Diabetes Management

Slide 1:Diabetes Management, Treatment and Tool KitInterdisciplinary Continuing Education Event

Sponsors Southern Counties RHEP (Rural Health Education Center) Southeastern AHEC (Area Health Education Center) WVRHEP Gorge Connection CAMC Health Education and Research Institute Thanks to All 1

Slide 2:Diabetes Education Toolboxfor Developing Service Learning Projectsand Patient Education Programs

RHEP / AHEC Interdisciplinary Conference August 3rd & 10th, 2010 Robert Foster, RPh – Clinical Coordinator - Southern Counties Jerad Bailey – PharmD Candidate – WVU School of Pharmacy Nathaniel Linville – Student WVU 2

Slide 3:Robert L. Foster, Jr., BS, RPh.

WVU – Biology Degree – 1973 Auburn University – Pharmacy Degree – 1976 CAMC General - Staff Pharmacist - 5 years Kanawha Valley Memorial – Director of Pharmacy Services – 5 years Pharmacy Management & Consulting Services, Inc. – President - 25 years Boone Memorial Hospital – Director of Pharmacy Services – 24 years Patient Focused Care – Patent Focused Decisions - Always 3

Slide 4:INTRODUCTION

What is a Diabetes Toolbox ? Thought / Idea Stimulator - provide the seeds that lead to service learning and education projects Fear Reduction Kit – supplies you with ideas for student service learning projects Resources – those needed by students and providers Internet Sites Contact Information for Local Expert Consultants Basic Outlines - of the components of a project Examples of Projects 4 The greatest source of anxiety and fear comes from the requirement that your student must participate in a service learning project. Also – one of the biggest reasons that people do not do large projects is that they imagine the task is more difficult than is the reality. The outline provided by this toolkit allows you to more accurately gauge the complexity of the work to be doneThe greatest source of anxiety and fear comes from the requirement that your student must participate in a service learning project. Also – one of the biggest reasons that people do not do large projects is that they imagine the task is more difficult than is the reality. The outline provided by this toolkit allows you to more accurately gauge the complexity of the work to be done

Slide 5:INTRODUCTION

The Goals of this Presentation Motivate You to Act Become a Student Preceptor / Field Faculty Start a Diabetes Education program Promote Students / Co-Workers – their ability, intelligence, and desire to work will surprise you – just provide them the opportunity to contribute Understanding and Appreciation of Interdisciplinary Teamwork 5

Slide 6:INTRODUCTION

The Goals of this Presentation Explore New Ideas – List Some Old Ones Solicit Input from the Audience - tap into the vast store of knowledge and experience here tonight Allow you the Opportunity to Form New Networks with Fellow Professionals Give you the Mechanism and the Confidence to Become a Facilitator Versus a Lecturer Provide Resources & Guidelines to gain reimbursement for Educational Services 6

Slide 7:Outline of the Presentation

Components of the Project – (multiple slides) – see next slide for list of all the components Sample Student Project - Diabetes Care Team Sample Student Project - Innovative Educational Tools for a Targeted Audience Educational Tools - Additional Slides Screen Shots of Websites - all are included in the links page 7 This slide and the next slide are here more to help the Student or your Education Team determine the contents of the Toolbox and the order of the subjects.This slide and the next slide are here more to help the Student or your Education Team determine the contents of the Toolbox and the order of the subjects.

Slide 8:Outline of the Presentation

Screen Shots Treatment Algorithms Diabetes Medications – table of medication properties Insulin Information Chart Website Links - live links on “bit.ly” website Student Project Lists – multiple slides Sample Student Project - basic course in diabetes Human Resources – Contact Information 8

Slide 9:Components of the Project Aspects that need to be Chosen and Defined

Scope of Project – ongoing, two months, one time…… People Needed– which providers, others needed (community groups, administration, billing dept……..) Target Audience – patient, community group, providers Venue – health fair, support group, seminar…….. Subject / Topic / Student Projects Education Tool / Modality – blog, podcast, lecture … 9

Slide 10:Components of the Project Scope of Project

Long Term / Ongoing Project Ideal situation for student project – multiple rotations over long period of time – project evolves and grows The scope you would pick for ongoing service in your clinic, office or hospital (projects without students) Defined Time Period Project One year, one month, one weekend – research study, seminar presentation ………….. One Time Project Lecture, elementary school health fair …….. 10

Slide 11:Components of the ProjectPeople Needed

Professional Providers Physicians, Nurses, Dietitians, Pharmacists ….. Hospital / Clinic / Office Staff Administration, House Keeping, Billing, Public Relations Department, Social Services ….. Community Involvement Churches, Clubs or Civic Groups, City Government … Other Professionals Professional Marketing Firm, Media Outlets … 11

Slide 12:Components of the ProjectTarget Audience

Patient and / or Family - Multiple Aspects Age – Geriatric, Middle Age, Pediatric Educational Level (Health Literacy) Factors Motivational State - Compliance History Community Groups Wellness Groups (i.e. – Boone Counties “All About Health”) AARP and other Senior Citizens groups UMWA Wellness programs ……… 12

Slide 13:Components of the ProjectTarget Audience – (cont.)

Professionals / Providers – for C.E. Seminars, Education Team Development …. Institutional Review Board - for approval of proposed research project Insurance Firm or Third Party Payer - to gain approval for payment for educational services 13

Slide 14:Components of the ProjectVenue

Health Fair Booth - Hospital or Community Fair Community Diabetes Support Group Patients and Caregivers – monthly, weekly sessions Multiple topics and Educational Modalities (see slides on these specific subjects) Clinic, Office, or Hospital Practice Education Sessions (non-accredited) Partner with local Pharmacy through Collaborative Practice Act to provide Patient Management 14

Slide 15:Components of the ProjectVenue – (cont.)

Formal Patient Education Sessions By Accredited “Diabetes Education Team” Service billable to Medicare, Medicaid and Third Party Payers Diabetes Screening or Education Fair Shopping Mall Your Hospital or Clinic or Office Collaborative Practice Agreement Protocol Driven / Physician Controlled - Disease Management Partnership with local Pharmacists 15

Slide 16:Components of the ProjectSubject / Topics

Cooking for Diabetics and Family (purposely listed first – one of most difficult aspects of a treatment plan) Foot care Oral Hypoglycemics (patient or provider education) Insulins Relationships between Exercise, Diet, Medications and Blood Sugar Levels “Low Health Literacy” Issues (and educational tools to address this problem) 16 The next several slides will just list some of the unlimited number of topics or subject matter that could be developed or used in a Diabetes Education Project No details included to avoid restricting the imagination or thought process of the student or your teamThe next several slides will just list some of the unlimited number of topics or subject matter that could be developed or used in a Diabetes Education Project No details included to avoid restricting the imagination or thought process of the student or your team

Slide 17:Components of the ProjectSubject / Topics - (cont.)

Preventative Care Aspects The new “pre-diabetic” concept (diagnosis) How to prevent developing diabetes Risk factors – warning signs How to minimize consequences of diabetes Research Topics Current Drug Company “Patient Info” packets Insulins – properties of each and when to use See “PROJECTS” slides for more research project 17

Slide 18:Components of the ProjectSubject / Topics – (cont.)

Educational Topics for Family and Friends Signs and Symptoms of Diabetes Hypoglycemia and Hyperglycemia – signs, symptoms and treatment for each Sources of glucose and where to keep them for emergencies Blood Glucose Monitors – the basics Patient Support – diet, exercise, meds and monitoring Basic understanding of Diabetes 18

Slide 19:Projects for Students

Establish Diabetes Education Network Providers in your discipline Providers in other disciplines Community people Diabetics and/or Family members Educators Department of Health Recruit New Members to Existing Team Helps Student learn to reach out to other providers Professional Retention – If they have ownership in community through the project – more likely to stay – RHEP / AHEC major focus is Recruitment & Retention 19 A later slide will give you a list of Human Resources – they will all be Pharmacists – So if you are not a Pharmacist you have a easy choice for the first project to assign your student (or your staff) Determine who in your neighborhood would be interested in joining a Diabetes Support or Education Team??A later slide will give you a list of Human Resources – they will all be Pharmacists – So if you are not a Pharmacist you have a easy choice for the first project to assign your student (or your staff) Determine who in your neighborhood would be interested in joining a Diabetes Support or Education Team??

Slide 20:The Diabetes Care Team

Diabetes must be approached from many different angles Lifestyle Modifications Medication Regimen Dietary Considerations Supportive Care A diverse range of issues necessitates a diverse care team Jerad Bailey - PharmD Candidate WVU School of Pharmacy I HEARD A QUOTE on NPR from an Ohio University Physician / Researcher – he said “patients need ongoing communication, support and frequent treatment adjustments – an the Physician is too busy to do all that is needed” Luckily – Diabetes is one disease state that is almost universally recognized as one that requires treatment through an interdisciplinary team approach. I HEARD A QUOTE on NPR from an Ohio University Physician / Researcher – he said “patients need ongoing communication, support and frequent treatment adjustments – an the Physician is too busy to do all that is needed” Luckily – Diabetes is one disease state that is almost universally recognized as one that requires treatment through an interdisciplinary team approach.

Slide 21:The Diabetes Care Team

Physician (PCP, Endocrinologist, Ophthalmologist, Podiatrist) Nurse Educator (Possibly CDE) Pharmacists (Possibly CDE) Dentists Dieticians or Dietitians (Possibly CDE) Exercise Trainers – Wellness Expert The Patient Jerad Bailey - PharmD Candidate WVU School of Pharmacy The team can vary – based on the resources available at your site – However – an accredited Education team (one qualified for third party payments) has to have at least some input or oversight – if not direct in person involvement - from almost all of the providers listed here. First aside – Kristen – can you be certified as a Diabetic Educator?? Second question – what are you – a Dietitian or Dietician I learned something here. A second student’s presentation – later – will spell the word “Dietitian” – he was a National competitor in Hosa’s medical terminology competition – so I looked it up – Googled it in todays parlance. Both are correct.The team can vary – based on the resources available at your site – However – an accredited Education team (one qualified for third party payments) has to have at least some input or oversight – if not direct in person involvement - from almost all of the providers listed here. First aside – Kristen – can you be certified as a Diabetic Educator?? Second question – what are you – a Dietitian or Dietician I learned something here. A second student’s presentation – later – will spell the word “Dietitian” – he was a National competitor in Hosa’s medical terminology competition – so I looked it up – Googled it in todays parlance. Both are correct.

Slide 22:Components of the ProjectEducational Tools / Modality

A Student’s Project I asked my Pharmacy Student – Jerad Bailey – to help me with this presentation. His specific assignment was to research educational tools that would improve the probability of reaching a certain Target Audience, of his choice. The results of his work (following slides) demonstrate that different generations see the world from a different prospective – and show the value in asking a student to help!! 22 mo·dal·i·ty (mo-dal'i-te) noun A therapeutic method or agent, mo·dal·i·ty (mo-dal'i-te) noun A therapeutic method or agent,

Slide 23:Diabetes Education – New Ideas for an Old Subject

Not Your Grandfather’s Podcast Jerad Bailey – PharmD Candidate WVU School of Pharmacy I asked my Pharmacy student – first block, 4th year – to help me with this presentation. The ensuing Brain Storming sessions ventured into a realm of ideas to which I had come unarmed – at least for the Brain part. Blogs and Podcast and Wiki’s – Talk Shoe and Movie Maker and YouTube (at least I new this one – thanks to Noel Devine’s fame and the WVU Bands postings there) – my head was spinning – but after multiple repeated explanations – the endless possibilities for Educating all spectrum of Patient and Professionals begin to take form in my head. The beauty of the ideas was that I could have my cake and eat it too – I could be part of these cutting edge technologies and techniques – and someone else would do all the work – does it get any better than that. The corny title slide is mine – do not blame Jerad for that.I asked my Pharmacy student – first block, 4th year – to help me with this presentation. The ensuing Brain Storming sessions ventured into a realm of ideas to which I had come unarmed – at least for the Brain part. Blogs and Podcast and Wiki’s – Talk Shoe and Movie Maker and YouTube (at least I new this one – thanks to Noel Devine’s fame and the WVU Bands postings there) – my head was spinning – but after multiple repeated explanations – the endless possibilities for Educating all spectrum of Patient and Professionals begin to take form in my head. The beauty of the ideas was that I could have my cake and eat it too – I could be part of these cutting edge technologies and techniques – and someone else would do all the work – does it get any better than that. The corny title slide is mine – do not blame Jerad for that.

Slide 24:Reaching Your Target Demographic

The average age of the newly diagnosed patient with Diabetes is decreasing “Classic Consultation” may not be the best method for approaching younger patients It is important to recognize methods of reaching out to all demographics Your students will be more likely to pursue (and thrive using) more modern methods of educating patients Jerad Bailey - PharmD Candidate WVU School of Pharmacy

Slide 25:The Advantages of Video

Practical Applications How to Perform a Finger Stick Test How to Administer Insulin Easy to Make Budget Video Recorders (Flip Cameras) Free Editing Software (Windows and Mac) Free / Cheap to Distribute Physical Media (CDs, DVDs and Flash drives) Electronic Distribution (Website, YouTube, etc.) Jerad Bailey - PharmD Candidate WVU School of Pharmacy

Slide 26:The Advantages of Video

Physical Media Over 80% of consumers own a DVD player Cheap to mass produce (about $0.25 / disc) Up to 2 hours of footage, multiple language audio tracks, and subtitles (closed captioning) Electronic Distribution Younger patients more inclined towards computers, cell phones, and the internet YouTube provides instant syndication Embeddable into personal and professional websites Jerad Bailey - PharmD Candidate WVU School of Pharmacy

Slide 27:The Advantages of Audio

Some settings are not amenable to watching videos Many people now own MP3 players 25% of Americans have listened to one in the vehicle “Podcasts” have reached wide syndication and have gained a tremendous amount of popularity among users Jerad Bailey - PharmD Candidate WVU School of Pharmacy

Slide 28:What are Podcasts?

Podcasts are like radio broadcasts available for download on the internet Formats range from talk radio, news, sports, entertainment, music, tech, and informative Synched to your MP3 player as soon as its released Listen at your convenience at home, during your exercise regimen, in the car ride to/from work, etc. Jerad Bailey - PharmD Candidate WVU School of Pharmacy

Slide 29:What are Podcasts?

Potential Uses for Podcasts Continuing education for caregivers Updates on recent breakthroughs Recap of conferences Interviews Patient education and motivation Diet and cooking advice Jerad Bailey - PharmD Candidate WVU School of Pharmacy

Slide 30:Utilizing Social Networks

At least 50% of Americans are on a social networking site Facebook MySpace Twitter “Blogs” remain a popular medium to convey information to a large number of individuals Jerad Bailey - PharmD Candidate WVU School of Pharmacy

Slide 31:Utilizing Social Networks

A Facebook Scenario Create a “XYZ Diabetes Care Team” Page Facebook members “Become a Fan” of the “XYZ Diabetes Care Team” Administrators can update the page regularly with content “Fans” of the page are notified immediately of new content “Fans” can also post their own questions which can be answered (publicly or privately) by a Page Administrator Jerad Bailey - PharmD Candidate WVU School of Pharmacy

Slide 32:Components of the ProjectEducational Tools / Modality

Educational Resources that People Like, Listen to and Do as they tell them Oprah Winfrey – her show and web site http://www.oprah.com/index.html The Dr. Oz Show – his show and web site http://www.doctoroz.com/ Both have had big emphasis on Diabetes in their recent shows – very influential with a large segment of your patient population 32

Slide 33:Components of the ProjectEducational Tools / Modality – (cont.)

Other Ideas Webinars – used extensively by professional associations – ASHP & Others Wiki’s – North Carolina has big program Videos – YouTube / Windows Movie Maker Newspaper Articles Jump (Flash) Drive provided to patient 33

Slide 34:Components of the ProjectEducational Tools / Modality – (cont.)

TalkShoe A website that specializes in recording Live radio shows. Could do a traditional “Radio Call-In” Show – “The Diabetes Care Show” that airs from 8 to 9 every Thursday night. Do a Topic introduction or information segment at the start – then 30 to 45 minutes of listener call in. You control the “mike” and the show is saved automatically for a permanent record. http://www.talkshoe.com/se/about/TSAbout.html 34 Can anyone guess from where or what the name of the website originates?? Ed Sullivan always said that “tonight he had a very big SHOE – meaning show See TalkShow screen shot Can anyone guess from where or what the name of the website originates?? Ed Sullivan always said that “tonight he had a very big SHOE – meaning show See TalkShow screen shot

Slide 43:See Link to Reimbursement GuideSee Link to Reimbursement Guide

Slide 44:CAMC Outpatient Diabetes Education Program

http://www.camc.org/diabetes/ CAMC Outpatient Diabetes Education* Program CAMC Outpatient Diabetes Education Services are available for everyone with diabetes (including pre-diabetes). Family members are encouraged to participate in all aspects of their loved one’s education. Diabetes Education Services 3-Step Diabetes Self-Management Education Program This 10-hour program is divided into three (3) appointments offered at various times and days for your convenience. Program topics include Discussing types of diabetes Making healthy food choices Developing a meal plan with a dietitian Reviewing your medications Practicing blood glucose monitoring Initiating physical activity plan Discussing prevention and treatment of diabetes complications Setting and evaluating personal goals *Our program data shows past program participants have improved Hgb A1c, reported weight loss, included daily physical activity and prevented long-term complications. Pregnancy and Diabetes Education This two-hour class is for pregnant women with type 1, type 2, gestational diabetes or women with diabetes in need of pre-pregnancy counseling Advanced Carbohydrate Counting Education This four-hour program is designed to help those who take insulin before meals, whether by injection or via insulin pump. It works by matching mealtime insulin doses to the amount of carbohydrate they eat. Recommendations prior to attending class: Diabetes Self-Management Training Self-blood glucose testing 4 to 7 times a day Willing to keep detailed records for one (1) week of program

Slide 45:CAMC Outpatient Diabetes Education Program – (cont.)

Recognized Program The CAMC Outpatient Diabetes Education Program has been awarded recognition by the American Diabetes Association in meeting all quality standards for Diabetes Self-Management Education Training. Our instructional team is dedicated to providing quality education How to Get Started? Talk to your physician or health care provider (HCP) asking to be referred to the CAMC Outpatient Diabetes Education Program. Check with your health insurance plan to determine the extent of your coverage for Diabetes Self Management Education services. Your HCP will complete and submit your program referral. We will contact you to schedule your services. Please call us if you have questions. What to Expect? Convenient location Variety of class days and times Friendly and competent staff   Completion of your education program requirements will provide you tools to help meet your personal behavior change goals for a healthy lifestyle. Your Instructional Team Teresa Waugh RN, CDEProgram Coordinator Jenny McMillion RD, LD, CDEProgram Dietitian Chris Terpening, PhD, PharmDClinical Associate Professor Department of Family Medicine and Clinical Pharmacy Contact us: Phone: (304) 388-5555 E-mail: diabetes@camc.org

Slide 46:Create links with shortened address namesCreate links with shortened address names

Slide 47:Web Site Links – by “bit.ly”

Click Here to access the Diabetes Web Sites Links Click on the above link to go to the live Web Site Links set up on the Internet site called “bit.ly” This site takes long web site addresses and shortens them to meaningful titles You must have Internet Access (well Duh!!) You must have the Power Point presentation in “Slide Show” mode to make the link above active The web sites you access are on the next slide 47 This Slide shows that us OLD people still have skills (tech skills – I mean) – Jerad did not do this one. Okay I confess – Dewey Clayton – 30 something Accountant tech guru at the Hospital helped me on this one. He showed me at work at noon and I still remembered how that night – so that is good!!!!This Slide shows that us OLD people still have skills (tech skills – I mean) – Jerad did not do this one. Okay I confess – Dewey Clayton – 30 something Accountant tech guru at the Hospital helped me on this one. He showed me at work at noon and I still remembered how that night – so that is good!!!!

Slide 48:Diabetes Tool Kit LinksEducational Materials Websites PatientsAmerican Diabetes Association BD Diabetes Learning Center ProfessionalsAmerican Diabetes Association and Prevention: Professional Resources Online Centers for Disease Control and Prevention American Association of Diabetes Educators Centers for Disease Control and Prevention: Diabetes Public Health Resource Medscape: Diabetes and Endocrinology Merck Medicus (registration required) Google Scholar Insulin Comparison Charts Activity of Insulin Preparations (Image) Current Intensive Insulin Regimens for Type 2 Diabetes (Image) Sliding Scale Insulin Regimens for Type 2 Diabetes Using Multiple Daily Injections (Image)   Free Educational Materials American Diabetes Association: Free Informational Packets National Federation of the Blind: Diabetes Information Packets Diabetes Action: Free Diabetes Information Booklet National Diabetes Education Program: Diabetes Resources Texas Department of State Health Services: Free Diabetes Education Materials for Patients and Professionals American Pharmacists Association: Create a Patient Education Center in Your Pharmacy   Reimbursement Information Reimbursement Tips for Primary Care Practice (PDF file) American Association of Diabetes Educators Alternative Settings Department of Health and Senior Services: Diabetes Management in the School Setting   Low Health Literacy National Network of Libraries of Medicine: Research Findings on Impact of Literacy Georgetown University Center on an Aging Society: Low Health Literacy Skills Increase Annual Health Care Expenditures by $73 Billion Health Literacy Practices in Primary Care Settings: Examples From the Field (Journal Article) 

48

Slide 49:Projects for Students

Organize File Cabinet for Toolbox Create file folders for each component listed Make copies of the pages with each components title and file in specific section Add “NEW PROJECT” file section Student gets an overview of the education project possibilities – which hopefully motivates them to act 49

Slide 50:Projects for Students – (cont.)

Update and Add Links to the Website Links Resource Page – Using “bit.ly” or Other Program Expand the websites page with detailed information on what the site has to offer Research Requirements for Gaining Accreditation for your Diabetes Education Team 50

Slide 51:Projects for Students – (cont.)

Reimbursement for Diabetes Education - do research on possible payers Negotiate with Third Party Payers for reimbursement for specific services Design Study that Documents Justification for payment for Education Demonstrate decreased ER visits Show reduction in Hospitalizations 51

Slide 52:Projects for Students – (cont.)

Protocol Development Protocol for newly diagnosed patient Finger Stick Blood Sugar Protocol for Nurses Initiation of Insulin therapy Review Diabetes Medications New Medications for formulary addition New uses for existing meds Studies that demonstrate advantages of a med for a certain type of patient (co-morbidity, age, race) Needed education pieces for that medication 52

Slide 53:Diabetes MellitusType 1 and 2 – A Basic Course for Patient and Family

Nathaniel Linville Student - WVU This is a second example of a project assigned to a student – he chose to do a patient level education piece for the patient and the patient’s family – the power point would work for newly diagnosed and existing diabetics and as a basic class for a support group. I had no input during the power point development (even though I anticipated many questions – none were asked) – and other than a couple minor changes – this is all the students work. The student covered many subjects >>>>>>>>>>>>>>>This is a second example of a project assigned to a student – he chose to do a patient level education piece for the patient and the patient’s family – the power point would work for newly diagnosed and existing diabetics and as a basic class for a support group. I had no input during the power point development (even though I anticipated many questions – none were asked) – and other than a couple minor changes – this is all the students work. The student covered many subjects >>>>>>>>>>>>>>>

Slide 54:What is Diabetes?

Collectively, diabetes is known as a metabolic disease in which glucose cannot or has difficulty entering the cells of the body. Since the glucose cannot be absorbed from the blood stream, the patient has a condition of hyperglycemia. The disease is divided into Type 1 and Type 2 Diabetes mellitus. Nathaniel Linville - Student WVU

Slide 55:Type 1 Diabetes Mellitus

Is classified as an autoimmune destruction of insulin-producing ß-cells in the pancreas. Since the cells are under attack, they cannot produce insulin, therefore, leading to hyperglycemia. Nathaniel Linville - Student WVU

Slide 56:What causes Type 1 Diabetes?

This is not totally understood. Some believe it is triggered by a virus as an autoimmune response, killing both the virus and ß-cells of the pancreas. Certain environmental factors may also play a key role but those are not fully understood either. Nathaniel Linville - Student WVU

Slide 57:Signs and Symptoms of Type 1 Diabetes

Frequent urination Frequent, unquenchable thirst Extreme hunger Weight loss without an effort to do so Fatigue Blurred vision Nathaniel Linville - Student WVU

Slide 58:What did I do wrong to get Type 1?

Probably nothing. There is a genetic predisposition to developing Type 1. It essentially comes down to an error in how your DNA codes for your immune system to work. There may be an environmental factor involved, but Type 1 presents in completely healthy people and unhealthy people alike. Nathaniel Linville - Student WVU

Slide 59:Type 2 Diabetes Mellitus

Defined as having high blood glucose in context of insulin resistance or insulin deficiency. Your pancreas has either worked so hard that it is exhausted or your cells cannot uptake glucose normally. Nathaniel Linville - Student WVU

Slide 60:Controllable Risk Factors for Type 2 Diabetes

Obesity Contributes to 55% of Type 2 Diabetes cases Diets high in trans and saturated fats Low level of physical activity High blood pressure Nathaniel Linville - Student WVU

Slide 61:Uncontrollable Risk Factors for Type 2 Diabetes

Metabolic syndrome with high blood pressure Acromegaly Cushing’s Syndrome Thyroid conditions Your doctor will inform you of these conditions. Nathaniel Linville - Student WVU

Slide 62:Signs and Symptoms for Type 2 Diabetes

Frequent urination Your body can’t filter the glucose, and so draws up large amounts of water to dilute it. Constant, unquenchable thirst Losing weight without trying Tingling/Numbness in extremities This is called neuropathy. Neuro- meaning nerve and –pathy meaning disease or disorder. Nathaniel Linville - Student WVU

Slide 63:Myths Surrounding Diabetes

People with diabetes cannot eat carbs. FALSE: Diabetics can eat carbohydrates but they must be included in a diet plan created by a dietitian. Nathaniel Linville - Student WVU

Slide 64:Myths Surrounding Diabetes

Diabetes in women prevents them from having children. FALSE: As long as blood sugar is kept in normal range before conception and throughout pregnancy, it is totally possible. Nathaniel Linville - Student WVU

Slide 65:Myths Surrounding Diabetes

Since it’s called sugar diabetes, it must come from the sugar I eat. FALSE: Diabetes is a disease concerning how your body utilizes glucose, which is your body’s basic source of energy. The glucose is derived from multiple sources. The amount ingested and how your body reacts and processes the glucose is the key. Nathaniel Linville - Student WVU

Slide 66:Myths Surrounding Diabetes

Since I have “borderline diabetes” I don’t need to be all that concerned. FALSE: There is no such thing as “borderline diabetes”. You either have it or you don’t, and you should see your doctor about how to control the problem. Nathaniel Linville - Student WVU

Slide 67:Exhibiting diabetic symptoms? See your doctor!! Untreated diabetes can lead to:

Amputations Previously mentioned neuropathy allows for extremities to become infected more easily Blindness From diabetic retinopathy. Retino- meaning the retina, and –pathy meaning disease or disorder. Heart Disease/Stroke Kidney Disease (Nephropathy) Death If left untreated long enough, diabetes WILL kill you. Nathaniel Linville - Student WVU

Slide 68:How can I lower my chances of developing diabetes?

Exercise! Be sure to include cardio/aerobic/ and resistance exercises. Get plenty of fiber Go for whole grains Lose excess weight Skip fad diets! Nathaniel Linville - Student WVU

Slide 69:Will I ever live normally again?

Diabetes nowadays is very manageable, but it may be possible to “reverse” some cases of Type 2 diabetes. In theory, the amount of fat on your body’s cell membranes interferes with their ability to interpret the hormone insulin correctly. Clearing this fat could allow them to better interpret this signal. Not everyone can do this, and it should be discussed with your doctor. Nathaniel Linville - Student WVU

Slide 70:What should I do if a loved one develops diabetes?

Educate yourself. Learn about what diabetes is and what all the disease entails. Find out what your loved one really needs. Talk about your feelings. Nathaniel Linville - Student WVU

Slide 71:In Case of Diabetic Emergency

There are two emergency conditions commonly associated with diabetes: Hyperglycemia Excess glucose Hypoglycemia Low glucose Nathaniel Linville - Student WVU

Slide 72:Hypoglycemia

Hypo- meaning low/below and –glycemia meaning condition of glucose. Occurs when the diabetic has too much insulin Taking too much insulin Not eating enough More exercise than usual Nathaniel Linville - Student WVU

Slide 73:Hyperglycemia

Hyper- above/excess –glycemia meaning condition of glucose. Didn’t take enough insulin Ate too much Less exercise than usual Nathaniel Linville - Student WVU

Slide 74:Put in table w/ s/s of hypo/hyperglycemia

Nathaniel Linville - Student WVU

Slide 75:First Aid for Diabetic Emergencies

Make sure the scene is safe If victim is unresponsive, call for help immediately If victim is responsive, communicate! Do a primary survey and give First Aid for the most life threatening conditions Place into recovery position, do ABC! Look for medical alert bracelet/necklace Nathaniel Linville - Student WVU

Slide 76:Things You Should Be Familiar With

Quick sugar sources Orange juice, glucose tablets or gel, pure sugar Blood Glucose Monitor Functions of the monitor How to load a test strip Finger prick How to draw a blood sample and test it Nathaniel Linville - Student WVU

Slide 77:New Medical Breakthroughs Are Making Life With Diabetes Easier

Diabetes is a serious disease that needs to be managed carefully, but that doesn’t mean you can’t live a full, happy life. With some vigilance and common sense, diabetes won’t rule your life. Nathaniel Linville - Student WVU Nice Work – wouldn’t you say – Which discipline would you guess the student is studying?? Nathaniel has just finished his Freshman year at WVU – he is in Pre-Med – but has no medical training. His plans also included a video using “Movie Maker” software – to be used for the low health literacy person and as a “send home” tool for anyone unable to attend the live education session. During brain storming session for the development of the “Toolkit” Nathaniel contributed many of the ideas included in this presentation. The point is – Trust the student – DO NOT UNDERESTIMATE their ability. Remember the studies that demonstrated that the student’s performance will correlate to your expectations for that student – the higher the expectations you project , the greater the results.Nice Work – wouldn’t you say – Which discipline would you guess the student is studying?? Nathaniel has just finished his Freshman year at WVU – he is in Pre-Med – but has no medical training. His plans also included a video using “Movie Maker” software – to be used for the low health literacy person and as a “send home” tool for anyone unable to attend the live education session. During brain storming session for the development of the “Toolkit” Nathaniel contributed many of the ideas included in this presentation. The point is – Trust the student – DO NOT UNDERESTIMATE their ability. Remember the studies that demonstrated that the student’s performance will correlate to your expectations for that student – the higher the expectations you project , the greater the results.

Slide 78:Human Resources – Contact Info.

Patty Johnston, RPh and Arnie Vaughn, RD, CDE – Colony Drug Beckley, WV 304-252-5305 http://www.colonydrug.com/Pharmacy.htm Face to Face Diabetes Program (PEIA) Barbara Smith, RPh, CDE – UC School of Pharmacy - Instructor – Department of Pharmacy Practice 304-357-6854 – Diabetes Education Program as Joint Venture with Roane General – Utilizes Students as Integral Component – Module Development & Teaching Jeff Hamrick, RPh, CDE – St. Mary’s Hospital Outpatient Pharmacy 304-526-1234 ext. 3227 78

Slide 79:Human Resources – Contact Info.

CAMC Outpatient Diabetes Education* Program Teresa Waugh RN, CDE - Program Coordinator Jenny McMillion RD, LD, CDE - Program Dietitian Chris Terpening, PhD, PharmD - Clinical Associate Professor Department of Family Medicine and Clinical Pharmacy Contact us: Phone: (304) 388-5555 E-mail: diabetes@camc.org Boone Memorial Hospital – Pharmacy Department Robert “Bob” Foster, RPh – Executive Director of Pharmacy Services – 304-369-1230 Ext 251 E-mail: rfoster@bmh.org

Slide 80:Conclusion – Yea!!

Call to Action Get a Student or Establish a Network Utilize Your Student, Network or Staff Start a Diabetes Education Program / Service Learning Project Believe in Your Student’s or Staff’s Ability Most Importantly – Focus on the Patient – a Patient Focused Endeavor Never Fails 80

Slide 81:Conclusion

Thank You Very Much for Your Attention ? Questions Please ? Remember - to Download PowerPoint Presentations go to: https://www.wvrhepahec.org/Southern/index.asp (If you download presentation and play slideshow – all links are live) 81