Kansas City Medical Society NOVEMBER 17 TH , 2016
Our Mission “To empower patients, health care providers, families, and their communities by providing education, research, and skills needed to successfully manage their diabetes.”
How Do Diabetes Educators Help? • AADE7™ Self -Care Behaviors: Healthy Being Monitoring eating active Taking Problem- Healthy medication solving coping Reducing risks
Diabetes Education Patient Benefits • Studies have shown people who receive diabetes education: Use primary Take care / medications as prevention prescribed services Control glucose, Have lower blood pressure, health costs LDL cholesterol
Diabetes Education Underutilized • Few people with diabetes receive diabetes education…
The research shows: People with Diabetes Providers • Don’t follow through • Know importance of DE, but don’t on referral • Are emotional / necessarily prescribe – or don’t prescribe shocked at diagnosis definitively enough • End up relying on • Sometimes forget to family / friends follow up with patients • Believe they know to encourage enough / can handle it attendance on their own
Hypoglycemia Unawareness • 30% of patients with type 1 DM • “the onset of neuroglycopenia affected by severe hypoglycemia before the appearance of (unable to (1) autonomic warning symptoms” • Hypoglycemia unawareness reported in up to 40%, less prevalent in type 2 DM but increased risk with longer duration of disease (2) • Cause is multifactorial, each patient is unique • Unawareness can be reversed and awareness restored (1) Choudhary et al, 2010 (2) Martin-Timon et al, 2015
Causes of Hypoglycemia Too much insulin SFU Medication Missed timing meals Alcohol Exercise consumption
Reasons for Delaying Treatment Embarrassment No clear action plan Treatment not on hand Something else more important Fear of hyperglycemia “I’ll be fine”
Triggers of Hypoglycemia Unawareness Fast drop in blood Low blood sugar in sugar past 24-48 hours Alcohol consumption History of frequent low within the past 12 hours blood sugars Having diabetes for Stress or depression many years
Hypoglycemia Unawareness Takeaways • Set target blood sugars slightly higher to reduce risk of hypoglycemia • Reduce frequency of lows • Reduce recurrent low blood sugar • Adjust for exercise and/or delayed meals • Have action plan ready
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