-MICHAEL ABOUASSALY, MDBURLINGTON AREA FAMILY PRACTICEHEALTHY LIVING CLINIC
Michael AbouAssaly MD: Work Experience • Education and Training • Undergraduate • University of Iowa • B.S. Exercise Physiology • Graduate • University of Iowa College of Medicine • Post graduate training • West Suburban Hospital and Medical Center, Chicago, Illinois • Family Practice Residency Program • Burlington Area Family Practice Center, West Burlington, IA 1998 to Present • Northwestern University Feinberg School of Medicine – Clinical Instructor/Preceptor 2006 to Present • University of Iowa College of Medicine – Clinical Instructor/Preceptor 2008 to Present • Medical Director: Healthy Living Clinic & Weight Loss Center 2009 to present
Practice • Burlington Area Family Practice • 16 partners • 55,000 patients • See average of 30 pts/day • Full scope family practice to include in-patient, newborn, pediatric and adult • Assist on total joint replacement with own pts • Office surgery
http://www.cdc.gov/diabetes/statistics/slides/long_term_trends.pdf; 2007 CDC Press Release: http://www.cdc.gov/media/pressrel/2008/r080624.htm Huang E, et al. Diabetes Care. 2009.; 32: 2225-2229. Incidence of diabetes is increasing rapidly 2008 24 Million2 2034 Projection 44 Million3
National Diabetes Fact Sheet of the National Center for Chronic Disease Prevention and Health Promotion; NCHS; CDC; ADA; AACE; http://www.dagc.org/diastatsUS.asp (Numbers are based on the US population). Tomorrow…
Diabetes is a Progressive Disease:Complications Begin Prior to Diagnosis Years From Diagnosis 10 0 5 -10 -5 Insulin resistance Insulin secretion Glucose Levels Microvascular complications Macrovascular complications Impaired Glucose Metabolism Type 2 diabetes Diagnosis Onset 7 Adapted from Ramlo-Halsted BA et al. Clinical Diabetes. 2000; 18(2):80-85
Glucose Criteria for Diabetes and Impaired Glucose Metabolism Diabetes 126 Impaired Fasting Glucose (IFG) IFG + IGT 100 Fasting Glucose (mg/dL) Normal Fasting Glucose (NFG) Impaired Glucose Tolerance (IGT) 140 200 2-h Postload Glucose (mg/dL) 8 American Diabetes Association. Diabetes Care. 2009; 32:S13-S61.
79 million Americans are pre-diabetic, with 2.4% converting annually US Adult Population (MM)1 222 million Annual Medical Costs2 1,900,0001 pre-diabetics convert to Type 2 diabetes each year • National Diabetes Fact Sheet. Centers for Disease Control, 2011. • The United States of Diabetes. United Health Group, 2010.
Medical costs increase years before diabetes diagnosis Diabetes Conversion (Diagnosis) Dollars ($) Years Before Diagnosis Nichols G, et al. Diabetes Care. 2000; 23:1654-1659. Nichols G, et al. Diabetes Care. 2000; 23:1654-1659.
Diabetes is a preventable disease *Currently, no medications are FDA-approved for the prevention of diabetes 1. Diabetes Prevention Program Research Group. NEJM . 2002; 346:393-403. 2. Tuomilehto J, et al. NEJM. 2001; 344:1343-1350. 3. DREAM Trial Investigators. Lancet. 2006; 368:1096-1105. 4. Zinman B, et al. Lancet. 2010; 376: 103-111. 5. DeFronzo R, et al. Late Breaking Clinical Presentation: 68th ADA Scientific Sessions, 2008.
6-month long program • High-touch between staff and members • Combines 3E’s (Exercise, Education, Eating) • No medications are prescribed to induce weight-loss or appetite suppression • Accountability • Wellness Coaching • Healthy Living Clinic opened specifically to oversee OpT
Start With A Clean SLATE • Science supported diet • South Beach style, “real foods”, long term success • Life-based education • Positive lifestyle changes • Accountability • Weekly weigh-ins, random phone calls, weekly emails/reminders • Tracking results • Baseline measures then 1/3/6 month follow ups • Exercise • 150 minutes/wk, functional, group motivation
Community Involvement • Local grocery stores have made food shopping easy by marking approved items with OpTlogo • Local grocery store’s in-house chef and dietician have created OPT “take away” meals and weekly menus • Local restaurants have created OPT approved menus to compliment their regular items • Operation Recess has been created to encourage grade school age children to move during recess • On-site education and exercise at companies
Our Results • 84% weight-loss success rate after 6 months • 92% weight-loss success rate after 12 months • Average individual weight-loss = 26 pounds • Average change in Body Fat: 4.24% • Average change in BMI: 5.27% • 8,300 TOTAL pounds lost • 2,900 inches lost • 500+ total members of the Healthy Living Clinic Programs