The Ultimate One-Day Diabetes Course

While 1 in 13 Americans have diabetes; 1 in 4 are diagnosed with pre-diabetes. All healthcare professionals will be responsible for patients with diabetes, pre-diabetes or metabolic syndrome on a daily basis, regardless of specialty.

Startling statistics:

• The majority of patients with diabetes have an A1C of > 9%.
• Diabetes is the number one cause of blindness, non-traumatic amputation and new cases of renal failure.
• 65-70% of patients with diabetes die of heart attack or stroke, which is 2-4 times as many without diabetes.
• Diabetes and diabetes related complications can be delayed or prevented with ABC’s (control of A1C, blood pressure, and cholesterol).

As management of diabetes becomes increasingly complex, it is imperative to keep up-to date on new treatment options including medical nutrition therapy, the latest treatment options and standards regarding complication prevention. Upon completion of this seminar recording you will have an in depth understanding of the latest approaches in assessing and treating patients with diabetes, as well as, new skills to apply for those at risk for diabetes. Presenter, Laurie Klipfel, RN, MSN, ANP-BC, CDE, will provide you with helpful insight regarding learning styles and preferences to optimize patient education and empowerment in efforts to help you improve the care you provide to diabetes patients.

Objectives:

1. State diagnostic criteria for diabetes and understand the differences between Type 1, Type 2 and pregnancy induced (gestational) diabetes.
2. Understand metabolic syndrome (“the deadly quartet”: diabetes, hypertension, hyperlipidemia and obesity) and pre-diabetes.
3. Recognize symptoms of hyper- and hypoglycemia and use current research for optimal pharmacologic and nonpharmacological treatment based on ADA Standards of Care.
4. Understand basal/bolus concept of insulin administration including various insulin administration schedules to achieve optimal control.
5. Compare and contrast diabetic ketoacidosis (DKA) and hyperglycemic, hyperosmolar non-ketotic syndrome (HHNK) and understand the prevention/treatment of each.
6. Utilize current research to support nation wide impetus for tight glycemic control for hospitalized patients including management strategies during illness or surgery.
7. Learn what to do when a patient is wearing an insulin pump.
8. Analyze motivational techniques to assist patients to progress from knowing to doing.
9. Describe new treatment therapies (such as inhaled insulin, glucose sensors, sensor augmented insulin pumps, incretins, DPP-4 inhibitors) and what is on the horizon.

Outline

Diabetes: Current Diagnostic Criteria and Prevalence

• Type 1/Type 2
• Pregnancy and diabetes
• Metabolic syndrome/pre-diabetes
• Other causes of hyperglycemia

Importance of Glycemic Control

• Outpatient:
  • Acute Complications: Causes, Symptoms and Treatment
  • Diabetic ketoacidosis (DKA)
  • Hyperglycemic hyperosmolar non-ketotic syndrome (HHNK)
  • Hypoglycemia
  • Infection
  • Fatigue/depression
• Chronic Complications:
  • Prevention, Identification, and Treatment
  • Cardiovascular disease
  • Peripheral vascular disease
  • Retinopathy
  • Nephropathy
  • Neuropathy
• Inpatient:
  • Morbidity
  • Mortality
  • Length of stay

Goals of Therapy

• Glucose control
• Blood pressure control
• Lipid management
• Smoking cessation
• Improved “well-being”

Treatment

• AADE-7 behavioral goals
• Healthy Eating (carbohydrate counting, balanced fat/protein/carb)
• Being active with complications of diabetes
• Healthy coping/stress management/depression treatment
• Monitoring: frequency, timing and evaluation of results
• Risk reduction
• Problem-solving with case examples
• Medication: Indications and Contraindications
  • Oral medications:
    • Sulfonylureas
    • Meglitinides
    • Thiazolidinediones (TZD)
    • Biguanides
    • Alpha-glucosidase inhibitors
    • DPP-4 inhibitors
    • SGLT-2 inhibitors
    • Combinations
  • Insulin:
    • Action times
    • Basal/bolus dosing
    • Benefits of insulin pump therapy
    • Management of insulin pump in the hospital
• Incretin Mimetics: Byetta
• Amylinomimetics: Symlin

New Therapies

• • Glucose sensors
  • Sensor-augmented insulin pumps
• On the Horizon: Closed loop insulin pumps
  • Improved pancreatic transplants
  • Many combination pills
  • More DPP-4 inhibitors
  • Obesity medications
  • Stem cell research
• New Medications
• Patient education and empowerment techniques
  • Adult learning styles
  • Setting “SMART” goals
  • Motivational techniques

Resources for Patients and Professionals