Diabetes, Endocrine Disorders and Obesity Longevity Program

Considering the restrictions inherent in the current practice of medicine, Dr. Safa desires to provide diabetes, metabolic and endocrine care to a number of his patients in a more detailed personalized way with a commitment to limit the number of patients and provide optimal time for an advanced high quality specialty care.  This would be most appropriate for management of diabetes, obesity and its frequently observed metabolic co-morbidities. Dr. Safa with more than 35 years of experience in taking care of complex patients along with his experienced staff envision to provide optimal care to the patients that desire this level of service.

A definite challenge to our current diabetes and metabolic management and complicated endocrine patients is aligning the interests of patients, physicians, pharmaceutical companies, and payers (insurance companies and Medicare) to ensure an efficient, economical, and effective use of resources. Unfortunately, the central role of the endocrinologist in this complicated multifactorial process has been largely ignored by payers.

Approximately Twenty percent of United States healthcare dollars is spent on the management of diabetes and its complications, amounting to enormous economic burden for the nation. However, the payments for the professional medical care have plummeted dramatically, resulting in severe shortage of endocrinologists and diabetes specialist in the country. As the result of the financial constraints created by the insurance companies and government health systems, sufficient time is not spent on the evaluation, management and follow-up of these patients that is essential for optimal outcomes. As published in Medical Economics (October 14, 2024), the biggest economic challenge in their study of certain medical practices were 28% reduction in reimbursement and 36% overall increased cost to practice medicine. As the results of these economic limitations seventy percent (70%) of the counties in the United States have no endocrinologist – A disastrous situation.  This inappropriate payment for professional services has resulted in a reduction of desired outcomes and an increase in the burden of disease and associated conditions such as obesity, arterial hypertension, lipid disorders and metabolic syndrome. This places these patients at a significant disadvantage, leading to life threatening complications and shorter health span and lifespan – an entirely avoidable phenomenon.

In this innovating program, our intention is to optimize the care, moving away from the traditional one-size-fits-all model and focus on treating each patient as a unique individual. In this process, we will tailor diagnostic evaluation and available technology, laboratory testing and treatments to the specific needs of individuals.

It is our aim to find the right management for the right patient, at the right time in order to extend a healthy, long and happy life for individuals with diabetes, prediabetes, obesity and metabolic disorders – eliminating or minimizing potential complications. By understanding the unique makeup of a patient, we will be able to make informed decisions leading to the most effective course of treatment and outcome.

In the evolution of diabetes management, we have come a long way from the inadequate tools of traditional diagnosis and treatment with older oral medication and insulin therapy as the primary treatment of diabetes. We now have the opportunity to use advanced testing and, medical technology, modern imaging, progress in pharmacological products, state of the art evaluation and management of complications, preventive care and eventually the use of many classes of medication with varying mechanism of actions to optimize the outcome. While these drugs can be effective, the goal is to more specifically target the underlying drivers of diabetes including obesity. We try to detect illness at its earliest, most treatable stage that can prevent chronic conditions from escalating. These advances help to identify the disease state and provide insight into the nature of diabetes. Among the notable drugs is the discovery of Glucagon – like peptide 1 (GLP-1) analogs, targeting diabetes and obesity management.

It is our privilege to be able to gather a team of highly trained professionals, including nurse practitioner certified in advanced diabetes management and supporting personnel with years of experience in the management of diabetes, endocrine, metabolic disorders and obesity. Considering above facts, current obstacles in reimbursements and desire for optimal outcome, we have elected to create this personalized program, which will be unrelated to financial coverage by insurance companies and Medicare to improve the life span and heath span or our patients.

THE COMPONENTS OF OUR PERSONALIZED LONGEVITY PROGRAM ARE AS FOLLOWS.

These items can be adjusted to the individual need.

1. Initial interview (in person or virtual to explore if the patient is interested in the program and agrees with the requirements. (This can be done expeditiously by our diabetes longevity liaison for our existing patients).
2. Scheduling a comprehensive history and physical exam.
3. Comprehensive, detailed laboratory testing obtained in our office. You would be able to use your insurance for covered lab tests. Additional laboratory tests panels may be obtained at additional out of pocket cost, if desired.
4. Evaluation of cardiovascular risk factors.
5. Electrocardiogram, if not previously done.
6. Screening for peripheral vascular disease of the lower extremities (ABI).
7. Foot examination
8. Management of obesity as needed, using appropriate FDA approved drugs.
9. Attention to female and male health care including hormone replacement therapy.
10. Body composition analysis by InBody in our office as needed.
11. Advice regarding vaccination schedule.
12. Initiation of continuous glucose monitoring (CGM) and instructions regarding its use.
13. Periodic electronic monitoring and data analysis of the continuous glucose monitoring (CGM) by our staff either in person or by telemedicine and appropriate recommendations.
14. Follow-up every 3 months or more frequently either in person or by telemedicine.
15. Access to our emergency line 24/7.
16. Availability by video telemedicine.
17. Consideration of the use of insulin pump.
18. Access to our diabetes longevity liaison.
19. Same day or next day follow-up availability.
20. In office laboratory tests (Quest lab) with no appointment or waiting that can be done by Quest and billed to your insurance or Medicare.

We collaborate with Fairfax Radiology for the following procedures as needed and will be happy to review the results and make appropriate recommendations.

1. Abdominal ultrasound if appropriate. Ultrasound of the Aorta (age specific)
2. Coronary calcium score and CT coronary angiogram for high-risk patients pending initial evaluation and laboratory tests (appropriate for age and disease process).
3. Bone densitometry exam (DEXA), appropriate for age and risk factors
4. Chest x-rays (appropriate for age and disease process)
5. Carotid duplex ultrasound (for appropriate clinical finings).

We also coordinate care for the following evaluations with appropriate consultants as needed:

1. Cardiovascular consultation
2. Eye exam.
3. Upper gastrointestinal endoscopy and colonoscopy as appropriate for age, symptoms and risk factors.
4. Other consultation referrals as needed.

We are currently registering interested patients to enroll in this program that will be available for individuals on a self-pay basis, as well as for organizations seeking to offer to their employees.

Please contact our Longevity liaison Andrea Mullins (703)938-8885 to learn more about this exciting program and register.