A continuing Education Session for Pharmacists

1. Dr. Dalia A. Hamdy
BPSc, MSc, PhD, RP (ACP), MRSC
dr.daliahamdy@gmail.com

2. 1. Identify Importance and applications of screening
2. List the self care recommendations for diabetic patients
3. Apply tools for patient management and follow up
4. Employ counselling skills to educate the diabetic patient
Education & Management of Diabetics (DH/AY/NK, April 16, 2014)
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3.  Hopkins M., Silver R. Patient Self-Care. 2nd Edition. Canadian Pharmacists
Association; 2010. Chapters 27 & 28
 Blackburn DF, Mansell K, Arnason T . Therapeutic Choices. 2nd Edition.
Canadian Pharmacists Association; 2011. Chapter 31
 2013 Canadian Diabetes Association Guidelines.
http://guidelines.diabetes.ca/
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4.  Screening every 3 years is recommended in
people over 40 years of age
 Annual screening is recommended in people
at high risk.
 High risk patients
 CANRISK
 Who fall in the table below
Education & Management of Diabetics (DH/AY/NK, April 16, 2014)
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5. 5
• I am 40 years old or older
• Diabetes runs in my immediate family (Dad, Mom, Brother, Sister and/or children)
• Either or both of my parents are Aboriginal, African, Asian, Hispanic, or South Asian
• I have been told I have prediabetes
• I am a woman who had gestational diabetes during pregnancy
• I am a woman and at least one of my babies weighed 9lbs or more
• I have heart disease (history of heart attacks, strokes, TIA (mini-strokes))
• I have kidney, nerve or certain eye conditions that are associated with diabetes
• I am overweight
• I carry my excess weight around my belly
• I have high blood pressure
• My good cholesterol (HDL) blood level is low
• I have high triglycerides
• I have any of the following:
• Obstructive Sleep Apnea
• Depression
• Bipolar disorder
• Schizophrenia
• HIV infection
• Polycystic ovary syndrome
• Acanthosis nigricans
• I take certain medications including:
• Anti-inflammatory steroids
• Antipsychotic medications
Education & Management of Diabetics (DH/AY/NK, April 16, 2014)

6.  Early identification of prediabetes
 Prediabetes :
 impaired fasting glucose,
 impaired glucose tolerance
 an A1C of 6.0% to 6.4%,
each of which places individuals at high risk of developing diabetes and
its complications
Education & Management of Diabetics (DH/AY/NK, April 16, 2014)
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7. “This isn’t a diet, it’s your new lifestyle.”
• Life style changes remain the most important intervention
to delay the development of diabetes.
• Low calorie, low fat, low saturated fat, high fibre diets
• moderate intensity exercise for 150 minutes per week
Education & Management of Diabetics (DH/AY/NK, April 16, 2014)
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9.  Statins
>40 years, macrovascular and microvascular disease
>30 years + >15 years diabetics
 ACEIs or ARBs
Drugs of choice for treatment of hypertension in diabetics
-clinical macrovascular disease
- >55 years
-microvascular disease
- use in women (reliable contraception)
 Low dose ASA
-macrovascular disease
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 Autonomy!

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14.  Wear diabetic identification at all times
 Achieve healthy lifestyle
 BGL at target level
 Blood pressure and Cholesterol levels at target levels
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15.  Do not smoke
 Exercise
 Foot Care
 Regular checkups doctor, dentist, eye specialist
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16.  Vaccination (Influenza every winter and pneumonia once)
 Attend diabetes education sessions
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