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Diabetes Self Management Laura Wintersteen-Arleth, MN, RN,CDE.

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Presentation on theme: "Diabetes Self Management Laura Wintersteen-Arleth, MN, RN,CDE."— Presentation transcript:

1 Diabetes Self Management Laura Wintersteen-Arleth, MN, RN,CDE

2 Learning Objectives o Understand the impact of diabetes o Distinguish the different types of Diabetes o Identify treatment options for diabetes management o Identify methods of applying the Chronic Care Model to diabetes self-management o Describe tools which health care providers can use to empower patients

3 Impact of Diabetes o 220 million worldwide have diabetes o 80% of deaths from diabetes in low and middle-income countries o Diabetes deaths will double between 2005 and 2030 o Diabetes has significant financial impact

4 Diabetes Diabetes is a chronic disease, which occurs when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces. This leads to an increased concentration of glucose in the blood

5 Diabetes o Type 1 o Type 2 o Gestational o LADA: Latent Autoimmune Diabetes of Aging o Pre-Diabetes o Impaired Glucose Tolerance (IGT) o Impaired Fasting Glucose (IFG)


7 Risk Factors for Diabetes Type 1 o Under 30 o Genetics o Autoimmune o Environment o Viral infection Type 2 o Older age o Overweight o Hypertension o Abnormal lipid levels o Genetics o Race/ethnicity o History of gestational diabetes o History of vascular disease o Inactivity

8 Clinical Manifestations: Comparisons Type 1 o Polyuria o Polyphagia o Polydipsia o Significant weight loss o Fatigue Type 2 o Fatigue o Dry, itchy skin o Numbness, tingling o Polydipsia o Polyuria o Blurred vision o Impaired healing o Yeast infections o Sexual dysfunction

9 Acute Complications of Diabetes o Dawn Phenomenon o Somogyi Phenomenon o Hypoglycemia o Diabetic Ketoacidosis o Hyperglycemia, Hyperosmolar Syndrome


11 Chronic Complications of Diabetes Microvascular o Retinopathy o Nephropathy o Neuropathy

12 Chronic Complications of Diabetes Macrovascular o Cardiovascular Disease o Cerebral Vascular Accident o Peripheral Vascular Disease

13 Glucose Tolerance Categories 18 mg/dL = 1 mmol, therefore 18 mg/dL X 7 mmol = 126 mg/dL Adapted from The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 1997;20:1183-1197. FPG 126 mg/dL 100 mg/dL 7.0 mmol/L 5.6 mmol/L Impaired Fasting Glucose Normal 2-Hour PG or OGTT 200 mg/dL 140 mg/dL 11.1 mmol/L 7.8 mmol/L Diabetes Mellitus Impaired Glucose Tolerance Normal Diabetes Mellitus 1-2

14 Treatment Options for Diabetes o Nutrition o Activity o Medications

15 Importance of Testing Blood Sugars o Testing blood glucose o Alternate times o Develop a pattern o Be sure to include 2 hours post prandial o Record the numbers o Discuss at visits o Use to revise treatment plan

16 Chronic Care Model and Diabetes

17 o The patient becomes knowledgeable and the expert in diabetes and its complications o The patient understands the importance of taking control of their diabetes o The patient has people who are important to them and their management of diabetes and the provider includes them as the patient wants o The provider will take time to build a relationship with the patient and understands their beliefs, values, culture

18 Maslow’s Theory

19 Using the 5 “A’s” With Diabetes o Assess o Advise o Agree o Assist o Arrange

20 Empowering Patients: 4 Important Lessons Patient Need to Learn o Their illness is serious o Their condition is essentially self-managed o They have options o They can change their behavior

21 Helping Patients Set Goals o Start at the problem o Develop a collaborative goal o Validate their goal and plan

22 Old Model vs New Model: Being put on Insulin Old Model If you don’t start to control your blood glucose, I am going to have to put you on insulin and you will have to take shots. Your diabetes is not getting any better. New Empowering Model You have been working to control your blood glucose, but often a patient will need some assistance form insulin. Research shows that starting someone on insulin sooner than later, assists them in getting better control. What about insulin concerns you?

23 World Health Organization and Diabetes o The mission of the WHO Diabetes Program is to prevent diabetes o Core Functions o Diabetes Action Now o World Diabetes day

24 Summary o Diabetes is a chronic condition affecting millions worldwide o Self-management techniques can delay or prevent complications o Empowering the and becoming a partner with them, will help provide positive results of control o Tools were given to assist the provider in understanding diabetes and thus assisting their patients

25 Questions and Discussion

26 Contact Information Laura Wintersteen-Arleth, MN, RN,CDE

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