Ohio River Regional Chapter LEADERS ADDRESS ENTUCKY ... Fourth Quarter 2016.pdfOhio River Regional...
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Fourth Quarter 2016
Notice: The printing and mailing of this issue was delayed.
Ohio River Regional Chapter
LEADERS ADDRESS THE
KENTUCKY DIABETES NETWORK
Dr. Hiram Polk, pictured at left,
Commissioner of the Kentucky Department
for Public Health and Charles Kendell,
pictured on the right, an independent
consultant and former chief of staff with the
Kentucky Department for Public Health,
presented at the Kentucky Diabetes Network
(KDN) meeting held December2nd at the
Kentucky History Center in Frankfort.
Hiram Polk, MD, Commissioner of the
Kentucky Department for Public Health,
addressed diabetes professionals and
advocates at the Kentucky Diabetes
Network (KDN) meeting held December
2nd at the Kentucky History Center in
Frankfort. Dr. Polk noted that
addressing diabetes and prediabetes are
public health priorities and that reaching
more Kentuckians to improve their
health is important. Dr. Polk said that as
a surgeon he saw first-hand the
ravages of diabetes and how critical
prevention efforts — such as foot
examinations — continue to be.
Charles Kendell, an independent
consultant and former chief of staff with
the Kentucky Department for Public
Health, also addressed KDN by giving an
overview of how a bill becomes a law and
differences in lobbying versus education.
Mr. Kendell summarized the recent
legislative changes in Frankfort and
stressed the need to “educate and become a
resource” especially for new legislators.
Lastly, Mr. Kendell shared a link whereby
a person can sign-up to follow Kentucky
legislation — http://kentucky.gov/services/
pages/billwatch.aspx.
2
A NEW Kentucky Diabetes TRENDS column will begin to be featured ongoing as part of this publication.
Data and charts will be taken from the Centers for Disease Control and Prevention (CDC),
Behavioral Risk Factor Surveillance System (BRFSS).
Kentucky diabetes trend data may be used by organizations across the state to identify strengths and weaknesses. The data may
then be utilized to set goals for improving diabetes care practices in Kentucky. Watch future newsletters for the continued series.
KY DIABETES TRENDS IN CARE PREVENTIVE CARE PRACTICES
HEALTH PROFESSIONAL VISIT FOR DIABETES
To access the complete data for cumulative years shown in graph: https://gis.cdc.gov/grasp/diabetes/diabetesatlas.html#.
ATTENDED DIABETES SELF-MANAGEMENT CLASS
To access the complete data for cumulative years shown in graph: https://gis.cdc.gov/grasp/diabetes/diabetesatlas.html#.
Age-Adjusted Percentage, Adults With Diabetes
Year Percentage
2003 92.8%
2004 93.3%
2005 92.5%
2006 90.7%
2007 87.4%
2008 92.6%
2009 88.8%
2010 85.9%
2011 87.6%
2012 84.1%
2013 87.5%
2014 *
*Indicates “No Data”
Vertical dotted line indicates major changes made to the survey methods in 2011. Horizontal dotted line indicates “No Data”, “Suppressed Data”, or both.
Vertical dotted line indicates major changes made to the survey methods in 2011. Horizontal dotted line indicates “No Data”, “Suppressed Data”, or both.
Age-Adjusted Percentage Adults — Total
Year Percentage
2003 46.8%
2004 54.8%
2005 51.6%
2006 54.3%
2007 51.7%
2008 47.5%
2009 52.2%
2010 58.0%
2011 45.7%
2012 50.5%
2013 54.4%
2014 *
*Indicates “No Data”
87.5 % adult
Kentuckians
with
Diabetes
report
visiting a
health
professional
for diabetes
in the last
year (2013).
Just a little
over half
(54.4%)
adult
Kentuckians
with
Diabetes
report ever
attending a
diabetes self–
management
class (2013).
3
Photo at Left
Governor Bevin Signed
a Diabetes Proclamation
in November for National
Diabetes Month.
To view the Proclamation:
http://apps.sos.ky.gov/
Executive/Journal/
execjournalimages/2016-
PROC-247006.pdf
DIABETES MONTH AROUND
KENTUCKY Photo at Left
A group of diabetes
professionals and
advocates attended
the Health and
Welfare Interim Joint
Committee legislative
meeting on October
19, 2016, where Bob
Babbage presented
an “Update on
Diabetes in
Kentucky”.
Attendees at the
meeting, pictured left
to right, were Mary
Beth Lacy, Becki
Thompson, Diana
Reed, Reita Jones,
Kim DeCoste, Dr.
Joseph Loftus,
Theresa Renn,
Stewart Perry, Bob
Babbage, Jim
DeMasters
Julie Babbage and
Gary Dougherty.
COURIER-JOURNAL
DIABETES SERIES WAVE 3 TV
DIABETES EDITORIAL WAVE 3 TV (Louisville) General Manager, Ken Selvaggi,
aired a diabetes editorial entitled, Dealing With Diabetes.
To view the video, visit: http://www.wave3.com/
story/33847921/wave-3-news-editorial-december-1-2016-
dealing-with-diabetes.
Photo at Right
University of Kentucky
Memorial Hall was lit
up blue in recognition of
World Diabetes Day
on November 14th.
In November, the Louisville Courier-Journal printed an
intensive series of diabetes / prediabetes articles, listed below,
and an opinion piece by Bob Babbage and Stewart Perry.
11-13-16 Disease A State Scourge Silent Killer Ranks 6th Worst in US
Teen Adjusts to Type 2 Diabetes
11-14-16 Bedeviling “Diabetes Belt” Diabetes Remains on Rise Despite Efforts in KY, IN Prediabetes Signals Need to Change Lifestyle Habits
11-20-16 Diabetic’s Diagnosis: Lose His Leg or His Life Disease Complications are Leading Cause of Non-injury
Amputations
Medicaid Changes Could Affect Diabetes Care
11-21-16 Going Vegan, Reluctantly
But A New Diet is Part of Life Changes for Diabetics
Reds All-Star is Powering Through Type 1 Diabetes
To read the complete series of articles, go to:
http://www.courier-journal.com/story/life/wellness/
health/2016/11/18/diabetes-kentuckys-epidemic/94070310/ .
4
DIABETES MONTH AROUND KENTUCKY (CONTINUED)
Lake Cumberland District
Photo at Right: McCreary County
Judge Douglas Stephens,
pictured on the left, holds
up a diabetes
proclamation with Vicky
Albertson, RN, pictured
on the right.
Photo at Right: Clinton County
Judge Richard Armstrong,
pictured on the left, holds up a
diabetes education packet with
Vicky Albertson, RN, pictured
on the right.
Photo at Left: Green County
Judge John Frank,
pictured on the left, signed
a diabetes proclamation in
recognition of World
Diabetes Day on November
14th with Janet Cowherd,
RN, BSN, pictured on the
right.
Photo at Left: Cumberland County
Judge John Phelps, Jr.,
pictured on the right, signed a
diabetes proclamation
recognizing diabetes month
with Vicky Albertson, RN,
pictured on the left.
Photo at Right: Casey County
Judge Randy Dial, pictured
on the right, signed a
diabetes proclamation while
Janet Cowherd, RN, BSN,
pictured on the left,
looks on.
Photo at Left: Adair County
Judge Mike Stephens,
pictured on the left, signed a
diabetes proclamation during
diabetes month in November
with diabetes educator Jamie
Lee, RN, CDE, MLDE,
pictured on the right.
November 14th was declared Diabetes Awareness Day across the entire Lake
Cumberland District as all ten County Judge Executives signed proclamations to
increase awareness of diabetes as well as support for those living with diabetes.
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Pulaski County Judge Steve Kelley, pictured on the right, smiles
after signing a diabetes proclamation during diabetes month
with Jamie Lee, RN, CDE, MLDE.
Photo at Right: Wayne County Judge Mike Anderson,
pictured above on the right, smiles as he
prepared to sign the 2016 Diabetes
Proclamation with Vicky Albertson, RN,
pictured above on the left.
Russell County Judge Gary Robertson,
pictured above on the right, signed a
diabetes proclamation while Jamie Lee,
RN, CDE, MLDE, pictured above left,
looks on. Photo at Left: Taylor County Judge Eddie Rogers,
pictured above on the left, after he
signed the diabetes proclamation
with Janet Cowherd, RN, BSN,
pictured on the right.
DIABETES MONTH AROUND KENTUCKY (CONTINUED)
NEW MY DIABETES CARE RECORD NEW
Download or order this
item from KDN at:
http://
www.kydiabetes.net/
kdncontinuousqualityim
provementtoolkit.html
Available Soon!
My Diabetes Care Record
The My Diabetes Care Record will soon be available on the
Kentucky Diabetes Network (KDN) website to download or
order. Up to 50 cards can be ordered directly without charge
from KDN.
This card can be used to teach patients about their Diabetes
ABCs — A1C, Blood Pressure, Cholesterol, Stop Smoking and
Self-Management Education. The card can also be used to
encourage other important recommended tests and exams. This
card folds up small enough to fit in a wallet.
Diabetes Proclamation Sample
used in Lake Cumberland
shown below.
6
KENTUCKY STATEWIDE DIABETES
SYMPOSIUM
Susan Weiner, MS, RDN, CDE, CDN, pictured at left, the
2015 AADE Diabetes Educator of the Year (from Bellmore, NY) and
Tom Karlya, BA, pictured at right, the Vice President of the Diabetes Research Institute Foundation, Inc.
(from Surfside Beach, SC) jointly presented
“Type 1 Diabetes — The Missing Diagnosis”.
Tina Claypool, PharmD, CDE, pictured at left,
with KentuckyOne Health, University of Louisville
Hospital Outpatient Pharmacy (from Louisville, KY)
presented “New Diabetes Medications: Provider Pearls
AND Medication Therapy Management (MTM) in
Diabetes”.
Jenny Marshall-Willis, APRN, CDE, CPT, pictured at left, with
Kosair Children's Hospital, Maternal - Fetal Medicine Specialists
Louisville, KY and Molly Houser, MD, FACOG, CDE, pictured at
right, formerly with Baptist Health Lexington
jointly presented
“Diabetes and High Risk Pregnancies: Improving Outcomes”.
Shubham Gupta, MD, pictured at
left, Assistant Professor of
Urology with the
University of Kentucky,
Lexington, KY presented
“Sexual Health in Diabetes”.
Larry A. Watson, Certified
Coach, BS, pictured at right,
with Pathway Consulting from
Cincinnati, OH presented
“Diabetes Care Professional:
Optimizing Performance to
Enhance Patient Outcomes”.
The KY Statewide Diabetes Symposium 2016 boasted
attendance of 361 professionals. The breakdown of
participants included professionals from KY, IN, IL,
TN, OH, and AZ (Nurses 139 [of this number 110 RN,
26 APRN, 3 LPN]; Dietitians / RDs 106; Pharmacists
51 [of this number 42 Pharm D, 9 RPh ]; Diabetes
Paraprofessionals 12; LCSW (Social Workers) 4;
MD 4; Diabetes Camp Leaders 2; ADA Leader 1;
Certified Nutritionist 1; KY Employees Health Plan
Leader 1; Photographer 1; Speakers (not counted
elsewhere) 2; Exhibitors (not counted elsewhere) 37.
The KY Statewide Diabetes Symposium 2016 was Held on November 4th in
Recognition of World Diabetes Day at the Marriott Louisville East.
7
The Kentucky Statewide Diabetes Symposium committee presented the 2016 Industry Allies Council members with an appreciation award. In photo
above, pictured left to right are Alex Horn with Boston Scientific, Dr. Joseph Loftus with Novo Nordisk, Brandy McDaniel with Novo Nordisk, Jim
DeMasters with Novo Nordisk, Stacy Koch, State Symposium Exhibitor Coordinator and Julie Shapero, State Symposium 2016 Chairperson.
Symposium Photos Courtesy of:
O'Neil Arnold Photography, Louisville, KY
DIABETES SYMPOSIUM (CONTINUED)
Symposium attendees shown above visiting exhibits. Exhibitors
included: Abbott Diabetes Care, ACON Laboratories Inc, Animas
Corporation (Johnson & Johnson), Anthem BCBS, AstraZeneca
Pharmaceuticals, Boehringer Ingelheim, Boston Scientific, CCS
Medical, CinSulin, Dexcom Inc, Dialysis Clinic Inc, Eli Lilly,
Humana CareSource, Janssen, Kroger, Medtronic, Meijer, Merck,
Novo Nordisk, Omnipod, Premier Kids Care, Sanofi, Spectra Mental
Healthcare, Tandem Diabetes Care and Valeritas.
Symposium Committee 2016
Symposium committee members pictured left to right, front row: Teresa
Bunch, Stacy Koch, Barb Jolly, Julie Shapero, Dee Deakins Sawyer,
Janice Haile, and Cathy McCormick. Second row: Deanna Leonard,
Ann Ingle, Betty Bryan, Mechelle Coble, Merritt Bates-Thomas, Theresa
Renn, Janey Wendschlag, Unknown, Maggie Beville, and Dana Graves.
Kentucky Diabetes Symposium 2016 Partners (alphabetical order)
American Association of Diabetes Educators KY Coordinating Body
American Diabetes Association (ADA)
Diabetes Educators of the Cincinnati Area (DECA)
Greater Louisville Association of Diabetes Educators (GLADE)
Juvenile Diabetes Research Foundation (JDRF)
Kentucky Association of Diabetes Educators (KADE)
Kentucky Diabetes Network (KDN)
Kentucky Diabetes Prevention and Control Program (KDPCP)
Tri-State Association of Diabetes Educators (TRADE)
Mark Your Calendar!
Kentucky Statewide
Diabetes Symposium 2017
November 3rd
Industry Allies Council Silver - Novo Nordisk Inc Bronze – Boston Scientific
8
It is hard to believe another year has gone by
and we are looking forward to a year of new
leadership for the Kentucky Coordinating
Body (KY CB). It was such a pleasure
working with those who represent your Local
Networking Groups (LNGs). This included
Maggie Beville, Betty Bryan and Vanessa
Paddy from GLADE; Janey Wendschlag and
Dee Deakins Sawyer from KADE; Janice
Haile, Teresia Huddleston, and Kelly Dawes
from TRADE; as well as Julie Shapero from
DECA.
It is my pleasure to announce the 2017 CB
Leaders: 2017 Leader – Maggie Beville RN, BSN, CDE, MLDE
(GLADE – Greater Louisville Association of Diabetes
Educators)
2018 Leader Elect – Merritt Bates-Thomas RD, CDE (TRADE
– Tri State Association of Diabetes Educators)
Financial Leader – Betty Bryan RN, CDE, MLDE (GLADE);
Dee Deakins Sawyer MS, RN, CDE, BC-ADM (KADE –
Kentucky Association of Diabetes Educators)
Web Administrator – Janice Haile RN, CDE (TRADE)
State Advocacy Grassroots Coordinators – Maggie Beville
and Betty Bryan
Member at Large – Julie Shapero RD, CDE (DECA – Diabetes
Educators of Cincinnati Area)
I have to admit that the Kentucky LNG (Local Networking Group)
Leaders are certainly an awesome group with whom to work. Those
2016 Leaders and members and the LNGs they represent are:
KADE – Janey Wendschlag (Leader), Dee Deakins Sawyer, Ava
Eaves
GLADE – Vanessa Paddy, Ronda Merryman-Valiyi
TRADE – Kelly Dawes (Leader), Deanna Leonard, Teresia
Huddleston
The bimonthly KY CB conference calls with a couple of face-to-
face meetings went well this year. Some of the discussions included
the following:
LNG leaders report during each KY CB call — and I can say we
all have very active groups. GLADE, KADE and TRADE all
have meetings that occur 4 to 6 times per year. KADE’s all day
continuing education (CE) diabetes program was offered in May
and TRADE had an all day program in September. These CE
programs, along with the state diabetes symposium, provide the
needed continuing education for Certified Diabetes Educators
(CDEs) to maintain their certification.
Licensed Diabetes Educators (LDE) – the KY CB had several
discussions around needed guidelines to help professionals who
want to become licensed diabetes educators. A sub-committee
has been created for guideline development and includes Janey
Wendschlag, Maggie Beville and Dana Graves. A draft of
recommendations will be created and sent for the KY CB to
KENTUCKY COORDINATING BODY (CB)
DECA ▬ DIABETES EDUCATORS CINCINNATI AREA ● GLADE ▬ GREATER LOUISVILLE ASSOCIATION OF DIABETES EDUCATORS
KADE ▬ KY ASSOCIATION OF DIABETES EDUCATORS ● TRADE ▬ TRI-STATE ASSOCIATION OF DIABETES EDUCATORS
Submitted by: Dana Graves, RN, MSN, CDE, MLDE, KY, Coordinating Body (CB) Leader
Dana Graves
2016 KY CB Leader
NEW EDITION!
THE ART AND SCIENCE OF
DIABETES SELF-MANAGEMENT
EDUCATION DESK REFERENCE
The American
Association of
Diabetes Educators
(AADE) recently
released the NEW
EDITION of “The Art
and Science of
Diabetes Self-
Management
Education Desk
Reference”.
Order at:
https://www.diabeteseducator.org/online-store
review. I have to thank Vanessa Paddy and Betty Bryan for
keeping us informed about the overall licensure progress!
Diabetes Advocacy has been led by Betty Bryan and Maggie
Beville. The KY CB is hoping to work with the KY Diabetes
Network to organize a “Diabetes Day at the Capitol” with our
legislators in early 2017. We are also collecting stories from
people with diabetes to share with the legislators.
Maggie Beville and Diane Ballard (representing Merritt) will
be attending the annual AADE Coordinating Body (CB)
Leaders meeting in Chicago in early January. Diane Ballard
(from KADE) will be the KY CB 2018 Leader Elect.
A KY CB policy is being developed to help explain and guide
the KY CB. Once completed, it will be shared with members of
each LNG.
A list of new Kentucky AADE members was sent out monthly
by AADE. These members received a “Welcome Letter” from
their respective LNG Leader.
The KY CB group does well to represent the diabetes educators
throughout Kentucky. I highly recommend for each diabetes
educator to get involved with the LNG that is closest to you. The
LNGs provide networking and professional growth at each meeting
(and of course at times great food!!!). When you join AADE, you
choose the LNG you want to be involved in.
I certainly enjoyed this year as the KY CB Leader and I look
forward to 2017 with Maggie at the helm! I believe this year will be
awesome and hope each of you will plan to get involved!
9
We all know that insulin is
not just a drug — for people
with diabetes it is literally a
matter of life and death.
Due to the skyrocketing costs of insulin,
some people have been rationing their
insulin, and others have been going
without other necessities to pay for it. This tragedy strikes at the
heart of our mission. That’s why the American Diabetes
Association’s Board of Directors recently passed a resolution and
we launched a petition calling for immediate action to make insulin
affordable for everyone who needs this lifesaving medication.
Specifically, the Association is requesting for all entities in the
insulin supply chain to increase transparency and to ensure that no
person with diabetes is denied affordable access to insulin. We are
also calling for Congress to hold hearings with all entities in the
insulin supply chain to identify the reasons for the dramatic
increases in insulin prices and to take action to ensure that all
people who use insulin have affordable access to it.
At this writing, the petition has garnered more than 135,000
signatures and is growing every day. Our social media posts about
the petition have been our most successful posts of all time.
The petition continues to pick up speed, but we need help to keep
the momentum going. Please help us ask everyone in the diabetes
community and the general public to lend their voices to this effort
and sign our petition at StopDiabetes.com/insulin. Please share the
petition with your networks, colleagues, friends, family and
neighbors.
This is an important effort for the diabetes community - one that the
Association will continue to work on throughout the coming weeks
and months.
ADA LAUNCHES
INSULIN AFFORDABILITY CAMPAIGN
Gary Dougherty
Submitted by: Gary Dougherty, Director-State
Government Affairs, American Diabetes
Association (ADA). The Board of Directors for the American Diabetes
Association released the following resolution:
WHEREAS, people with diabetes who use insulin need this
medication every day of their lives in order to live;
WHEREAS, health care providers work with people who use
insulin to determine the types and quantities of insulin necessary
to successfully manage their diabetes and to reduce long- and
short-term health consequences, including blindness, amputation,
kidney failure, heart attack, stroke, and death;
WHEREAS, the annual cost of diabetes, gestational diabetes
and prediabetes in the United States skyrocketed to $322 billion
in 2012, a 48 percent increase in just five years;
WHEREAS, the cost of insulin has risen steadily and steeply,
creating financial hardships for individuals who rely on it to
survive, particularly those who are uninsured or underinsured;
WHEREAS, between 2002 and 2013 the average price of insulin
nearly tripled;
WHEREAS, insulin is frequently cited as one of the most
expensive categories of drugs by private and government health
care payers, with insulin leading the list of price hikes for non-
generic drugs in a recent government report on Medicare
spending;
WHEREAS, insulin pricing is driven by a complex supply chain
consisting of many players including manufacturers, wholesalers,
pharmacy benefit managers (PBMs), insurers and pharmacies;
WHEREAS, in much of Europe, insulin costs about a sixth of
what it does in the United States;
WHEREAS, the increased cost of insulin has resulted in a
growing number of people with diabetes telling their health care
providers they are unable to afford the insulin prescribed for
them, thus exposing them to serious long and short term health
consequences; and
Therefore I join with the American Diabetes Association and:
Call upon all entities in the insulin supply chain, including
manufacturers, wholesalers, PBMs, insurers and pharmacies
to substantially increase transparency in pricing associated
with delivery of insulin to the end user patient;
Call upon all entities in the insulin supply chain to ensure that
no person with diabetes is denied affordable access to insulin;
and
Call upon Congress to hold hearings with all entities in the
insulin supply chain to identify the reasons for the dramatic
increases in insulin prices and to take action to ensure that all
people who use insulin have affordable access to the insulin
they need.
10
Submitted by: Tina Claypool, PharmD, CDE
KentuckyOne Health/University Hospital,
Louisville, KY
New Insulin Therapy:
Basaglar® (insulin
glargine injection) U-100
Millions of patients living with diabetes
have new medication therapy and device
options available. As additional new and
complex therapies emerge, it is important
that prescribers, pharmacists, and diabetes educators remain current
with products and formulations to help patients achieve safe and
effective glycemic control. Basaglar® is the first biosimilar insulin
and was approved for use in the European market September 2014.
Basaglar® is expected to enter the United States (US) market, mid-
December of 2016.
Biosimilar Facts: To date, the US Food and
Drug Administration
(FDA) has approved only
four biosimilar
medications since the first
biosimilar was approved in
2015. The European
Medicines Agency (EMA)
has approved seven
biosimilar medications
since 2006 with several
more in clinical trials.
Biosimilars are
medications that contain
an active medication substance that is derived from or composed
of a living organism highly similar to an existing biologic already
approved by the FDA, also known as the “reference product”.
Biosimilar medications must exhibit no clinically meaningful
differences in quality, safety, and efficacy from the reference
product. It is important to understand that biosimilars are NOT
considered generic medications, because they are not chemically
manufactured.
Although the FDA classifies biologic interchangeability, it is US
state laws that govern drug substitution processes. Pharmacists may
NOT substitute a biosimilar product unless the FDA has ruled that
biosimilar to be interchangeable and permits pharmacy substitution
for the reference product. Otherwise, prescribers must write the
specific name of the biosimilar product on the prescription or order.
The goal of biosimilar medications is to improve patient medication
access by offering more affordable medication options without
compromising quality, safety, and efficacy. Biosimilars typically
cost significantly less than their reference products and are projected
to greatly reduce future health care spending.
Basaglar® Dosing: Basaglar® is a new biosimilar long-acting insulin with the same
amino acid sequence as its reference product, Lantus® (insulin
glargine injection). Basaglar® is indicated to improve glycemic
control in adult and pediatric patients with type 1 diabetes mellitus
and in adults with type 2 diabetes mellitus. It is to be administered
subcutaneously once daily at the same time each day. Basaglar® is
contraindicated during episodes of hypoglycemia and in patients
hypersensitive to insulin glargine or any of its excipients. It is not
recommended for treatment of diabetic ketoacidosis.
Basaglar® will be available in a disposable prefilled insulin pen,
KwikPen®, that contains 100 units/mL of insulin glargine per 3 mL
device. The maximum dose per injection is 80 units, thus requiring
more than one injection for doses greater than 80 units.
The recommended starting dose of Basaglar® in patients with type 1
diabetes should be approximately one-third of total daily insulin
requirements, with short or rapid-acting insulin used for meal-time
coverage. The recommended starting dose of Basaglar® in patients
with type 2 diabetes is 0.2
units/kg or up to 10 units SQ
once daily. If changing from
another insulin glargine 100
units/mL product to
Basaglar®, the Basaglar®
dose should be the same as
the other insulin glargine
product. If changing from
once daily insulin glargine
300 units/mL or twice daily
NPH insulin to Basaglar®,
the recommended initial
Basaglar® dosage should be
80% of the insulin glargine
300 units/mL or twice daily
NPH insulin. If changing
from an intermediate or long-acting basal insulin other than insulin
glargine 100 units/mL to Basaglar®, a change in the dose of the basal
insulin, shorter acting insulin, and any blood glucose lowering
medications may need to be adjusted. Increased frequency of blood
glucose monitoring is always recommended when changing insulin
therapies.
Storage: Basaglar® insulin pens are stable up to 28 days after first use. New
pens are to be refrigerated between 36-48ºF. It is recommended that
pens are kept at room temperature for at least 1 hour prior to first
injection and remain at room temperature until empty or expired (28
days). Patients should complete a “safety test” or “pen needle
prime” prior to each injection to ensure they receive the correct
insulin dose and that the pen and needle are working properly. Pens
are to be stored with the pen cap on and not with pen needles
attached. Basaglar® may be injected subcutaneously in the upper
arms, stomach, and thighs. The injection button should be held in
during injection and for an additional five seconds before releasing
the injection button and removing the needle from the skin.
New Insulin Therapy: Basaglar
Tina Claypool
11
Warnings and Precautions: Basaglar® KwikPens® should never be shared between patients,
even if the needle is changed. Sharing Basaglar® increases the risk
for transmission of blood-borne diseases.
Hyperglycemia or hypoglycemia are possible with any changes in
insulin strength, manufacturer, type, or administration method.
Patients should increase blood glucose monitoring and only make
insulin dose changes under close medical attention.
Side Effects: The most common side effect of any insulin, including Basaglar®,
is hypoglycemia, which can be life threatening. Careful monitoring
of blood glucose levels is critical to avoid hypoglycemic events.
Other common adverse reactions associated with Basaglar® include
hypersensitivity and allergic reactions, injection site reactions,
hypokalemia, fluid retention, and weight gain.
As with other insulin, concomitant use of thiazolidinediones can
result in dose-related fluid retention which can lead to or exacerbate
heart failure. Patients should be advised to notify their provider if
they experience swelling or weight gain while taking Basaglar® in
combination with a thiazolidinedione.
Drug Interactions: Drugs that may increase the risk of hypoglycemia:
Antidiabetic medications, ACE inhibitors, angiotensin II
receptor blockers, disopyramide, fibrates, fluoxetine,
monoamine oxidase inhibitors, pentoxifylline, pramlintide,
propoxyphene, salicylates, somatostatin analogs, and
sulfonamide antibiotics
Drugs that may decrease Basaglar® blood glucose
lowering effect:
Atypical antipsychotics, corticosteroids, danazol, diuretics,
estrogens, glucagon, isoniazid, niacin, oral contraceptives,
phenothiazines, progestogens, protease inhibitors,
somatropin, sympathomimetics, and thyroid hormones
Drugs that may increase or decrease blood glucose
lowering effect of Basaglar®:
Alcohol, beta-blockers, clonidine, lithium, pentamidine
(hyperglycemia may follow)
Drugs that may blunt hypoglycemia signs and symptoms:
Beta-blockers, clonidine, guanethidine, and reserpine
Clinical Trials: The ELEMENT 2 clinical study is a 24-week phase 3, randomized,
double-blind trial in 756 adults with type 2 diabetes who were
either insulin-naïve and uncontrolled on 2 or more oral antidiabetic
medications or on Lantus® products along with 2 or more oral
antidiabetic medications with adequate or inadequate control.
Results: 1. There was no statistically significant A1C lowering of
Basaglar® vs. Lantus® products
• Both Basaglar® and Lantus® products reduced A1C by
1.3% at 24 weeks
2. Similar percentage of patients achieved A1C <7% at 24 weeks
• 48.8% patients taking Basaglar® achieved A1C <7%
• 52.5% patients taking Lantus® products achieved A1C
<7%
3. Similar incidence of patients experienced severe symptomatic
hypoglycemia*
• *Defined as an event with symptoms consistent with
hypoglycemia that required assistance of another person
and was associated with either blood glucose <50 mg/dL
or prompt recovery after oral carbohydrate, IV glucose, or
glucagon administration
• <1% patients taking Basaglar® experienced severe
symptomatic hypoglycemia over 24 weeks
• <1 % patients taking Lantus® products experienced
severe symptomatic hypoglycemia over 24 weeks
4. Similar adverse reaction reporting for both Basaglar® vs.
Lantus® products
• Infection was reported in 17% patients taking Basaglar®
and 16% patients taking Lantus® products
• Nasopharyngitis was reported in 6% of patients taking
Basaglar® and 6% patients taking Lantus® products
• Upper respiratory tract infection was reported in 5%
patients taking Basaglar® and 4% patients taking Lantus®
products
Medication errors have been reported when other insulin products
have been accidentally administered instead of insulin glargine.
With more insulin products, concentrations, and formulations
available than ever before, it is extremely important to remind
patients, providers, and caregivers to always verify the insulin label
before each injection.
Basaglar® and Basaglar® KwikPen® are trademarks of Eli Lilly and
Company.
References: Basaglar® (insulin glargine injection) full prescribing information
BASKP-0002-USPI-20160617. Indianapolis, IN: Eli Lilly and
Company.
8 Things to Know About Biosimilars. Medscape. Nov 23, 2016.
Rosenstock J, Hollander P, Bhargava A et al. Similar efficacy and
safety of LY2963016 insulin glargine and insulin glargine
(Lantus®) in patients with type 2 diabetes who were insulin-naïve or
previously treated with insulin glargine: a randomized, double-blind
controlled trial (ELEMENT 2 study). Diabetes, Obesity and
Metabolism 17: 734-741, 2015.
New Insulin Therapy (Continued)
12
MENTAL HEALTH AND DIABETES MAKING APPROPRIATE REFERRALS
Many studies have documented the detrimental effects of depression
in diabetes care. Non-adherence, increased severe catastrophic
health events, and early mortality have all been associated with the
effect of depression. However, less understood is how
psychotherapy can assist with better glycemic control as measured
through A1C reduction1.
Diabetes appears to have a unique relationship to depression when
compared to other chronic illness. Chronic illnesses such as COPD,
CVA, chronic pain, or unregulated blood pressure all improve with
adequate psychotherapy interventions. However, none of these other
chronic illnesses require the same level of intense self care as
diabetes.
This writing is not intended to be a complete
synthesis of the research but rather a
practical guide for clinicians.
This article will attempt to synthesize evidence that
supports: 1. Psychotherapy as an effective tool to assist People With Diabetes
(PWD) in increasing treatment adherence & achieving better
outcomes,
2. Appropriate empirically based tools for making referral
decisions, and
3. Some techniques to facilitate patient referral follow-through.
To date, psychotherapy interventions have focused mostly on
depression outcomes and glycemic control as a dependent variable
of Cognitive Behavioral Therapy (CBT) as routinely practiced and
generally effective at remitting depression.
There is robust evidence that CBT works to decrease depression in
PWD. When the intervention is designed for adherence and
delivered by mental health professionals trained in health
psychology, treatment adherence increases and A1C significantly
improves. Cognitive Behavioral Therapy for Adherence and
Depression (CBT-AD) and similar approaches have been
documented to be more effective than usual care.2.
The American Diabetes Association (ADA) recommends screening
at least every six months for clinical depression. Although at any
given time at least 25% of those with diabetes will be suffering from
depression, psychotherapists and mental health professionals are
poorly utilized for PWD.
What Is The Missing Link? We have all heard, and most of us are guilty of, venting about
adherence issues. The conversation goes something like this. “I told
them what they need to do. I explained the consequences of not
changing their behavior. Yet when they come back they are still
doing the same old thing that got them into trouble. I've done my
job!“
Further, there is increased pressure on the provider to learn new skill
sets that are widely known to increase the length of a consult. A
common technique is motivational interviewing. In health
psychology we call it giving hope. Health psychology is the missing
link. Many studies document this but referrals seem to lag behind
what the research would indicate is appropriate.
As clinicians we have all been affected by the increased demands
for better outcomes, the need to see more people in less time, and
pay for performance. Appropriate psychotherapy decreases A1C, a
concrete measure of outcomes. The patient is less likely to perceive
the clinician as the “diabetes police”, which decreases no-shows.
The time needed for an appointment is decreased as there are fewer
complications to review.
Empirical Evidence Supporting Better
Diabetes Outcomes and Psychotherapy;
Cognitive Behavioral Therapy for Adherence
and Depression (CBT-AD) with uncontrolled
T2, Life-Steps 3
Much written about the effective treatment of depression in diabetes
care without corresponding improvement in glycemic control, which
is beyond the focus of this article. As published in Diabetes Care on
CBT-AD4, researchers found robust results when compared to an
enhanced treatment as usual (ETAU) control group.
The Enhanced Treatment as Usual (ETAU) & CBT-
AD groups received the following: 1. A nurse diabetes educator for diabetes self-management
education to tailor goals for self-care.
2. Meetings with a dietitian for nutritional assessment and goal
setting.
3. One session of Life Steps (CBT-AD) a stand-alone CBT
intervention designed to improve adherence to medical
recommendations.
Karl Bates, LCSW
Watch future issues of this newsletter for the continued
Mental Health and Diabetes series..
Submitted by: Karl Bates, LCSW, Spectra Mental Healthcare, Louisville, KY
WHY REFER, WHEN TO
REFER, WHO TO
REFER TO, & HOW TO
SUCCESSFULLY REFER
13
The American Diabetes Association
(ADA) recently published the
Standards of Medical Care in
Diabetes 2017.
ADA STANDARDS OF
CARE 2017
CAMP HENDON JULY 2-7 — REGISTER NOW
Camp Hendon: Taking on Type 1 Diabetes
http://www.camphendon.org/
This fun, safe, and medically-supervised camp is for children
with type 1 diabetes in Kentucky, Southern Indiana and the
surrounding area. The camping experience offers quality
diabetes management education to children ages 8 - 17.
Registration is now open for campers at: https://
hendon.campintouch.com/ui/forms/application/camper/App
Registration is now open for volunteer staff at: https://
hendon.campintouch.com/ui/forms/application/staff/App
View the full
Standards at:
http://
professional.diabetes.
org/sites/
professional.diabetes.
org/files/media/
dc_40_s1_final.pdf.
4. The Montgomery-Asberg Depression Scale and a clinical
interview, administered by a masters or doctoral level
psychologist.
5. The depression assessment results were sent to the participant's
physician with instructions to treat as if patient was not in a
study.
The CBT-AD experimental intervention group received the above
treatments as did the ETAU group. However, the experimental
group also participated in CBT-AD, delivered across 9-12 sessions,
which included educating the patient to the nature of CBT and
motivational interviewing for behavior change. Although the 9 - 12
session protocol is less than usual for depression treatment, a
positive result was obtained. Table 1 shows that the CBT-AD groups
sustained more of the gains made over ETAU during the 12 month
study.
Table 1: CBT-AD Superior to ETAU at
12 Month Follow-up 2013 American Diabetes Association. Published online6
There are only a few other studies that have examined both
psychotherapy, CBT, and treatment adherence, the content, using
specific psychological training material focused on disease treatment
adherence4.
A bibliography may be requested at [email protected].
Please state in the subject line bibliography and this article title
in the text of the email.
MENTAL HEALTH AND
DIABETES (CONTINUED)
Medication Compliance : CBT-AD 24.3% greater compliance
than ETAU
Glucose Monitoring: CBT-AD 16.9% greater compliance than
ETAU
A1C: CBT-AD .63% lower than ETAU
Watch future issues of this newsletter for the
continued Mental Health and Diabetes series.
14
Submitted by: Reita Jones, RN, BSN, LDE, Kentucky Diabetes Prevention and Control Program (KDPCP)
KENTUCKY DIABETES COALITION EFFORTS
PROFILED AT APPALACHIAN CONFERENCE
Ashley Wilks, RN,
represented
Lawrence County
Health Department
and is pictured at
left.
Courtney Barnes,
Health Educator,
represented Estill
County Health
Department and Estill
County Diabetes
Coalition and is
pictured at left.
Debra Cox, RN,
BSN, represented
Estill County
Diabetes Coalition
and is pictured at
left.
Jamie Francis,
RN, ADN, BSW,
represented
Gateway District
Health Department
and is pictured at
left.
Jamie Lee, RN, CDE,
MLDE, represented
Lake Cumberland
District Health
Department and
Clinton County Health
Coalition and is
pictured at left.
Jennifer Wilson,
Health Educator,
represented
Johnson County
Health Department
and is pictured at
left.
Kentucky was represented at the “Appalachian Diabetes Coalitions Celebrating Success 2016” conference by numerous
presenters and participants.
The Centers for Disease Control and Prevention’s (CDC)
Diabetes Division has par tnered with the
Appalachian Regional Commission since 2001 to
address the high prevalence of diabetes in the thirteen
Appalachian states, particularly targeting areas
designated as “distressed counties”.
The project is directed and managed by Marshall University who
periodically awards grants to eligible communities forming or
strengthening community partnerships or coalitions to address
diabetes needs. This project has awarded numerous grants over the
last fifteen years — with many going to Kentucky communities.
Marshall University provides ongoing technical assistance, support,
trainings, and site visits.
The Appalachian Project grantees were invited to attend the
"“Appalachian Diabetes Coalitions Celebrating Success 2016” conference October 5-7 in Gatlinburg, Tennessee. Kentucky was
represented at the conference by several local diabetes coalitions and
by the Kentucky Diabetes Prevention and Control Program
(KDPCP). There were nine presentations on the conference agenda
by Kentucky coalition representatives to profile one or more of their
group’s projects. Kentucky presenters included Jennifer Wilson of
Johnson County; Ashley Wilks representing Lawrence County;
Christy Nuetzman of Clinton County; Brittany Martin of Pike
County, Jamie Francis representing Morgan County, Susan Kincaid
of Lee County, Debra Cox; and Courtney Barnes for Estill County;
Valerie Horn for Letcher County; and Jamie Lee, Janet Cowherd and
Vicky Albertson representing counties covered by the Lake
Cumberland District Health Department.
Kentucky Diabetes Coalition Efforts Include: Diabetes Prevention Program
Diabetes and Prediabetes Awareness Campaigns
Diabetes Self-Management Support Programs
Diabetes Screening Events
Physical Activity and Healthy Nutrition Classes and Events
Community, School and Senior Center Gardens
It was exciting and encouraging to hear all the good work coalitions
are doing to address diabetes-related needs in their communities.
Great work folks and we are proud to have you represent our
state at the conference!
15
Some hopeful trends related to obesity rates in 2-4
year olds were recently reported by the Centers for
Disease Control and Prevention (CDC). CDC’s News
and Notes, Division of Nutrition, Physical Activity,
and Obesity, reported a modest drop in obesity in
thirty-four states among 2 to 4 year old participants
in the special supplemental nutrition program for
Women, Infants, and Children (WIC). The percentage
of obesity among 2-4 years olds participating in WIC
decreased from 15.9 percent in 2010 to 14.5 percent in
2014.
These findings come from a new study from the Centers for Disease
Control and Prevention (CDC) and the United States Department of
Agriculture (USDA), published in the November 17th Morbidity and
Mortality Weekly Report.
In 2013-2014, the overall obesity prevalence in all children in the
US aged 2-5 was 9.4%. Childhood obesity is more prevalent among
lower-income young-children. These children are often
disproportionately affected by barriers such as access to healthy,
affordable foods and beverages and opportunities for low-cost
physical activity.
Authors noted several factors may have contributed to the drop
in obesity among WIC toddlers including:
WIC Food Package Redesign: In 2009, the WIC food
packages were redesigned to align with the U.S. Dietary
Guidelines for Americans.
National Awareness: Obesity programs and reports such as
Let’s Move! and the Institute of Medicine recommendations
for childhood obesity prevention policies raised awareness of
this issue.
Federal Support of State and Local Health
Agencies: CDC provided funding, training, and tools to all
50 states and D.C. to address childhood obesity prevention in
Early Care and Education settings.
Access the WIC Participant Characteristic Kentucky
data at:
https://nccd.cdc.gov/NPAO_DTM/
LocationSummary.aspx?state=Kentucky.
For more information about CDC’s childhood obesity
prevention efforts: www.cdc.gov/obesity/childhood.
OBESITY RATES DROP
AMONG 2 TO 4 YEAR OLD
WIC PARTICIPANTS
SPECIAL ISSUE EVIDENCED-BASED
DIABETES MANAGEMENT
Read the full issue at: http://www.ajmc.com/journals/
evidence-based-diabetes-management/2016/
December-2016
The American Association of Diabetes Educators (AADE) and the
American Journal of Managed Care (AJMC) recently published a
joint issue of Evidence-Based Diabetes Management, which
highlights the economics of diabetes and the need for more coverage
and payment for Diabetes Self-Management Education and Support
(DSMES) as well as diabetes prevention.
The special issue highlights the growing body of evidence
supporting DSMES as an effective disease management tool that
saves health systems money but is woefully underutilized. It argues
that more widespread use of DSMES will require that payers — both
public and private — rethink policies and payment structures.
In addition to coverage, the special issue features the following:
The accumulating evidence of the value of DSMES programs
accredited through AADE’s Diabetes Education Accreditation
Program.
The role of diabetes educators in helping Accountable Care
Organizations (ACOs) achieve the triple aim of improved
population health, improved patient experience and reduced
costs.
AADE’s role in scaling the National Diabetes Prevention
Program to the point that Medicare is prepared to pay for it
beginning January 1, 2018, as well as AADE’s
recommendations for reimbursement policy.
A focus on continued problems with Medicare’s Competitive
Bidding Program for diabetes testing supplies.
The
Journal,
pictured at left,
focuses on the
Cost and
Clinical
Effectiveness of
Diabetes Self-
Management
Education and
Support
(DSMES)
http://
www.ajmc.co
m/journals/
evidence-
based-
diabetes-
manage-
ment/2016/
December-
2016
16
JDRF 2017
KENTUCKY
NEW KY HOUSEHOLD
SHARPS DISPOSAL
FACT SHEET The Kentucky Department for Environmental Protection,
Division of Compliance Assistance (DCA) and the Kentucky
Department for Public Health, Diabetes Prevention and Control
Program (KDPCP) recently released a 2017 Waste Management
Fact Sheet for Household Sharps Disposal. This new fact sheet
provides safe options for the disposal of household sharps as
well as resources to obtain additional information.
Submitted by: Jeramie Irwin, Outreach and
Development Manager, JDRF Kentucky and
Southern Indiana Chapter, Louisville, KY
2017
JDRF
Upcoming
Events:
For 2017 JDRF Upcoming Events
Details — Visit:
http://www.jdrf.org/events/?location=Louisville%2C%20KY
Jeramie Irwin
The new 2017 Waste Management Fact Sheet for Household
Sharps Disposal, pictured above, was developed by Jon
Maybriar, Division Director of Waste Management (DWM),
Department for Environmental Protection, Energy and
Environment Cabinet (EEC) and Derek Bozzell with the Division
of Compliance Assistance in cooperation with the state staff of
the Kentucky Department for Public Health, Diabetes Prevention
and Control Program.
Consider including copies of this publication in your diabetes
education patient packets — Download at:
http://dca.ky.gov/DCA%20Resource%20Document%
20Library/SharpsDisposalFactSheet121416.pdf.
17
NEW NIDDK VIDEOS
ON MANAGING
DIABETES
ENDOCRINE SOCIETY
NEW GUIDELINES
HAVE YOU HEARD?
The National Institute of
Diabetes and Digestive and
Kidney Diseases (NIDDK)
recently released new videos on
managing diabetes. The
following topics are available:
The link between diabetes and heart disease
Living with diabetes and kidney disease
What to do when blood glucose gets too high or too low
How to cope with stress related to managing a chronic
health problem
In addition, a new animated video short, called “What is
Diabetes?” uses plain language to explain what diabetes is,
type 1 and type 2, potential complications and ways to
manage the disease.
For more information visit: http://ndep.nih.gov/resources/
diabetes-healthsense/?utm_source=newsletter_dk_health-
info-news&utm_medium=email&utm_campaign=october-
2016.
ADA ONLINE
RESOURCES
The Endocrine
Society recently
released a new
Clinical Practice
Guideline called
Diabetes Technology
— Continuous
Subcutaneous Insulin
Infusion Therapy and
Continuous Glucose
Monitoring in Adults.
Visit the ADA Patient Education Library website at:
http://professional.diabetes.org/search/site?f%5B0%
5D=im_field_dbp_ct%3A32&retain-filters=1
for access to patient education materials.
The American
Diabetes Association
(ADA) offers print-on-
demand patient
education handouts
that are free to
download and
distribute.
To download the new guideline visit: https://
www.endocrine.org/education-and-practice-management/
clinical-practice-guidelines.
NDEP TOOLKIT FOR
PROFESSIONALS
The National
Diabetes Education
Program (NDEP)
offers a toolkit for
professionals:
“Working Together to
Manage Diabetes: A
Toolkit for
Pharmacy, Podiatry,
Optometry, and
Dentistry (PPOD)”.
Download the toolkit at: http://www.cdc.gov/diabetes/
ndep/pdfs/ppod-guide.pdf.
For additional professional resources visit the NDEP
website: https://www.niddk.nih.gov/health-information/
health-communication-programs/ndep/Pages/index.aspx.
18
Earn 7 Complimentary CE
with Just Released AADE16
Symposia Recordings.
AADE is excited to offer five recorded sessions from AADE16 and the chance for members to
earn up to seven complimentary hours of CE.
Learn about the some of the latest diabetes education topics while earning complimentary CE from the
following sessions: Beginner’s Guide to Continuous CGM Earn 1 CE ($0 for members/$30 for nonmembers)
Optimizing Insulin Therapy Through Applied CGM Earn 1.5 CE ($0 for members/$45 for nonmembers)
Achieving Partnerships and Improving Outcomes in Your Diabetes Patients Earn 1.5 CE ($0 for members/$45 for
nonmembers)
Does the Shoe Fit? Matching the Right Insulin Combination to Individual Patients with T2DM Earn 1.5 CE ($0 for members/
$45 for nonmembers)
Constructing an Open and Shut Case for the Practical Application of New Insulin Formulations in T2DM Earn 1.5 CE
($0 for members/$45 for nonmembers)
More Free CE
These aren’t the only complimentary CE opportunities you have access to. AADE members have access to more than 20 hours of free CE.
Check out the full list of webinars and online courses that are available at no charge to members.
Register Online at: https://nf01.diabeteseducator.org/eweb/DynamicPage.aspx?WebCode=WebReplay&pager=10.
DIABETES EDUCATION OFFERINGS
Nurses, Dietitians, and Pharmacists earn
continuing education.
Certified Diabetes Educators earn hours
toward certification.
Contact: Julie Shapero or Janice Haile
[email protected] or [email protected].
KADE Symposium 2017
Navigating the Maze of
Diabetes Care
May 19, 2017 Clarion Hotel
1950 Newtown Pike
Lexington, KY Registration Opens March 15th
For additional information:
KADENET.org
19
KENTUCKY DIABETES NETWORK (KDN)
MEETINGS SCHEDULED
The Kentucky Diabetes Network (KDN) is a network of
public and private providers striving to improve the
treatment and outcomes for Kentuckians with diabetes, to
promote early diagnosis, and ultimately to prevent the onset
of diabetes.
Anyone interested in improving diabetes outcomes in
Kentucky may join. Membership is free. A membership form
may be obtained at www.kydiabetes.net or by calling 502-564
-7996 (ask for diabetes program).
KDN 2017 Meeting Dates 10 am - 3 pm Eastern
June 16 Lexington — St. Joseph Office Park
September 15 Louisville — UL Shelbyville Campus
December 8 Frankfort — KY History Center
Register for a KDN Quarterly Meeting online:
www.kydiabetes.net
DECA DIABETES EDUCATOR
MEETINGS SCHEDULED
Diabetes Educators of the Cincinnati Area (DECA) (covers
Northern Kentucky) invites anyone interested in diabetes to
our programs. Please contact Susan Roszel at:
[email protected] 513-977-8942. Meetings are
held in Cincinnati four times per year at the Good Samaritan
Conference Center unless otherwise noted.
Registration 5:30 PM — Speaker 6 PM
1 Contact Hour
Fee for attendees who are not members of National AADE.
The Kentucky Association of Diabetes Educators (KADE),
(covers Lexington and Central Kentucky), meets quarterly
(time & location vary). For a schedule or more information, go
to www.kadenet.org or contact: Janey Wendschlag
KADE Program March 21, 2017 5:30 pm
St. Joseph Office Park — Lexington, KY Dinner Provided
RSVP Needed For All Events / Programs
www.kadenet.org
KADE DIABETES EDUCATOR
MEETINGS SCHEDULED
GLADE DIABETES EDUCATOR
MEETINGS SCHEDULED
The Greater Louisville Association of Diabetes Educators
(GLADE), (covers Louisville and the surrounding area),
meets the second Tuesday every other month. Registration
required. For a meeting schedule or to register, contact Anne
Ries at 502-852-0253 [email protected] or Christina
Weiermann at 502-879-8831 [email protected].
TRADE DIABETES EDUCATOR
MEETINGS SCHEDULED
The Tri-State Association of Diabetes Educators (TRADE),
(covers Western KY / Southern IN / Southeastern IL) meets
quarterly from 10 am – 2:15 pm CST with complimentary
lunch and continuing education. To register , email
Merritt Bates-Thomas at: merritt.bates-
[email protected] or call 270-686-7747 ext. 3018.
TRADE 2017 Quarterly Programs / Meetings April 20, 2017
Owensboro Health — Owensboro, KY
July 20, 2017 The Medical Center — Bowling Green, KY
October 19, 2017 TRADE CONFERENCE Deaconess Hospital — Evansville, Indiana
Learn About CDC’s National Diabetes Prevention Program
http://www.cdc.gov/diabetes/prevention/index.htm
The Ohio River Regional Chapter of the American
Association of Clinical Endocrinologists (AACE) and the
Kentuckiana Endocrine Club (KEC) meet on a regular basis.
For a schedule of meetings, contact Vasti Broadstone, MD,
phone 812-949-5700 email [email protected].
Register online at: https://www.aace.com/chapters/
Ohio-River-Region/Annual-Meeting/register/1
ENDOCRINOLOGISTS
MEETINGS SCHEDULED
Online
Registration
Now
Available
20
Editor
PO Box 309
Owensboro, KY 42302-0309
Presort Std.
US Postage
PAID
Owensboro, KY
42301
Permit # 120
NOTE: Editor reserves the right to edit for space, clarity, and accuracy.
Ohio River Regional Chapter
www.chfs.ky.gov/diabetes/
NEED A KY DIABETES RESOURCE?
Kentucky Diabetes Resource Directory Update your entry information
https://prd.chfs.ky.gov/KYDiabetesResources/
Local Networking Group of AADE
KENTUCKY ASSOCIATION
of DIABETES EDUCATORS
www.kadenet.org