Smad session 1
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Shared Medical Appointments for Diabetes: Session 1
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Smad session 1
- 1. Shared Medical Appointments for Diabetes Session 1 Created by Rebecca Bates, DNP(c), RN, CFNP July 2014
- 2. Objectives • 1. Participants will gain a basic understanding of diabetes: signs, symptoms, and complications. • 2. Participants will develop personal strategies to address psychosocial issues and concerns. • 3. Participants will learn to monitor blood glucose and other parameters and to interpret these results for self- management decision-making. • 4. Participants will understand how to “live with diabetes.” • 5. Participants will learn how to cope with “sick days.”
- 3. Diabetes: Statistics • Total: 25.8 million children and adults in the United States— 8.3% of the population—have diabetes. • Diagnosed: 18.8 million people • Undiagnosed: 7.0 million people • Prediabetes: 79 million people • New Cases: 1.9 million new cases of diabetes are diagnosed in people aged 20 years and older in 2010. Source: www.diabetes.org
- 4. Overview of Diabetes in the U.S. Click to play video.
- 5. Diabetes: Facts • Diabetes is a chronic disease • You are in charge of managing your diabetes • Blood glucose monitoring can help you manage your diabetes • Who is most likely to have diabetes?
- 6. Diabetes: Myths and Facts Myths Facts 1. Insulin is a cure for diabetes 2. You can catch diabetes 3. It is easy to manage this disease 4. You can’t eat sweets if you have diabetes 5. You should only eat small amounts of foods 6. The only problem is blood glucose 7. Insulin causes diabetes to get worse 8. Insulin causes complications 1. You can lower high blood glucose with high-fiber foods 2. Your body needs carbohydrates for energy 3. You are in charge of managing your diabetes 4. Smoking increases the risk of complications 5. Blood glucose monitoring can help you manage your diabetes
- 7. An Emotional Journey • The emotional side of this disease • Common feelings • Diabetes can affect you physically and emotionally • Coping Activity: Discuss how you felt at diagnosis and how you feel today.
- 8. Information You Need Click to play video.
- 12. Tracking Results •Use a glucometer •Download your meter results to your computer •Use a blood sugar diary •Use a smart phone App Activity: Discuss how you track your results.
- 13. How are blood sugar results used? • Changing your meal plan • Keeping active • Medicine • Plan for checking blood sugar • Schedule health checkups • Manage sick days
- 14. Keeping Active Click here for video.
- 15. Medicine • Oral medications • Injected medications (non-insulin) • Injected insulin Activity: Share with other participants what types of medications you use to help control your diabetes.
- 17. References American Diabetes Association. (2014). Statistics about diabetes. Retrieved from http://www.diabetes.org/diabetes-basics/statistics/ Clearly Health. (2009). What is type 2 diabetes? Retrieved from http://www.clearlyhealth.com/videos/diabetes/introduction/type_2 MonkeySee. (2011, February 24). Diabetes management – Being active. YouTube. Retrieved from https://www.youtube.com/watch?v=_kFZNzHCLEA NovoNordisk. (2014). Request educational materials. Retrieved from https://www.novomedlink.com/diabetes-patient- support/educational-materials.html WebMD. (2013, June 11). Type 2 diabetes 101. YouTube. Retrieved from https://www.youtube.com/watch?v=Xcy365ROoYU
Editor's Notes
- Welcome participants to Session 1.
- Please review Objectives with the group.
- Please read these statistics.
- Play this video.
- A. Diabetes is a chronic disease. B. You are in charge of managing your diabetes. C. Blood glucose monitoring can help you manage your diabetes. D. Who is most likely to have type 2 diabetes? [Allow participants to suggest answers before reading the following.] 1. People with a family history. 2. People >40 years of age. 3. Females with a history of gestational diabetes and/or who have had a baby > 9 pounds at birth. 4. Overweight or obese people. 5. People under stress (illness, injury, emotional). 6. High-risk ethnic groups. 7. High blood pressure > 140/90. 8. Have an HDL cholesterol level < 45 mg/dl in men and < 55 mg/dl in women and a triglyceride level > 200.
- These may be read or you may ask participants to sort into “myth” or “fact” by reading each statement aloud before clicking on this slide. Myths: insulin is a cure for diabetes; you can catch diabetes from someone else; diabetes is a fairly easy disease to manage; people with diabetes can’t eat sweets or chocolate; if you have diabetes, you should only eat small amounts of starchy foods; the only problem in diabetes is blood glucose; insulin causes diabetes to get worse; insulin causes complications Facts: you can lower high blood glucose with high-fiber foods; your body needs carbohydrates for energy; you are in charge of managing your diabetes; smoking increases the risk of the complications of diabetes; blood glucose monitoring can help you manage your diabetes.
- Please read the following and then encourage participants to discuss the activity statement. In addition to understanding diabetes, another challenge for people with diabetes can be dealing with the emotional side of the disease. These feelings are common and expected – it is important to recognize them and how they affect the choices you make in caring for your diabetes. The point is not to change your feelings as much as figure out how to use them. 3. Diabetes can affect you physically and emotionally. You may feel any or all of these emotions. 1. Discouraged-Frustration trying to manage blood sugars through diet, exercise, and/or medication on a daily basis can feel overwhelming. 2. Stressed -This is the ‘fight-or-flight’ response. Stress may increased because of difficulty managing diabetes. 3. Depressed-Signs of depression: loss of pleasure in normal activities, sleep disturbance, decreased energy, feeling guilty, difficulty concentrating, nervousness. 4. These normal emotions may have a negative impact on your ability to best manage your diabetes. 5. Coping = the way you deal with emotions: Support network (healthy relationships with family & friends); Exercise; Meditation; Therapy/counseling; Faith-based activities; Joining a support group; Enjoyable hobbies; Positive thinking
- Play the video. 1. Diabetes is a condition where the pancreas does not produce enough insulin or when the body does not use its own insulin correctly. 2. Most of the foods we eat are changed to blood glucose (sugar). 3. A chemical in our bodies (hormone) called insulin helps the body use blood glucose. 4. Insulin is produced in an organ called the pancreas. 5. The liver has many jobs including making glucose. 6. Excess food and glucose is generally stored as body fat. 7. The components of managing your diabetes include: healthy eating, being active, monitoring, taking medication, problem solving, reducing risks, & healthy coping)
- 1. Hyperglycemia: increased thirst, sleepy, frequent urination, blurry vision, increased hunger, slow healing, numbness/tingling, sexual dysfunction
- 2. Hypoglycemia: shaky, sweaty, hungry, dizzy, headache, fatigue, sudden change in behavior, nervousness
- As if participants know their ABCs. 1. Essential part of a management program designed to help keep the blood glucose levels within a normal range. 2. Self-monitoring helps the participant stay in control of diabetes. 3. Blood glucose testing is an important part of self-care: a. Confirms balance of food activity and medications. b. Alerts when changes are needed. c. Confirms when “feelings” are due to abnormal blood glucose d. Always take meter and self-monitoring record to appointments 4. How often and when to monitor blood glucose may include 1-4 times daily: a. at bedtime and when you wake up; b. before meals; c. 1 to 2 hours after meals; d. before and after physical activity 5. More frequent testing needed a. During illness b. During pregnancy c. During times blood glucose is out of control d. When more information about blood glucose is needed e. When activity level changes [All participants should demonstrate correct glucometer use.]
- 1. Use a glucometer 2. Download your meter results to your computer 3. Use a blood sugar diary 4. Use a smart phone App [Have participants discuss how they track their results. Ask what Apps or Web based programs they may use.]
- Read the following: 1. Help manage diabetes by changing your meal plan, activity level, medicine (with your care team), help to plan for checking blood sugar, and schedule health checkups 2. Help manage sick days. a. Keep track of your blood sugar b. Continue to take your diabetes medicines c. Keep eating carbs. You may be vomiting or having diarrhea. Or your blood sugar may be high. Even so, you need to continue to take in carbohydrates. To prevent low blood sugar, try to eat or drink about 50 grams of carbs every 3 to 4 hours. You can get 15 grams of carbs from these foods: ½ cup of fruit juice, regular soda, or regular gelatin dessert, 1 double ice pop, 1 cup of soup, 1 cup of sports drink, 1 slice of toast, or 6 soda crackers. d. Drink up: 8 ounces of caffeine free liquid every hour. e. Call your diabetes care team if you have any questions or concerns and if: Your blood sugar is less than 70 mg/dL; You have high blood sugar (240 mg/dL or more) for more than 6 hours; You can’t eat or drink for at least 4 hours; You have a fever (101.5 F or higher); Your illness lasts for more than 24 hours; You have severe pain in your stomach, have chest pain, or have a hard time breathing; You have been vomiting or having diarrhea for more than 6 hours; You have moderate to large amounts of ketones in your urine for more than 6 hours
- Another aspect of managing your diabetes is keeping active or getting enough physical activity. Play this video.
- Taking medicine is another way to lower blood glucose. There are a lot of different medicine options. [Ask participants to share what types of medications they use.]
- Please complete Goals sheet before leaving and bring to the next class. [This is an individual goal sheet that should be in each participants packet. They are responsible for completing their goals to work on before the next session. If there is time, you may ask participants to share their goals.]