A Champion of Patients in Diabetes Care

Managing any chronic disease is tough, and can feel like a full-time job. Diabetes is certainly no different.

“It impacts every single part of your life – from the foods you eat, to how activity impacts your body. There are medications to help, but you are constantly monitoring everything you do and everything you consume,” explains Heidi Diez, PharmD ‘04. 

And if that’s not hard enough, those diagnosed with diabetes also deal with the epidemic of callousness. 

“There is unfortunately such a lack of compassion for a disease that is so cumbersome. Many wrong assumptions are made about people suffering from diabetes.” 

But where there isn’t a lack of compassion? Any room that Dr. Diez enters. A champion for diabetes patients, she wears many hats – Clinical Pharmacist Specialist at Michigan Medicine, Co-Director of the Michigan Collaborative for Type 2 Diabetes (MCT2D) and Clinical Associate Professor at the U-M College of Pharmacy. 

Building Trust with Patients

As a Clinical Pharmacist Specialist, Dr. Diez sees patients at a clinic – many of whom are navigating a recent type 2 diabetes diagnosis. 

Under a collaborative practice agreement, she is able to prescribe medications for diabetes, hypertension and hyperlipidemia, work with patients on lifestyle changes, make changes to medications as needed, take blood pressure, perform foot exams and order labs as necessary. What’s most important to Dr. Diez, though, is making sure patients feel seen, heard and championed. 

“I love connecting with people. I feel lucky, as a pharmacist, to be given the time to focus on one disease, make a connection, gain the trust of a patient and empower them to believe in themself,” Diez reflected. “Celebrating patients when they modify their diet and lose a couple of pounds and congratulating them for walking from their front door to the mailbox is important. People need someone to believe in them, and I do.” 

She works with physicians to ensure her patients have everything they need to manage their diabetes – including continuous glucose monitors (CGM’s). “I feel like I’m the queen of CGM’s,” Diez joked. “I was once told by a payer that a CGM is a luxury item, but it’s such an important tool for these patients to have. They can see in real-time how foods impact their blood sugar.”

She didn’t originally expect to be the CGM queen, though. It wasn’t until after she earned her PharmD that she realized the need for individualized care for diabetes. 

“I was working in a community pharmacy performing medication therapy management sessions and I started to notice that so many of my patients had diabetes. Because primary care physicians have limited time to spend with each patient, I knew there needed to be a focus on managing diabetes.” 

However, convincing the healthcare world that pharmacists bring great value to clinical care wasn’t always a picnic. 

“When I was early in my career working in a traditional community pharmacy, I was tasked with setting up clinical services. I sent out letters to local physicians and not every response I received was welcoming.”

Now, years later, the landscape has dramatically changed.

“I think back to 2019 when I took a three-week honeymoon, and the doctors I worked with were nervous that they wouldn’t have me for three weeks. That made me feel significant and that I bring a vital service to the clinic,” said Diez. 

Leading a Charge

On top of her clinical role with Michigan Medicine, Dr. Diez is advocating for diabetes patients in a different way as Co-Director of the Michigan Collaborative for Type 2 Diabetes (MCT2D) – a Collaborative Quality Initiative (CQI) funded by Blue Cross Blue Shield of Michigan that she helped launch. 

Historically, only physicians have served in director roles for Blue Cross Blue Shield of Michigan CQI’s, but Dr. Diez broke barriers to become the first pharmacist in a co-director capacity in the first population health-based CQI.

The initiative focuses on improving the lives of those living with type 2 diabetes via three aims to increase: prescribing guideline-directed medications like Ozempic, Mounjaro, Jardiance and Farxiga, CGMs and use of  low carbohydrate eating patterns. 

“Primary care physicians don’t have the time to focus on one disease state. This is an opportunity to present information to them in a concise way, support team care, and create clinical resources providing stronger and broader care ,” Diez explained. 

Each day working with the collaborative looks different for Dr. Diez as she works with her team to build educational tools for clinicians and patients, leads a patient advisory board and meets with insurance providers to advocate for broader coverage and expand coverage communication pathways to improve care for patients.  Some tools she’s most proud of include Dosing Guide , Clinician Decision Aid, Incretin Shortage Guide and Benefits of New Diabetes Medications for patients. 

Inspiring a New Generation

Dr. Diez shares her love for patient advocacy with future pharmacists as a Clinical Associate Professor at the U-M College of Pharmacy. 

Previously, Dr. Diez co-taught the PharmD diabetes unit and served as the Director of Immunization Implementation. Now, in a scaled-back faculty position, she is able to work one-on-one with students through experiential learning – as she leads students on rotation at her clinic. 

“I love sharing my patients with my students and showing them what I do. I love nothing more than having a student come on rotation with me who is more reserved and see them become more confident by the end of the five weeks.”

And even if they decide ambulatory care isn’t for them…

“I hope that if they end up in a role that isn’t patient-facing, they still reflect on their time with my patients. I always make sure to tell them to never lose sight of the patient, because that’s what healthcare is all about.”

As she reflects on her career thus far, she offers a piece of advice for PharmD students. 

“Explore as much as you can. You might come into pharmacy school thinking you’re going in one direction, and you may go off in another direction. Take the opportunities offered to you and seek new opportunities. You may just find a passion you didn’t know you had.”