Archive for May 2016

DPC pays for itself just in lab costs

I recently calculated out the cost of standard physical labs for a male patient of ours who had some blood sugar concerns.  These labs totaled over $933 if they had been billed directly to him by the lab company.  Mind you, none of that cost comes from the office visit or the interpretation of those labs.  That price is solely for the having the labs performed.

By cutting out the middle man and all the unnecessary fluff the cost of having those same labs done through our Direct Primary Care program would be $74.  That’s a savings of $859.  The yearly cost of his membership is $720.  By joining the DPC program his discount on labs is large enough to pay for the cost of the membership itself.

But of course the coolest thing of all is that all of his labs are included free with his membership.  So by joining the DPC program he has saved enough money in one set of labs to pay for the membership AND he doesn’t even have to pay for the labs.  It’s like a buy one get one free sale where you’re not required to buy one just get one free!



Why sugar makes you go blind. 

Here’s an interesting study looking at the prevalence of diabetic retinopathy in patients across the spectrum of blood sugar control.  It showed that individuals with a Hgb A1c greater than 5.5% have the biggest increase in retina damage due to sugar exposure.  A Hgb A1c of 5.5% is equivalent to an average blood sugar of 111 mg/dL.  For reference, diabetes is diagnosed when a fasting blood sugar is 126 mg/dL on two occasions.  That means that individuals who have not been diagnosed with diabetes may already have retina damage from high blood sugars.

Now is the time to change.  Call our office at 539-0270 to schedule an appointment with our Nutrition Counselors and take control of your blood sugar.  Save your vision!

Association of A1C and Fasting Plasma Glucose Levels With Diabetic Retinopathy Prevalence in the U.S. Population

Implications for diabetes diagnostic thresholds

OBJECTIVE To examine the association of A1C levels and fasting plasma glucose (FPG) with diabetic retinopathy in the U.S. population and to compare the ability of the two glycemic measures to discriminate between people with and without retinopathy.
RESEARCH DESIGN AND METHODS This study included 1,066 individuals aged ≥40 years from the 2005–2006 National Health and Nutrition Examination Survey. A1C, FPG, and 45° color digital retinal images were assessed. Retinopathy was defined as a level ≥14 on the Early Treatment Diabetic Retinopathy Study severity scale. We used join point regression to identify linear inflections of prevalence of retinopathy in the association between A1C and FPG.

RESULTS The overall prevalence of retinopathy was 11%, which is appreciably lower than the prevalence in people with diagnosed diabetes (36%). There was a sharp increase in retinopathy prevalence in those with A1C ≥5.5% or FPG ≥5.8 mmol/l. After excluding 144 people using hypoglycemic medication, the change points for the greatest increase in retinopathy prevalence were A1C 5.5% and FPG 7.0 mmol/l. The coefficients of variation were 15.6 for A1C and 28.8 for FPG. Based on the areas under the receiver operating characteristic curves, A1C was a stronger discriminator of retinopathy (0.71 [95% CI 0.66–0.76]) than FPG (0.65 [0.60 – 0.70], P for difference = 0.009).

CONCLUSIONS The steepest increase in retinopathy prevalence occurs among individuals with A1C ≥5.5% and FPG ≥5.8 mmol/l. A1C discriminates prevalence of retinopathy better than FPG.


Romaine Calm! Low carb Mexican dining just got easier

2016-04-30 17.12.52


I recently visited Abuelo’s in Turkey Creek and found their fajitas come with an option to be served with romaine lettuce leaves instead of the traditional tortilla’s wraps.  Many of our patients carry their own store-bought, low carb tortilla with them while eating out at a Mexican restaurant.  However, it is great to have another low carbohydrate option that is even better for you.


Trinity Direct Medical Care in Maryville is almost ready

I had a chance to visit Trinity’s new Direct Primary Care office in Maryville and see the renovations nearing completion.  It’s a beautiful new office that will be a perfect setting for the low cost, personalized health care we offer in our Direct Primary Care program.  It sits directly on East Lamar Alexander Boulevard and has great curb appeal.  Offering easy access in the parking lot and through the office I think Maryville patients will find this practice location quite enjoyable.  Dr. Hone has done a wonderful job coordinating the updating of that office!

They have plans for a soft opening in the next couple weeks.  We’ll host a grand opening in June and invite everyone to come see the location.

For more information about the Maryville office contact 982-0835.

For more information about Trinity’s Direct Primary Care program contact 244-1800 or attend our next informational meeting this coming Saturday, May 7th at 11:30am in the lobby of Trinity’s Fort Sanders West office.

-Dr. McColl2016-05-04 13.52.20