Full Course Description

Diabetes Medications: The Latest Treatments & Guidelines

Advancements in research and treatment for diabetes mellitus is exciting. With 9 classes of diabetes medications now available, there are a lot of options, but it can also be confusing to choose which medications are best to treat your patient with diabetes. Devising an individualized plan of care for each patient requires that your practice is up-to-date and based on the current evidence-based guidelines. Tracey Long, PhD, MSN, MS, RN, APRN-BC, CDE, CNE, CCRN, will share her expertise on the pharmacological management in this evolving specialty.

Program Information

Objectives

Differentiate between the nine currently available classes of medications to treat diabetes.
Apply ADA and AACE practice guidelines for medication decision making.
Describe side effects and effectiveness used for treatment of diabetes mellitus.
Explain the use of combination therapy for treatment of chronic hyperglycemia.

Outline

Diabetes Medication Classes

Oral antihyperglycemics: alpha-glucosidase inhibitors, biguanides, DPP4-inhibitors, meglitinides, SGLT2 inhibitors, sulfonylureas, thiazolidinediones
Injectable antihyperglycemics (not insulin): amylin analogs, incretin mimetics, GLP-1 agonists
Insulins: rapid, regular, intermittent, long acting

ADA and AACE Practice Guidelines

What has changed for 2022
Standards of care and diagnosing
Glycemic control algorithm
Guidelines for monotherapy and combination therapy

Comparison of Medication Side Effects

Medication decisions include side effects, organ effect, and adverse drug effects

Up-to-Date Prescription of Insulin

Insulin delivery systems: syringe, pen, pump, and inhaled insulin
Algorithm for adding/intensifying insulin
Patient education for storage, mixing and traveling
Multiple daily injections vs. continuous glucose monitoring

Target Audience

Nurses
Nurse Practitioners
Physicians
Physicians Assistants

Copyright : 03/25/2022

Weight Loss Medications: Evaluate Evidence, Risk & Cost for Prescriptive Decisions

You’ve seen it too….

With the goal of losing weight, patients will try endless efforts and gimmicks. As providers, we have explained the importance of maintaining a healthy weight and lifestyle. These conversations can lead to frustrations, for everyone involved.

Studies show a 5-7% weight loss with behavior changes (a mere 10-15 pounds for a 200-pound person). Often weight loss efforts lead to weight cycling, which carries documented health risks and often leads to higher than initial weights. In the past there have been a lot of assumptions about the cause of weight being more behavioral. Newer evidence supports a more genetic, environmental, and biologic relationship with weight.

However, many healthcare providers continue to recommend behavior changes for weight loss, despite documented research showing not only poor success with those tactics but great harm including weight stigma, decreased utilization or delay in medical care, repeated weight loss and regain/weight cycling, reduced self-esteem/motivation, eating disorders, stress, and depression. All of which have been shown to contribute negatively to overall health.

The seriousness of this situation has led both patients and providers to look at pharmacological interventions to manage weight. These options have significant cost and risk that need to be carefully considered against the potential benefits. You have an incredible opportunity to learn from Laurie Klipfel, RN, MSN, ANP-BC, CDCES, WCC, as she breaks down the very latest evidence supported weight loss medication options.

Imagine being able to support the lasting weight loss outcomes you’ve been hoping patients would experience! Purchase today!

Program Information

Objectives

Apply the latest evidence to select current pharmacological options for weight loss in patients.
Analyze the benefit vs cost and risk of the various weight loss medication options available today.
Evaluate the effect on weight for medications intended to treat other ailments such as hypertension, diabetes, or depression.
Determine benefits of focusing on outcomes such as health/longevity, rather than weight.
Choose therapies that best meet individual needs and provide effective support.
Investigate how big business can influence standards/recommendations for healthcare providers regarding weight loss options.
Develop techniques for successful motivational interviewing.

Outline

Current Non-Pharmacological Options

“Healthy” Diets

Dash diet
Mediterranean diet
Paleo
Atkins
Keto
Plant-based diet
Commercially prepared meals
Commercial weight loss plans

Activity

Cardio/aerobic
Resistance training/anerobic
Stretch/flexibility
Precautions

Stress management
Sleep hygiene
Surgical options
Motivational techniques to maintain healthy habits and avoiding fads

Pharmacological Options for Weight Loss

Older Medications Taken Off the Market Due to Complications

Sibutramine
Fenfluramine/phentermine “fen-phen”
Lorcaserin
Limitations/bias of older recommendations

FDA Approved Medications for Weight Loss (Effectiveness, Dosage, Side Effects, Warnings, Cost)

Orlistat
Phentermine/topiramate
Naltrexone/buproprion
Liraglultide
Semaglutide
Setmelanotide (only approved for 3 rare genetic conditions)

Medications Approved for Short Term Use Only (12 weeks)

Phentermine
Benzphetamine
Diethylpropion
Phendimetrazine

Medications Used Off Label for Weight Loss

A drug approved for treating a different medical problem
Two or more drugs at the same time
A drug for a longer time period than approved by the FDA

“Food Supplements” Not Under FDA Guidelines

Potential Mechanisms of Action for Future Medications

Regulating several gut hormones at the same time
Targeting specific genes that cause obesity
Allowing people to lose body fat without losing muscle during weight loss
Changing bacteria in the gut to control weight

Medications Used for Other Conditions that Affect Weight

Diabetes medications
Hypertension medications
Psychiatric medications

Target Audience

Nurse Practitioners
Clinical Nurse Specialists
Nurses
Physician Assistants
Pharmacists
Dietitians
Certified Diabetes Care and Education Specialists

Copyright : 11/10/2022

It’s All About the Food: Improving Diabetes Outcomes

Health care professionals often find themselves having to dispense recommendations about nutrition against a backdrop of rampant misinformation. Learn the latest guidelines about healthy eating with diabetes and which eating patterns are associated with the best outcomes. Common misconceptions about meal planning for diabetes will be exposed and you’ll learn how to expertly address today’s hottest topics like keto and artificial sweeteners.

Program Information

Objectives

Determine the key parameters for effective medical nutrition therapy in people with diabetes.
Evaluate the metabolic impact of macronutrients on blood glucose levels.
Analyze the use of various eating patterns on health outcomes in persons with diabetes.
Assess the guidelines for weight management in diabetes.

Outline

Diet Tribes: Which Diet is Best for Diabetes?
- Examining the evidence
Nutrient Know-How: How they impact blood sugar
- Is there an ideal macronutrient ratio?
Hot topics: EXPOSED!
- Misconceptions about meal planning
- The use of artificial sweeteners
- Role of carbohydrate in the overall diet
Locking in Behavior Change
- Meal planning tips
- Medical nutrition therapy guidelines
- Common resources

Target Audience

Nurses
Occupational Therapists
Occupational Therapy Assistants
Physicians

Copyright : 12/15/2022

Diabetes Meal Planning

You are seeing an increased volume of patients with diabetes and many of these cases are very challenging. You need practical strategies and meal plans you can put into practice the very next day. In this program, you’ll learn recommendations for specific nutrient modifications, nutrition assessment, patient monitoring and evaluation methods, and problem solving skills. Don’t miss this opportunity to advance your clinical practice and improve patient outcomes.

Program Information

Target Audience

Nurses, Nurse Practitioners, Clinical Nurse Specialists, Dietetic Technicians

Objectives

Choose questions to ask patients before establishing a meal plan.
Consider dietary considerations beyond carbohydrates in meal planning.
Recommend meal planning considerations for exercise.
Analyze the evidenced-based recommendations for the key diabetes nutrition interventions related to; glycemic index, plant based diets, very low calorie diets, hypoglycemia, exercise, weight control and sick day management.

Outline

Meal Planning Considerations for:

Blood Glucose Control
Current Diet
Meal Preferences
Type of Work
Medications
Socioeconomic
Cultural
Willingness to Change

Nutrition Management Priorities

Type I Diabetes
Type II Diabetes

Problem Solving

Sick Day Management
Travel Days
Weight Loss

Copyright : 03/23/2018

Implementing Motivational Interviewing

Motivational Interviewing is widely used and it is an efficient way to get your patients to increase their motivation to change. But, knowing how and when to implement the techniques isn’t an easy skill to master. In this program Marlisa Brown, will demonstrate different strategies by reviewing her own successful techniques. These insightful and practical tips will increase your confidence and enhance your motivational interviewing skills. Don’t miss this opportunity to improve the care you provide; your patients will thank you!

Program Information

Target Audience

Nurses, Nurse Practitioners, Clinical Nurse Specialists

Objectives

Assess a patient’s readiness to change.
Select the appropriate response based on motivational interviewing techniques.
Evaluate the patient’s emotional state and utilize appropriate counseling skills.
Adapt a more individualized approach to patient care.

Outline

Methods of Assessment

Identifying Patient Concerns
Working as the Collaborator, Not the Expert

Know your Role with Behavior Change

The 80/20 Talking Rule
Stages of Change
Behavior Change Strategies
SMART Goals
Motivational Interviewing Techniques

Helpful Tools

Learning Styles
Psycho-Social Considerations
Environment & Economic Considerations
Cultural Competency

Copyright : 04/28/2018

Managing the Diabetic Foot: Protocols That Work

According to the National Diabetes Statistics Report, 37.3 million adults are diabetic, 8.5 million are yet undiagnosed and 96 million are prediabetic. Up to 20% of these will develop a diabetic foot ulcer, 80% of which will result in amputation. It doesn’t have to be this way! This session will provide the assessment skills, common causes, complications, and treatment strategies both to prevent ulceration and achieve healing in these difficult cases.

Program Information

Objectives

Assess the characteristics of a diabetic foot ulcer.
Appraise the factors that contribute to the development of a diabetic foot ulcer.
Apply evidenced based interventions to promote healing.
Determine when to refer to other disciplines to complement healing.
Develop individualized treatment programs for each patient.

Outline

Comorbidities

Coronary artery disease
Large and small vessel damage
Depression

Causes of Foot Ulcerations

Peripheral & autonomic nervous system neuropathy
Mechanical stress
Foot deformities

Assessment and Diagnostic Tools

Loss of protective sensation
Semmes- Weinstein 5.07 monofilament
128hz tuning fork
Capillary refill
ABI

Managing the Diabetic Foot

L.E.A.P
Callus management
Footwear

Characteristics of a Diabetic Foot Ulcer

Location
Shape
Exudate
Wound bed appearance

Assessment of Bacterial Burden

Signs of infection
Silent infection
Quantitative tissue biopsy
Wound cultures
Proper wound cleansing

Orthopedic Assessment

X ray
Osteolysis
Charcot foot
Total contact casting
Offloading boots
Custom shoe inserts
Osteomyelitis

Vital Role of Dietitian

Protein & carbohydrates
RDA’s for adults
Amino acids
Nitric oxide

Optimal Wound Healing Requirements

Too wet/too dry
Dressings
Biologics
Silvers
Cytotoxics

Therapy Modalities

High and low frequency ultrasound
Pulsed lavage/jet ox
Hyperbaric oxygen
Topical/transcutaneous oxygen
Electric Stimulation (HVPG)
MIRE
Wound Vac

Target Audience

Nurses
Nurse Practitioners
Physicians Assistants
Physical Therapists

Managing the Sugar Bump: Caring for the Gestational Diabetes Client

Gestational Diabetes is one of the most common and significant complications a family can face during the childbearing year. Globally, it is estimated that 21.1 million live births were impacted by some form of hyperglycemia and of these 80.3% were due to Gestational diabetes. In the United States, about 2-10% of childbearing families will experience Gestational diabetes increasing the risk of adverse maternal, fetal, and neonatal outcomes. The overwhelming prevalence of Gestational Diabetes makes it likely that you will not only encounter this imperative health issue in your practice, but you will need to engage with families impacted by the condition at some point during their health journey. As clinicians and birth workers we can help improve current and future health outcomes for families impacted by Gestational diabetes by keeping abreast of the most current evidenced based recommendations. This session will provide you with the most up-to-date evidence that will equip you to care for your clients with Gestational Diabetes from antepartum through the postpartum period.

Program Information

Objectives

Determine the epidemiology, social determinants of health, risk factors, pathophysiology, prevention, screening, and diagnosis of Gestational Diabetes.
Evaluate the non-pharmacological and pharmacological treatment options for Gestational diabetes including lifestyle prescriptions for nutrition, exercise, stress, social support, and reducing toxic substances.
Execute clinical and nonclinical care of the client with gestational diabetes during the antepartum, intrapartum, and postpartum period.
Plan screening and follow-up for gestational diabetes including behavioral interventions and lifestyle change programs to prevent the development of Type 2 diabetes.

Outline

The epidemiology, determinants of health, risk factors and screening guidelines for Gestational Diabetes

Discuss global and national prevalence rates of Gestational Diabetes
Discuss the social and environmental contributors of Gestational Diabetes
Discuss the pathophysiology and risk factors for Gestational Diabetes including age, race/ethnicity, plurality, weight, family history and pre-existing conditions
Discuss screening and diagnostic tests for Gestational diabetes including the one-, two-, and three-hour oral glucose tolerance test (OGTT)

Non-Pharmacological and Pharmacological treatment options for Gestational Diabetes

Discuss non-pharmacological treatment options including lifestyle prescriptions for diet and exercise
Discuss contraindications to exercise during pregnancy and self-care strategies to employ during physical activity
Discuss oral medications and the use of insulin for the Gestational Diabetes client
Discuss technology used in diabetes care including insulin pumps, glucose meters, and continuous glucose monitors

Clinical and non-clinical care for the Gestational Diabetes client during the antepartum, intrapartum, and postpartum period

Describe and identify interventions that meet the physical, emotional, mental, and spiritual needs of the Gestational Diabetes client from antepartum to the postpartum period
Discuss the essential components of antenatal care including referrals to specialists, increased fetal monitoring, pharmacological and non-pharmacological treatment, patient education and anticipatory guidance
Discuss the intrapartum care including labor inductions, c-sections, and risk of birth trauma
Discuss postpartum care including breastfeeding and screening for neonatal hypoglycemia

Discuss the long-term follow-up for the client with Gestational Diabetes

Discuss screening guidelines for Type 2 diabetes including the OGTT at the 6-week post-partum visit
Discuss long-term screening and surveillance guidelines for Type 2 Diabetes following a Gestational diabetes diagnosis
Discuss behavioral interventions and lifestyle change programs that help prevent diabetes after a Gestational diabetes diagnosis

Target Audience

Nurses
Nurse Practitioners
Physicians
Physician Assistants
Midwives
Doulas

Management of Type 2 Diabetes

In this session, Matthew will discuss the two main treatment approaches for managing Type 2 Diabetes in a primary care setting. Starting with an overview of the complications, he will focus on the treatment approaches, and A1C guidelines. He will discuss both necessary lifestyle changes, including diet, and improving exercise/activity level. Additionally, he will cover the oral medicines for initial treatment and when insulin may be needed. Long term goals for treatment will be discussed to decrease the chance for heart failure, neuropathy and other complications.

Program Information

Objectives

Integrate the pathophysiology of T2D into the development of a management plan.
Educate patients on any medications prescribed for control of T2D.
Implement the ADA T2D clinical practice guidelines to improve outcomes for patients.

Outline

Complications
- Macrovascular
- Microvascular
- Neuropathy complications
Treatment
- A1C Goals
- Medications (ADA Guidelines) --cost of medications
- Patient teaching Reduction of ASCVD Risks
Goals
- Reduced HF Risk
- Reduce risk of Neuropathy
- Increased quality of Life

Target Audience

Nurses
Nurse Practitioners
Clinical Nurse Specialists
Physicians
Physician Assistants