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Adult Clinic

Patient Services


The past few years have been filled with progress as the Adult Clinic continues to strive for excellence in diabetes care and research. The Adult Clinic provides care for approximately 3,000 patients ages 18-75. The addition of Dr. Aaron Michels, who received his endocrinology training from the University of Colorado and joined the Clinic in July 2010, means that the Adult Clinic is now able to accept new patients, particularly those with type 1 diabetes.
Diabetes education is extremely vital to the Young Adult Clinic, whether the patient is newly diagnosed or has had diabetes for over 50 years.
As knowledge of type 1 diabetes expands and changes, it is our commitment that our patients share in that knowledge also. 

Services

Each of our patients is seen by at least one educator before he or she sees the physician. We have found this approach to be of utmost importance as it allows the patient to voice concerns about hypoglycemia, medications or other issues, as well as learn about improved therapies for diabetes care.
On staff, we are pleased to provide access to clinical social workers, a pharmacist, nurses, as well as dieticians, who are Certified Diabetes Educators.
These professionals educate our patients on how to effectively self manage their diabetes and to troubleshoot obstacles they may face in their health.
Our clinic has seen tremendous success with its newly implemented educational classes (see below) featuring carbohydrate counting instruction, insulin pump training, and continuous glucose monitor training. We also offer clinical trials for patients.
We welcome our new nurse educator, Sonya Walker who has a passion for educating those who share her quest to manage diabetes. We will be adding a new dietician in the near future as our clinics continue to grow. 

Adult Clinic Director:
Dr. Satish Garg, MD [ BioSketch ]

Newsletter:
October 2011

Seminars and Events: 
Skipping Insulin to Slim Down: The Dangers of Diabulimia  

 

 Adult Clinic Directory

 
Name Email
Peter Gottlieb MD Peter.Gottlieb@ucdenver.edu
Raymond Gutin MD Raymond.Gutin@ucdenver.edu
Aaron Michels MD Aaron.Michels@ucdenver.edu
Mary Voelmle MS, FNP, CDE Mary.Voelmle@ucdenver.edu
Christie Beatson MS, RD, CDE Christie.Beatson@ucdenver.edu
Sonya Walker RN, MBA Sonya.Walker@ucdenver.edu
Lisa Meyers MSW, CDE Lisa.Meyers@ucdenver.edu
Sam Ellis Pharm.D., BCPS, CDE Sam.Ellis@ucdenver.edu
 

 Classes Offered at Adult Clinic

 
Pediatric Transition
Introduction to Pump Therapy/CGM Class
Carbohydrate Counting
Continuous Glucose Monitoring
Pump Start
Class: Pediatric Transition
Date/Time: FIRST FRIDAY of EACH MONTH 9AM
Please call Heidi to schedule at 303.724.6755

Pediatric Transition Class is a class primarily for patients at the Barbara Davis Center for young adults transitioning from the Pediatric Clinic diabetes care to the Adult Clinic. The class utilizes a Conversation Map tool as well as slides to facilitate discussion and review of the following Diabetes 101 topics:

    Understand A1c Goals
    Understand glucose goals to reach A1c targets
    Review insulin action and duration
    Understand effect of alcohol on DM care
    Review concepts of pumps, CGM, and carbohydrate counting
Class: Pediatric Transition
Date/Time: FIRST FRIDAY of EACH MONTH 9AM
Please call Heidi to schedule at 303.724.6755

Pediatric Transition Class is a class primarily for patients at the Barbara Davis Center for young adults transitioning from the Pediatric Clinic diabetes care to the Adult Clinic. The class utilizes a Conversation Map tool as well as slides to facilitate discussion and review of the following Diabetes 101 topics:

    Understand A1c Goals
    Understand glucose goals to reach A1c targets
    Review insulin action and duration
    Understand effect of alcohol on DM care
    Review concepts of pumps, CGM, and carbohydrate counting
Class: Introduction to Pump Therapy/CGM Class
Date/Time: THIRD THURSDAY of EACH MONTH 3-5PM
Please call Heidi to schedule at 303.724.6755

Find out if you are a good candidate for insulin pump/ CGM. Pros and Cons of Pumping/ CGM. Understand the process to get started on an insulin pump/ CGM at the BDC. Visit with the representatives from the major pump/ CGM companies to find out which device is right for you.

Class: Carbohydrate Counting
Date/Time: SECOND WEDNESDAY of EACH MONTH 2PM
Please call Heidi to schedule at 303.724.6755

Learn what foods contain carbohydrates, understand portion control, and how much you should have each day. Is your A1c above the target of 7%? Do you have frequent hypo and hyperglycemia after meals? Getting ready to start insulin pump therapy? Are you finding it increasingly difficult to control your blood sugars? Are you tired of diabetes controlling your life? It's time for you to take control and understand your carbohydrate intake!

Class: Pump Start
Date/Time: SECOND WEDNESDAY of EACH MONTH 8AM
Please call Heidi to schedule at 303.724.6755

Patients will come to class at BDC to review inserting and button pushing of the CGM device. CGM is a device that provides "real-time" glucose readings and data about trends in glucose levels. It reads glucose levels under the skin (interstitial fluid) every 1-5 minutes. It provides alarms for high and low glucose levels. It works as a Behavior Modification Device. It displays and records glucose trending information throughout the day and night. It provides glucose direction and rate of change information to help you stay within your target glucose range. These concepts will be reviewed to help you understand how to best use your CGM.

 

Class: Carbohydrate Counting
Date/Time: SECOND WEDNESDAY of EACH MONTH 2PM
Please call Heidi to schedule at 303.724.6755

Insulin initiation for pump starts. The first 4 hours of this class is meeting with a diabetes educator to learn button pushing and infusion insertion for each insulin pump. After insulin is initiated, patients will meet to learn the theory behind insulin pumps and the goals of pump therapy. Advanced features of pump therapy will be reviewed at 2 week follow-up visit.

 

 Adult Clinic Diabetes Studies

 

CURRENT STUDIES

Type 1 - F3Z-MC-IOPV [ Show Detaile ]
This is a 26 weeks, comparing Humalog to Novolog in pump over 6 days of pump reservoir in-use. Additionally, compares Humalog 6 day use with Humalog 2 day use. Inclusion criteria: T1DM >24mo, age >13yo, pump >6mo, use <46U/day in 300U reservoir or <26U/day in 180U reservoir, BMI <35.0, A1c 5%-9%. Exclusion: CGM unless agrees to not use in study, impaired renal function, hypo coma or seizures last 12mo, hypo unawareness, ER visit last 12mo, many pump occlusions, staph infection past 5y, hemoglobin abnormality, glucocorticoid therapy, irregular sleep cycle, need 10-20 people.
Contact:
Christie Beatson – Christie.Beatson@ucdenver.edu
[ Hide Detail ]
Type 1- Medtronic MiniMed Paradigm X54 System [ Show Detail ]
35-46 day Randomized, cross-over study of the low glucose suspend (LGS) feature in the MiniMed Paradigm X54 system. Suspends from hypoglycemic episodes due to exercise. Pts will go low by exercising at BDC. 50 patients between 8 sites. Inclusion: 16-60yo, >45kg, T1DM >12mo, use a Medtronic pump last 3mo, A1c 7%-10%, ability to exercise for extended period of time, T1DM >20y. Excl.: hypo coma or seizure in last 3y, adverse skin reaction at site, heart condition, CVA, Graves disease, renal impairment, abnormal hematocrit, K, TSH, fT4; hx of smoking >5y, betablockers, steroids last 30d.
Contact:
Mary.Voelmle@ucdenver.edu
[ Hide Detail ]
SIBA: NN1250-3583 [ Show Detail ]
SIBA is Novo’s new, long acting insulin to rival Lantus,“Soluble Insulin Basal Analogue.” TIDM, 52 week trial comparing SIBA to Lantus, both with Humalog. 20 in-clinic visits, 22 phone contacts. A1c <10%, BMI <35, 34 screened, 31 enrolled. Ends Sept. 2010, extension study coming.
Contact:
Christie Beatson – Christie.Beatson@ucdenver.edu
[ Hide Detail ]
Type 1 - Novo Nordisk 3770 Study [ Show Detail ]
29 wEek trial comparing SIBA to Lantus both using insulin aspart. Randomized to either: 1.) Insulin glargine QD, 2.) SIBA QD, or 3.) SIBA fixed flexible schedule. 15 in-clinic visits, 14 phone contacts. A1c <10%, BMI <35. Expect 30-40 patients. Ends Sept., 2010, extension likely.
Contact:
Christie Beatson – Christie.Beatson@ucdenver.edu
[ Hide Detail ]
Type 1 - SIAC Extension Study NN5401-3645 [ Show Detail ]
Extension to the previous SIAC study NN5401-3594 of Novo’s Pre-mixed Basal/Bolus SIBA + Novolog, 6 months, 3 enrolled. Ends Nov., 2010.
Contact:
Christie Beatson – Christie.Beatson@ucdenver.edu
[ Hide Detail ]

UPCOMING STUDIES

Type 1 – 2nd Januvia Study, MRK-SI-100 [ Show Detail ]
Because our first Januvia Inv. Initiated study was positive, Merck is paying us to initiate a larger, 140 pt, 6 month Investigator initiated multi-center trial! This is a double-blind randomized study with 6 visits with 3 meal challenges and 4 weeks of DexCom wear over 6 months. 100 mg Januvia once daily, A1c 7.5-10%, BMI ≤ 35, injections or pump ok, 25ish screened, done end of Jan.
Contact:
Christie Beatson – Christie.Beatson@ucdenver.edu
[ Hide Detail ]
Type 1- Halozyme HALO-117-205 [ Show Detail ]
A 6 month, phase 2 crossover trial: PH20/Hyalouronidase is an approved substance that decreases interstitial viscosity so injected insulin disperses faster and thus acts faster. A1c 6.7 to 8.2, pump or injection ok, switch to BID lantus. 30 weeks, 12 weeks on Humalog and 12 weeks on either PH20+Humalog or PH20+Novolog.
Contact:
Christie Beatson – Christie.Beatson@ucdenver.edu
[ Hide Detail ]
Type 2- Halozyme 206 [ Show Detail ]
A 6 month, phase 2 crossover trial just Like HALO-205 except in T2DM instead of T1. No pramlitide, exenatide, liraglutide sulfonureas for 1-2 months. A1c 7 to 8.5, switch to BID lantus. 30 weeks, 12 weeks on Humalog and 12 weeks on either PH20+Humalog or PH20+Novolog crossed over.
Contact:
Christie Beatson – Christie.Beatson@ucdenver.edu
[ Hide Detail ]
Type 1 - SIBA: NN1250-3644 [ Show Detail ]
SIBA Extention study. Starting in Sept. 2010, as subjects finish 3583, 52 week trial comparing SIBA to Lantus, both with Novolog. Contact:
Christie Beatson – Christie.Beatson@ucdenver.edu
[ Hide Detail ]
Type 1- DexCom 10 Day and 14 day studies [ Show Detail ]
In and out, 2 week studies, similar to the past.
Contact:
Mary.Voelmle@ucdenver.edu
[ Hide Detail ]
Type 2- H9X-MC-GBDD [ Show Detail ]
Eli Lilly investigational long acting insulin for T2D. New insulin is injected once weekly. Noninferiority study to latus in glycemic control. Approximately 52 week parallel open label study. A1c >7% on insulin injections for less than 10 years
Contact:
Christie Beatson – Christie.Beatson@ucdenver.edu
[ Hide Detail ]