If you Wish upon a Tree

The VW Cross Fox from a Mexican VW ad.

Highlight of the day: All four of us went to dinner at a restaurant called Mandarin Box, and before we left, our waiter asked us if we wanted to make wishes as part of a Japanese tradition. We wrote our wishes on small pieces of paper and tied them on a tree. When they fall off, our wishes will come true. I wished for a Volkswagen Cross Fox, a model they have in Mexico, but not in the US. Here's to hoping my wish falls off the tree soon!

     Today when I got to Clínica San Pedro, Dra. Magda told me I would be spending the day with her friend, Dra. Marisol. Dra. Marisol treated only employees of IMSS. The majority of her cases were similar to those of Dra. Magda: diabetes, hypertension, and cases of the common cold for the most part.

The entrance to Clínica
San Pedro.

     Savannah and I decided to stay later than normal today to see how the DiabetIMMS program worked. DiabetIMMS is a program by IMMS that is especially for recently diagnosed diabetics. Since general patient visits are constrained to being only 10 minutes in length, DiabetIMMS gives patients a chance to be more thoroughly checked every month. About 30% of the population in Puebla is diagnosed with diabetes. Many patients do not take their medications regularly, causing more problems as their disease progresses. In DiabetIMMS, the doctor is able to spend more time examining lab results and changes in any complications, which should hopefully help keep complication rates down in the future. The ability to take the time to educate a patient one on one is vital to many patients fully understanding the importance of taking their medications and controlling their diabetes now rather than later when it is more difficult.

Here are the main things I learned from my afternoon in DiabetIMMS:

A poster titled "Understanding
Diabetes" which was in the
doctors office.

1. Metaformina is the most commonly prescribed drug for diabetes because it regulates glucose levels, it doesn't have as high of a resistance to insulin as other drugs, it can help reduce triglyceride levels, and it can assist in weight loss. It is also the cheapest option. 
2. About 80% of patients with diabetes are also diagnosed with onicomicosis, or onychomycosis, or alteration of the skin and nails. With proper treatment, onicomicosis does not have to be permanent. 
3. Being overweight or obese is common with diabetes. Last month, 28% of the patients in DiabetIMMS had a normal weight, 32% were overweight, and 40% were obese.

     DiabetIMMS is very useful to IMMS because it allows family practice doctors to focus more on other patients. Every month approximately 300 patients attend a DiabetIMMS appointment. In comparison, approximately 600 patients attend appointments with a family practice doctor, and approximately 1,500 patients are seen in the urgent clinic at Clínica San Pedro. There are a few clinics within a 50 block radius of Clínica San Pedro. Most of the larger medical facilities are focused in the most populous area of each state, in this case in Puebla, Puebla. It's nice for us, because we don't have to travel too far each day!