Diabetes Center of Excellence (DCOE)
The Diabetes Center of Excellence is a premier Air Force Medical Service specialty clinic dedicated to providing standardized diabetes care to beneficiaries across the military health care system. The clinic includes three equally important sections: clinical division, outreach division, and research division. The clinical component provides diabetes management, diabetes education, and diabetes prevention programs through referral care to over 50,000 TRICARE beneficiaries.
The DCOE is staffed by board certified endocrinologists, endocrine fellows, internal medicine residents, diabetes nurse practitioners, certified diabetes care and education specialists, and licensed vocational nurses. The clinic has a mix of active duty, civilian, and contract personal. Patients with diabetes are seen by referral in the Diabetes Center of Excellence at Wilford Hall Ambulatory Surgical Center (DCOE). Patients with other endocrine issues, such as pituitary dysfunction, thyroid dysfunction, thyroid cancer, adrenal dysfunction, bone/mineral disease such as osteopenia and osteoporosis, and gonadal dysfunction, will be cared for by the Endocrinology Service at BAMC.
Services at the DCOE
Diabetes Management (referral required)
The multidisciplinary staff collaborates with the PCMH to assist both type1 and type 2 diabetes mellitus, those patients on insulin pumps, continuous glucose monitors, using U-500 insulin, and other complex medical treatments. Once controlled, patients with type 2 diabetes may be returned to their primary care manager.
Diabetes Education (may self-refer – Call Clinic to Arrange)
The Diabetes Self-Management Education and Support (DSMES) services are recognized by the American Diabetes Association. Provides initial education (up to 10 hrs), recurring/refresher education and individual support as needed.
Diabetes Prevention (may self-refer – Call Clinic to Arrange)
The Prevention Team offers patients at risk for diabetes a Preventing Diabetes Workshop, as well as, the DPP Group Lifestyle Balance program. The CDC approved curriculum provides an intensive 12 week intervention followed by eight monthly support/education sessions. Program target goals are: 7% weight loss and 150 minutes of moderate activity per week.
Procedural Services Performed
Osteoporosis screening and management using DXA (dual energy X-ray absorptiometry) to measure bone density FibroScan - a noninvasive screening procedure that screens for fat deposition in the liver, that is associated with obesity and T2DM.
A Medical Visit can be stressful at the best of times. When you are concerned or not feeling well it is very easy to forget the topics that you wanted to address at your visit. A little preparation before your visit will make the time with your provider more productive. You may also want to involve a trusted third party (relative or friend) to assist with information or attend the visit with you.
To Prepare for Today’s DCOE Visit
Write down your questions or concerns. Include symptoms that you are concerned about: when they started, how long do they last, where they are located, what makes them better and what makes them worse. It is also helpful to gather the following information to help your Diabetes Care team know the things that will help them clarify your issues.
- Bring your Glucose meter and log
- Please check your blood glucose before and after each meal and at bedtime (7 times a day) for 3 days during the week before your scheduled appointment
- This is very important information your provider will use to adjust medications
- Phone apps are available for glucose monitoring
- A list of all your medications (including over-the-counter medications and herbals)
- Past and Current Medical Problems (include any identified since your last visit)
- Surgeries (when, what kind, why?)
- ER visits (when, what for, what was done?) since last seen in the DCOE
- Hospitalizations (when, how long, what for?) since last seen in the DCOE
- Family history (grandparents, parents, siblings) of diabetes and stroke
- Immunizations (Pneumonia, Flu, Hepatitis B)
- Visits to other providers (testing done, new medications and recommendations they made)
- Allergies to or intolerance of medications, or substances