Indian Health Diabetes Best Practice Diabetes Self-Management
Diabetes Self Managment
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Transcript of Diabetes Self Managment
Diabetes Self Management
Mili SarkarDiabetes Educator
DieticianAssociates Clinical Research & Trail
Learning Objectives
•Understand the impact of diabetes •Distinguish the different types of Diabetes•Identify treatment options for diabetes management
•Identify methods of applying the Chronic Care Model to diabetes self-management
•Describe tools which health care providers can use to empower patients
DiabetesDiabetes is a chronic disease, which occurs when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces. This leads to an increased concentration of glucose in the blood
Diabetes
• Type 1• Type 2• Gestational• LADA: Latent Autoimmune Diabetes
of Aging• Pre-Diabetes• Impaired Glucose Tolerance (IGT)• Impaired Fasting Glucose (IFG)
Risk Factors for DiabetesType 1• Under 30• Genetics• Autoimmune• Environment• Viral infection
Type 2• Older age • Overweight• Hypertension • Abnormal lipid levels • Genetics• Race/ethnicity• History of gestational
diabetes • History of vascular disease
• Inactivity
Clinical Manifestations: Comparisons
Type 1• Polyuria• Polyphagia• Polydipsia• Significant weight loss• Fatigue
Type 2• Fatigue• Dry, itchy skin• Numbness, tingling• Polydipsia• Polyuria• Blurred vision• Impaired healing• Yeast infections• Sexual dysfunction
Acute Complications of Diabetes
• Dawn Phenomenon
• Somogyi Phenomenon
• Hypoglycemia• Diabetic
Ketoacidosis• Hyperglycemia,
Hyperosmolar Syndrome
Chronic Complications of Diabetes
Microvascular
• Retinopathy• Nephropathy• Neuropathy
Chronic Complications of Diabetes
Macrovascular
• Cardiovascular Disease
• Cerebral Vascular Accident
• Peripheral Vascular Disease
Glucose Tolerance Categories
FPG
126 mg/dL
100 mg/dL
7.0 mmol/L
5.6 mmol/L
Impaired Fasting
Glucose
Normal
2-Hour PG or OGTT
200 mg/dL
140 mg/dL
11.1 mmol/L
7.8 mmol/L
Diabetes Mellitus
Impaired Glucose
Tolerance
Normal
Diabetes Mellitus
Treatment Options for Diabetes
• Nutrition• Activity• Medications
Importance of Testing Blood Sugars
• Testing blood glucose
• Alternate times• Develop a pattern• Be sure to include
2 hours post prandial
• Record the numbers
• Discuss at visits• Use to revise
treatment plan
Chronic Care Model and Diabetes
o The patient becomes knowledgeable and the expert in diabetes and its complications
o The patient understands the importance of taking control of their diabetes
o The patient has people who are important to them and their management of diabetes and the provider includes them as the patient wants
o The provider will take time to build a relationship with the patient and understands their beliefs, values, culture
Maslow’s Theory
Using the 5 “A’s” With Diabetes
• Assess • Advise • Agree • Assist • Arrange
4 Important Lessons Patient Need to Learn
• Their illness is serious• Their condition is essentially self-
managed• They have options• They can change their behavior
Helping Patients Set Goals
• Start at the problem• Develop a collaborative goal• Validate their goal and plan
Old Model vs New Model: Being put on Insulin
Old Model
If you don’t start to control your blood glucose, I am going to have to put you on insulin and you will have to take shots. Your diabetes is not getting any better.
New Empowering ModelYou have been working
to control your blood glucose, but often a patient will need some assistance form insulin. Research shows that starting someone on insulin sooner than later, assists them in getting better control. What about insulin concerns you?
World Health Organization and Diabetes
• The mission of the WHO Diabetes Program is to prevent diabetes
• Core Functions• Diabetes Action Now• World Diabetes day
Summary• Diabetes is a chronic condition
affecting millions worldwide• Self-management techniques can
delay or prevent complications• Empowering the and becoming a
partner with them, will help provide positive results of control
• Tools were given to assist the provider in understanding diabetes and thus assisting their patients
Questions and Discussion
Resources
Books: Diabetes Burnout
Caring for the Diabetic Soul
Organizations:American Diabetes Association (1-800-DIABETES)
North Carolina Diabetes Association (1-877-362-2678)