabetes MastersClass: Diabetes Guidelines and AOA Diabetes MastersClass: Diabetes Education for doctors and paraoptometrics. Also available are paraoptometric-only courses on diabetes: Para Speaker Series-Navigating Diabetes: Vision, Eye Health & Wellness Facilitated by Paraoptometrics; Diabetes and the Eye; and Practice Success-Diabetes 101 for Paras.
• Resources at AOA Marketplace include the updated Diabetic Retinopathy Fact Sheet and other patient education materials.
• The American Public Health Association recommends 17 actions for eye doctors, dentists, pharmacists and podiatrists for managing the care of patients with diabetes to get the best outcomes. Read and adopt actions in “A Call to Improve Patient and Public Health Outcomes of Diabetes through an Enhanced Integrated Care Approach.”
• Published in November 2021, the AOA Health Policy Institute paper, Diabetes Clinical Management, Education, Prevention and Support Bilaterally Integrated through Optometry and Diabetes Care and Education Specialists, emphasizes the positive health outcomes afforded by doctors of optometry through collaboration.
• Consider 12 ways to provide better care for patients with prediabetes and diabetes.
• The American Diabetes Association offers the public separate 60-second online risk tests for diabetes and diabetic retinopathy.