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The need fo diabetes education
 

The need fo diabetes education

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    The need fo diabetes education The need fo diabetes education Presentation Transcript

    • The Need for Diabetes Education in the U.S. Veronica Culpepper, RN,MSM,CDE VALLEY HEALTHCARE SYSTEM Columbus, Georgia
    • 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.
    • 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.
    • Types of Diabetes
      • Pre diabetes
      • Type 1 diabetes
      • Type 2 diabetes
      • Gestational diabetes
    • Pre diabetes
      • People with pre diabetes have a blood glucose levels higher than normal but not high enough to be classified as diabetes.
    • 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.
    • 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.
    • 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.
    • 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
      • 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.
      • 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
    • 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.
    • 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)
    • 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.
    • 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.
    • 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
    • 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.
      • Diabetes education also known as diabetes self management education (DSME/T).
      • DSME/T teaches life style intervention.
      • 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
    • 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.
    • 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.
    • 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.
    • 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.
      • 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