The need fo diabetes education


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The need fo diabetes education

  1. 1. The Need for Diabetes Education in the U.S. Veronica Culpepper, RN,MSM,CDE VALLEY HEALTHCARE SYSTEM Columbus, Georgia
  2. 2. Objectives <ul><li>The participants will be able to: </li></ul><ul><li>Name the four types of diabetes. </li></ul><ul><li>Cite the expected increase in diabetes in 2050. </li></ul><ul><li>Name four severe complications of uncontrolled diabetes. </li></ul><ul><li>Cite how activity plays a role treating diabetes. </li></ul>
  3. 3. Objectives continued… <ul><li>Name the seven self-care behaviors taught by diabetes educators. </li></ul><ul><li>State the percentage of people with diabetes that get effective diabetes education. </li></ul><ul><li>List two ways to increase the efforts of the diabetes educators to meet the needs of the increasing population with diabetes. </li></ul>
  4. 4. Types of Diabetes <ul><li>Pre diabetes </li></ul><ul><li>Type 1 diabetes </li></ul><ul><li>Type 2 diabetes </li></ul><ul><li>Gestational diabetes </li></ul>
  5. 5. Pre diabetes <ul><li>People with pre diabetes have a blood glucose levels higher than normal but not high enough to be classified as diabetes. </li></ul>
  6. 6. Type 1 Diabetes <ul><li>The pancreas stops producing insulin. Insulin is a hormone that regulates blood glucose. There is no known way to prevent type 1 diabetes. Type 1 diabetes usually occurs in children and young adults. </li></ul>
  7. 7. Type 2 Diabetes <ul><li>Type 2 diabetes is often called adult onset diabetes. It is associated with older age, obesity, family history of diabetes, history of gestational diabetes and race/ethnicity. </li></ul>
  8. 8. Gestational Diabetes <ul><li>Gestational diabetes is a form of glucose intolerance diagnosed during pregnancy. Most often in American Indians, African Americans, Hispanic/Latino Americans and Asians. 35 to 60% of these women will develop diabetes in the next 10 to 20 years. </li></ul>
  9. 9. Prevalence of Diabetes in the U.S. <ul><li>According to the Center for Disease Control and Prevention </li></ul><ul><li>25.8 million people (8.3% of the population) have diabetes </li></ul><ul><li>--18.8 million people are diagnosed </li></ul><ul><li>--7.0 million are yet undiagnosed </li></ul>
  10. 10. <ul><li>79 million Americans aged 20 years or older are estimated to have pre diabetes. </li></ul><ul><li>The proportion of people with diabetes increases as people age. </li></ul><ul><li>Diabetes is a concern for both men and women. </li></ul><ul><li>--13.0 million or 11.8 % of all men 20 years or older have diabetes. </li></ul><ul><li>--12.6 million or 10% of all men 20 years or older have diabetes. </li></ul>
  11. 11. <ul><li>1 out 0f 10 people in the U.S. have diabetes. </li></ul><ul><li>In 2050 1 out of 3 adults will have diabetes including both diagnosed and undiagnosed. </li></ul><ul><li>Diabetes affects some racial/ethnic groups more than others. </li></ul><ul><li>--Non-Hispanic whites: 15.7 million, or 10.2% 20 years or older have diabetes </li></ul><ul><li>--Non-Hispanic blacks: 4.9 million or 18.7% 20 years or older have diabetes </li></ul>
  12. 12. Complications of Uncontrolled or Unmanaged Diabetes <ul><li>Diabetes is the 7 th leading cause of death in the U.S. </li></ul><ul><li>Poorly controlled diabetes is the leading cause of adult blindness, end-stage renal disease and non-traumatic lower-limb amputations. </li></ul><ul><li>Diabetes also doubles the risk of stroke and heart disease. </li></ul><ul><li>People with diabetes are also at increased risk for neurological symptoms, cardio-vascular disease and other complications. </li></ul>
  13. 13. Estimated Diabetes Costs in the United States <ul><li>Total (direct and indirect </li></ul><ul><li>Direct medical costs </li></ul><ul><li>Indirect costs </li></ul><ul><li>$174 billion </li></ul><ul><li>$116 billion </li></ul><ul><li>Medical expenses for people with diabetes are 2.3 times higher than people without diabetes </li></ul><ul><li>$58 billion (disability, work loss, premature mortality) </li></ul>
  14. 14. Treatment of Diabetes <ul><li>Medications: both pills and injections. </li></ul><ul><li>--People with Type 1 diabetes must have insulin to survive. </li></ul><ul><li>--People with Type 2 diabetes may take no medication or pills along or pills or insulin. </li></ul>
  15. 15. Treatment of Diabetes cont. <ul><li>Meal plan </li></ul><ul><li>--Meal plan is important for all people with diabetes. </li></ul><ul><li>--Many people with type 2 diabetes can control blood sugar by following a health meal plan and exercise plan. </li></ul>
  16. 16. Treatment of Diabetes cont. <ul><li>Activity </li></ul><ul><li>--Increase in activity is a must for losing weight and maintaining weight control </li></ul><ul><li>--Decreases blood sugars </li></ul><ul><li>--Decreases blood pressure and cholesterol </li></ul>
  17. 17. Role of Diabetes Educators Teaching Self Management Education <ul><li>Who are Diabetes Educators </li></ul><ul><li>--Nurses, dieticians, pharmacist, physical therapist, who teach clients and their families how to manage their diabetes. </li></ul><ul><li>--There are 15,000 certified diabetes educators. </li></ul><ul><li>--There are 15,000 diabetes educators in practice who have not completed requirements for the CDE credentials. </li></ul>
  18. 18. <ul><li>Diabetes education also known as diabetes self management education (DSME/T). </li></ul><ul><li>DSME/T teaches life style intervention. </li></ul>
  19. 19. <ul><li>Diabetes education focuses on the ADDE7⁽™⁾ Self-Care Behaviors that are essential for improved health status and greater quality of life. </li></ul><ul><ul><li>Healthy Eating </li></ul></ul><ul><ul><li>Being Active </li></ul></ul><ul><ul><li>Monitoring </li></ul></ul><ul><ul><li>Taking Medication </li></ul></ul><ul><ul><li>Problem Solving </li></ul></ul><ul><ul><li>Healthy Coping </li></ul></ul><ul><ul><li>Reducing Risk </li></ul></ul>
  20. 20. Proportion of people with diabetes who receive diabetes education <ul><li>Estimates vary from 1% to 50%. </li></ul><ul><li>According to the 2007 Roper Study, out of 16,660,000 diagnosed diabetes patients in the U.S., 4,249,00 had seen a diabetes educator in the past 12 months. </li></ul><ul><li>AADE analyses of Centers for Medicare and Medicaid services reimbursement for diabetes education (DSMT) found about 1% of Medicare clients received education in 2004 and 2005. </li></ul>
  21. 21. Diabetes Education is an Effective Intervention <ul><li>A study show lifestyle intervention to lose weight and increase physical activity reduced the development of Type 2 diabetes by 58% during a 3 year period. </li></ul><ul><li>Data shows that diabetes education saves money and decrease health care utilization. </li></ul><ul><li>Hospital admissions was down 34% in patients who had at least one educational visit. </li></ul>
  22. 22. Diabetes Education is an Effective Intervention cont. <ul><li>Cost savings when A₁C decreases is associated with significant health care savings. </li></ul><ul><li>Reduction of severe complications of uncontrolled diabetes. </li></ul>
  23. 23. The Problem with Diabetes Education (DSME/T) <ul><li>The problem with DSME/T is how many clients diabetes educators see? 30,000 educators versus 26 million Americans </li></ul><ul><ul><li>Diabetes educators can effectively reach more people by expanding their education team to include community health workers and medical assistants. </li></ul></ul><ul><ul><li>Utilizing Telehealth </li></ul></ul><ul><li>Telehealth improves diabetes self management in an underserved community. </li></ul>
  24. 24. <ul><li>Findings of comprehensive pilots done in several areas in rural South Carolina </li></ul><ul><ul><li>Improved A₁C </li></ul></ul><ul><ul><li>LDL Cholesterol reduced in 12 months </li></ul></ul><ul><ul><li>High participant retention-6 and 12 month 90.9, 82.4% respectively </li></ul></ul><ul><ul><li>Medicare and many private insurers will pay for DSME/T via Telehealth. Medicare restriction is the recipient, must be in a rural or an underserved area. </li></ul></ul><ul><ul><li>My experiences with DSME/T with GaTelehealth </li></ul></ul>