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The need fo diabetes education

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

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