Diabetes Self-Management Education Record
|
|
|
- Rhoda Chapman
- 5 years ago
- Views:
Transcription
1 Diabetes Self-Management Education Record Patient Label Record level of competence and Initial: O=outcomes met; RT=reinforce teaching; NA=not applicable; P=prior knowledge Clinical Outcomes Information Source: Patient, Lab, Physician Office Time: Session 1 Session 2 Session 3 Session 4 Preprandial Blood Glucose Postprandial Blood Glucose Bedtime Blood Glucose Hemoglobin A1C (%) LDL HDL Triglycerides Checks feet/times per week Height: Weight: lbs lbs lbs lbs BMI: Goal #1: Met/New Goal: Progress/Barrier: Goal #2: Met/New Goal: Progress/Barrier: Pt will be able to: Discuss general facts of diabetes, identify personal type of diabetes Plan meals using their meal plan Correctly reads food labels and calculates exchanges Plan appropriate snacks Discuss special diet issues (alcohol, labels, heart healthy eating, sugar subs, eating out, grocery shopping, etc) Develop and appropriate physical activity program for themselves List appropriate physical activity for themselves, benefits/risks of activity and discuss nutrition changes needed for activity Identify type, dose, action and frequency of their medications Correctly draw up and administer insulin and discuss proper needle disposal Test blood sugar according to individual plan Meter: Demonstrate correct method of SMBS Target BS: to mg/dl Demonstrate correct method for testing ketones Use results of nutrition, activity, medication and blood sugar records to improve control Identify symptoms and treatment of and define hypoglycemia Discuss sick day management and effects of illness on diabetes Define hyperglycemia and its symptoms Discuss potential for complications of diabetes in relation to blood sugar Discuss eye care, how often to eye doctor Demonstrate proper foot care and complete self exam
2 Identify the need for screening tests: eg microalbumin, lipids, HbA1c Identify plan to quit smoking if appropriate Complete self-management goal sheet Utilize problem solving skills to make changes to improve control. Identify appropriate community resources Identify when to call health care team Discuss feelings related to having diabetes Discuss relation of stress to diabetes Involve family/friends in diabetes care Identify importance of preconception counseling Develop a plan of care for diabetes self-management during pregnancy Responsibilities of people with diabetes Initials/ Initials/ Initials/ Initial Assessment Materials Given- 1. Stepping Toward Control 7. Blood glucose log 2. Grief process 8. Patient bill of rights/responsibilities 3. Goals for control 9. Resources 4. Medic alert 10. Sample Menus 5. Guidelines for meal planning 11. Diabetes Outlook bag/ada box 6. Signs & symptoms hypo/hyperglycemia 12. Glucometer Nutrition Education Materials Given- Dates: 1. Medical Nutrition Therapy 2. Fabulous Fiber 3. Portion Sizes 4. Label Reading 5. Switch Ingredients 6. Exchange List 7. Plate Method 8. Not All Fats 9. Fast Food Guide Complications Prevention Class Materials Given- 1. Patient Bill of Rights/Responsibilities 2. Complications Pack/ Foot Screening 3. Sick Day Management/ Prevention/ Flu & Pneumonia Vaccinations BD Pamphlet 4. Benefits of Exercise BD Pamphlet 5. Medications 6. Stress Management BD Pamphlet 7. Outcomes Measures 8. Medical Identification
3 BARTON COUNTY MEMORIAL HOSPITAL DIABETES TEACHING PATIENT NAME: DOCTOR: COMMENTS: Signature: Signature: Signature:
4 Barton County Memorial Hospital Dietitian Diabetes Education Teaching Notes Time in: Time Time Time Time Time Education Materials Used / Medical Nutrition Therapy Basic Meal Planning Guidelines Fabulous Fiber Portion Sizes Label Reading Switch Ingredients Exchange List Plate Method Not all Fats Are Created Equal Comments: Signature:
5 BARTON COUNTY MEMORIAL HOSPITAL Complications Prevention Class Time in Time out Patient Name: Educational Materials Used: 1. Patient Bill of Rights/Bill of Responsibilities 2. Complications Pack / Foot Screening 3. Sick Day Management / Prevention / Flu, Pneumonia Vaccinations BD Pamphlet 4. Benefits of Exercise BD Pamphlet 5. Medications 6. Stress Management BD Pamphlet 7. Outcomes Measures 8. Medical Identification Patient Goals Met: Comments: Signature:
RISK FACTORS OR COMPLICATIONS AND RECOMMENDED TREATMENT GOALS AND FREQUENCY OF EVALUATION FOR ADULTS WITH DIABETES
RISK FACTORS OR COMPLICATIONS AND RECOMMENDED TREATMENT GOALS AND FREQUENCY OF EVALUATION FOR ADULTS WITH DIABETES Risk Factors or Complications Glycemic Control Fasting & Capillary Plasma Glucose Anti-platelet
MOVING ON... WITH DIABETES
MOVING ON... WITH DIABETES ADOLESCENT KNOWLEDGE & SKILLS CHECKLIST (AGE 17-18 YRS) DIABETES EDUCATOR/TEAM USER GUIDE PURPOSE Provides adolescent self-assessment of learning needs prior to transition. Provides
Outpatient Program Multidisciplinary Team Discharge Summary m
Diabetes Center Outpatient Program Multidisciplinary Team Discharge Summary m PATIENT: DOB:, Person instructed: Patient Other : Date of Completion: Diabetes Education Attended: Day 1: BG s: ac lunch pp
GLUCOSE MONITORING. How. When
GLUCOSE MONITORING Why Self-monitoring of blood glucose is the best way to see how your body handles food, activity, diabetes medication (pills and/or insulin), stress and illness. You can also see what
Diabetes Self-Care Information and Record Booklet
Diabetes Self-Care Information and Record Booklet Your personal guide... what you do each day really matters. This document is available online at www.wisconsindiabetesinfo.org What is Diabetes? Diabetes
MY PERSONAL ROADMAP WORKBOOK
FINALLY. Celebrate your successes, even the small ones! Learn from your efforts that don t turn out as you hoped or expected. If you do this, you can t fail! Set yourself up to succeed. Remember.. Most
Your Diabetes Care Records
Your Diabetes Care Records Make copies of the charts in this section. These charts list important things you should discuss with your doctor at each visit. Things to Discuss with Your Health Care Team
Diabetes: Everything You Want to Know. LCDR Bernadine John, RN, BSN, CDE
Diabetes: Everything You Want to Know LCDR Bernadine John, RN, BSN, CDE I have no financial affiliation to disclose as a conflict of interest regarding this presentation. DM Standards of Care The IHS Division
Application of the Diabetes Algorithm to a Patient
Application of the Diabetes Algorithm to a Patient Apply knowledge gained from this activity to improve disease management and outcomes for patients with T2DM and obesity Note: The cases in this deck represent
Patient Education Handouts Table of Contents 2013 General Diabetes Information Monitoring and Management
Patient Education Handouts Table of Contents 2013 We have highlighted some handouts that may be helpful for the new patient. Select the ones that are most useful to you. Avoid overwhelming the patient
Date of Birth. Black/African American. What is your occupation? Retired? Yes No
Health Risk Assessment Today s Date: Name Date of Birth GENERAL INFORMATION What is your race? American Indian or Alaskan Native Native Hawaiian or Other Pacific Islander Asian, Chinese, Japanese, Korean
Johnson City Internal Medicine 301 Med Tech Parkway, Suite 240, Johnson City, TN (423)
IDX# Johnson City Internal Medicine 301 Med Tech Parkway, Suite 240, Johnson City, TN 37604 (423)794-5823 SoFHA Diabetes Clinic Assessment Instructions: Please complete and bring to your appointment with
Health Risk Assessment
Health Risk Assessment Today s Date: Name Date of Birth GENERAL INFORMATION What is your race? American Indian or Alaskan Native Native Hawaiian or Other Pacific Islander Asian, Chinese, Black/African
Simple Start TM Diabetes Log Book
Learn about Diabetes & Earn rewards at the same time Simple Start TM Diabetes Log Book our engagement and rewards program that Empowers you through Education Learn how to manage your diabetes better with
Follow-Up Patient Self-Assessment (Version 2)
Follow-Up Patient Self-Assessment (Version 2) Demographics: Name: Address: E-mail: Phone Number: Date of Birth: What is your height? What is your current weight? feet inches lbs Have there been any change(s)
Welcome Everyone. Monitoring, Sick Days, Inpatient Management - Objectives. Mrs. Jones has new diabetes. She asks you: Page 1
Welcome Everyone Sign-In Enjoy Breakfast Meet someone new Enter Raffle Pick a team name Please silence phones We start at 8:00am Monitoring, Sick Days, Inpatient Management - Objectives Objectives: Strategies
The Johns Hopkins Diabetes Center JOHNS HOPKINS DIABETES EDUCATION PROGRAM DIABETES SELF-MANAGEMENT ASSESSMENT. Name: Marital Status: M S W SEP D
JOHNS HOPKINS DIABETES EDUCATION PROGRAM DIABETES SELF-MANAGEMENT ASSESSMENT Date: JHH # I. General Information Name: Marital Status: M S W SEP D Address: Phone: Home: Work: Email: Fax: Sex: M F Date of
Personal Diabetes Passport
Personal Diabetes Passport Contact information: Name: Physician: Diabetes Education Centre: Dietitian: Ophthalmologist: Chiropodist: Type of Diabetes: Type 1 (T1DM) Increased risk for diabetes Type 2(T2DM)
Managing DIABETES. Guidelines, resources and tips to help your family live better with diabetes
Managing DIABETES IN CHILDREN AND ADOLESCENTS Guidelines, resources and tips to help your family live better with diabetes A wellness publication prepared for members of Samaritan Health Plans OUR MEMBERS.
DIABETES Self Directed Test (12 Hours) Name: Ward/Practice Area: Mailing Address:
1 DIABETES Self Directed Test (12 Hours) Name: Ward/Practice Area: Mailing Address: 2 Learning Outcomes All nurses, regardless of practice setting, are required to work collaboratively with the person
Prediabetes 101. What is it and what can I do about it? Intermountainhealthcare.org/diabetes
Prediabetes 101 What is it and what can I do about it? Patient Education Intermountainhealthcare.org/diabetes What do you already know about prediabetes? Fact or Fiction? There are often no symptoms of
Patient Information. First Name Middle Last Preferred Name. Street Address City State Postal Code
Ms. Patient Information First Name Middle Last Preferred Name Street Address City State Postal Code Work Phone ( ) Home Phone ( ) Cell Phone ( ) Email Preferred Contact Email Cell Home Work Emergency Contact
Standard Medicare and Managed Medicare plans pay for diabetes education.
614-447-9495, ext. 1 You are scheduled to attend a series of four diabetes education classes. If you are not able to attend the class series, we ask that you cancel your appointment at least 48 working
CommUnityCare Women s Health Brackenridge Professional Office Building
Guidelines for Diabetes in Pregnancy Effective Date 7/1/11 *This document does not define a standard of care, nor is it intended to dictate an exclusive course of management. There are other accepted strategies
CHALLENGING CASE PRESENTATION Steroid Induced Hyperglycemia
CHALLENGING CASE PRESENTATION Steroid Induced Hyperglycemia Javier Carrasco, MD, PhD Juan Ramón Jiménez Hospital University of Huelva, Spain Case Study: Medical and Social History A 60 years old female
Leonard Wonnenberg, PA-C May 18, 2016
Using EHR to Establish a Workflow Process for Referring Patients to Diabetes Self- Management/Chronic Disease Self-Management Programs Leonard Wonnenberg, PA-C May 18, 2016 Horizon Proprietary = Data +
Clinical Practice Guideline Key Points
Clinical Practice Guideline Key Points Clinical Practice Guideline 2008 Key Points Diabetes Mellitus Provided by: Highmark Endocrinology Clinical Quality Improvement Committee In accordance with Highmark
Diabetes Mellitus Type 2
Diabetes Mellitus Type 2 What is it? Diabetes is a common health problem in the U.S. and the world. In diabetes, the body does not use the food it digests well. It is hard for the body to use carbohydrates
2. The charges will be sent to the insurance company on one bill, but will list each date that you come to a class.
614-447-9495, ext. 1 You are scheduled to attend a series of four diabetes education classes. If you are not able to attend the class series, we ask that you cancel your appointment at least 48 working
Diabetes 101 A Medical Assistant Training Module
Diabetes 101 A Medical Assistant Training Module July 2014 Wendy Stricklin RN, BSN Clinical Quality Consultant Michigan Primary Care Association www.mpca.net Objectives Participant will have a basic understanding
Living with Diabetes
Living with Diabetes You Are Not Alone! Diabetes continues to grow each year at an alarming rate in the United States. According to the Centers for Disease Control and Prevention (CDC), nearly 30 million
Tools for Life. Blood sugar basics.
Tools for Life. Blood sugar basics. OneTouch, Ultra, Ultra2, and UltraMini are registered trademarks, and Delica and DoubleSure are trademarks, of LifeScan, Inc. 2011 LifeScan, Inc. Milpitas, CA 95035
Lab Values Explained. working at full strength. Other possible causes of an elevated BUN include dehydration and heart failure.
Patient Education Lab Values Explained Common Tests to Help Diagnose Kidney Disease Lab work, urine samples and other tests may be given as you undergo diagnosis and treatment for renal failure. The test
Diabetes Mellitus Case Study
COLORADO STATE UNIVERSITY Diabetes Mellitus Case Study Medical Nutrition Therapy By: Emily Lancaster 9/28/2012 [Type the abstract of the document here. The abstract is typically a short summary of the
Record-Keeping Charts
In this appendix, we have provided some useful charts for you so you can record information that s important to manage your diabetes. Use these charts to keep track of the information not only for yourself,
Participant Self-Assessment of Diabetes Management
Participant Self-Assessment of Diabetes Management Name: Date: Date of Birth: Age: Gender: F M Ethnic Background: White/Caucasian Black/African American Hispanic Native American-Alaska Asian/Pacific Islander
Initial Patient Self Assessment Demographics:
Initial Patient Self Assessment Demographics: Name: Address: E mail: Phone Number: Date of Birth: Gender: Male Female Other Primary Language: English Spanish Other Occupation: Education: Clerical Skilled
Diabetes Passport. East Coast Area Diabetes Integrated Care
Diabetes Passport East Coast Area Diabetes Integrated Care Personal Details Name: Address: Developed by East Coast Area Diabetes Programme (ECAD), 2014. Thanks to Beaumont Hospital for allowing us to use
DIABETES SELF MANAGEMENT EDUCATION / NUTRITION COUNSELING INITIAL ASSESSMENT. NAME Today s Date
NAME Today s Date DATE OF BIRTH CONTACT INFORMATION: Home Number Cell phone number Work Number Okay to call at work? No Yes Answering machine No Yes Ok to leave message Your own personal Email Address
2015 Diabetes. Program Evaluation. Our mission is to improve the health and quality of life of our members
2015 Diabetes Program Evaluation Our mission is to improve the health and quality of life of our members Diabetes Care Program Evaluation Program Title: Diabetes Care Program Evaluation Period: January
What is Diabetes Mellitus?
Normal Glucose Metabolism What is Diabetes Mellitus? When the amount of glucose in the blood increases, After a meal, it triggers the release of the hormone insulin from the pancreas. Insulin stimulates
2013 UPDATE ON PREVENTION & SCREENING IN THE ELDERLY West Virginia Geriatrics Society October 3, 2013
2013 UPDATE ON PREVENTION & SCREENING IN THE ELDERLY West Virginia Geriatrics Society October 3, 2013 Joy Pelfrey, RN, MSN, FNP, NEA-BC Director of Senior Service Line Objective Providers will understand
MOVING ON... WITH DIABETES
MOVING ON... WITH DIABETES KNOWLEDGE & SKILLS SELF-ASSESSMENTS (AGES 13-16 YRS) DIABETES EDUCATOR/TEAM USER GUIDE PURPOSE Evaluates knowledge and skill level related to diabetes management. Directs further
Lifestyle & Pre-diabetes Questionnaire
Please complete this questionnaire. The time you take to provide this information will help your health care team work better for you. General, Medical and Health Information Date: Name: Age: Race: Current
Type 1 Diabetes - Pediatrics
Type 1 Diabetes - Pediatrics Introduction Type 1 diabetes prevents the body from removing sugar from the blood stream normally. Diabetes can lead to serious health problems if it is not treated. Currently
2017 Diabetes. Program Evaluation. Our mission is to improve the health and quality of life of our members
2017 Diabetes Program Evaluation Our mission is to improve the health and quality of life of our members Diabetes Program Evaluation Program Title: Diabetes Program Evaluation Period: January 1, 2017 December
Medical Nutrition Therapy & Nutrition Ed in DSMES What s the Difference?
Medical Nutrition Therapy & Nutrition Ed in DSMES What s the Difference? MEGAN ELLISON, MS, RDN, CSOWM, CDE WADE CONFERENCE APRIL 25, 2019 1 Disclosure to Participants Notice of Requirements for Successful
Common Diabetes-related Terms
Common Diabetes-related Terms A1C An A1C test measures a person's average blood glucose level over two to three months. Hemoglobin is the part of a red blood cell that carries oxygen to the cells and sometimes
Objectives. Objectives. Alejandro J. de la Torre, MD Cook Children s Hospital May 30, 2015
Alejandro J. de la Torre, MD Cook Children s Hospital May 30, 2015 Presentation downloaded from http://ce.unthsc.edu Objectives Understand that the obesity epidemic is also affecting children and adolescents
Clinical Practice Guidelines for Diabetes Management
Clinical Practice Guidelines for Diabetes Management Diabetes is a disease in which blood glucose levels are above normal. Over the years, high blood glucose damages nerves and blood vessels, which can
Diabetes Prevention (Managing Prediabetes)
IMPORTANCE OF FOCUS Although Prediabetes is not viewed as a clinical entity in its own right, it is a risk factor for diabetes and cardiovascular disease. It is estimated that approximately 1 in 3 U.S.
Advanced Diabetes Mellitus Education Information
Advanced Diabetes Mellitus Education Information Understanding Hemoglobin A1c Target Glucose and Hemoglobin A1c Monitoring Glucose and Tips Low Glucose Signs, Symptoms and Treatment, Rule of 15 Meal Planning
WELL-WOMAN EXAM REVEALS RISK. Katie Jones, MPH, CHES Iowa Department of Public Health Erin Hinderaker, MS, RD, LD Des Moines University
WELL-WOMAN EXAM REVEALS RISK Katie Jones, MPH, CHES Iowa Department of Public Health Erin Hinderaker, MS, RD, LD Des Moines University Disclaimer The information provided in this presentation is for informational
UNIT FOUR LESSON 10 OUTLINE
UNIT FOUR LESSON 10 OUTLINE Welcome participants to the final unit in the series Taking Ownership of Your Diabetes Ask participants how they are doing in terms of the Diabetes Checklist and goal setting.
Diabetes Overview. How Food is Digested
Diabetes Overview You are The Teacher, The Coach and the Fan Pathophysiology of Diabetes Complications Know the Numbers Treatment Can Good Control Make a Difference? Can Tight Control Be too Tight? How
How things normally work
Diabetes How things normally work When you eat, your body breaks food down into glucose. Glucose is a type of sugar that is your body s main source of energy. 6 How things normally work As blood glucose
**Medicare and Medicaid have other Billing Codes and different eligibility. Please contact our office for more information. Thank you!
Checking Your Insurance Benefits IMPORTANT Please check your insurance coverage prior to any Nutrition or Diabetes Education appointment. You will be responsible for any services that are not covered.
Monthly WellPATH Spotlight November 2016: Diabetes
Monthly WellPATH Spotlight November 2016: Diabetes DIABETES RISK FACTORS & SELF CARE TIPS Diabetes is a condition in which the body does not produce enough insulin or does not use the insulin produced
Diabetes Competencies for Community Nurses
Diabetes Competences for Community Nurses Lothian Health Board: August 2012 Lindsey Aniello, and Jill Little, Diabetes Specialist Nurses Judy Hamilton, District Nurse COMPETENCY DESCRIPTOR 1 Participates,
Heart Disease and Diabetes Teaching Module
Heart Disease and Diabetes eaching Module Pre-est 1 Cardiovascular complications will affect of people with diabetes. a. 75% b. 15% c. 99% 2 rue or alse? Chronic high blood sugars can cause arteries to
What are your numbers telling you?
What are your numbers telling you? What is Type 2 Diabetes? Type 2 diabetes (die-ah-bee-teez) is a health problem where blood glucose (sugar) levels are too high After eating a meal, the pancreas produces
Prediabetes. Clinical Health Education. 7/1//2014 Chronic Conditions Management Department
Prediabetes Clinical Health Education 7/1//2014 Chronic Conditions Management Department What are your concerns about having prediabetes? What are you doing to address these concerns? 2 People with prediabetes
Diabetes School October 2016
Diabetes School October 2016 Name Change- Why? Shorter Has my name in it Emphasizes a major part of the practice Still see non-research patients Novo Nordisk Lilly sanofi aventis! Thank You to our LucasResearch
Basic Diabetes Mellitus Patient Education
Basic Diabetes Mellitus Patient Education Diabetes Definitions: Diabetes Mellitus is defined as a group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not
ARE YOU PRE-DIABETIC?
hclhealthcare.in ARE YOU PRE-DIABETIC? Read on to find out. 1800 103 7070 FOR APPOINTMENT If a blood test shows that a person's blood sugar is higher than normal but not high enough to be called Diabetes,
Physical Activity/Exercise Prescription with Diabetes
Physical Activity/Exercise Prescription with Diabetes B R AD H I NTERMEYER C E P A C SM S A NFORD H E ALTH C A RDIAC R E H AB A N D D I ABE TES E XE RCISE The adoption and maintenance of physical activity
associated with serious complications, but reduce occurrences with preventive measures
Wk 9. Management of Clients with Diabetes Mellitus 1. Diabetes Mellitus body s inability to metabolize carbohydrates, fats, proteins hyperglycemia associated with serious complications, but reduce occurrences
Helping You Manage Your Diabetes
CVS Caremark Pharmacy Advisor Program Helping You Manage Your Diabetes Pharmacy Advisor Program Helping You Manage Your Diabetes Contents Know Your Diabetes...4 Medications to Lower Your Risk of Diabetes-Related
Figure 2.1: Glucose meter
CHAPTER TWO: MONITORING TECHNOLOGIES 2.1 Introduction Glucose monitoring is a method of self-testing glucose (blood sugar) levels for the management of diabetes. Traditionally, it involves pricking the
Type 1 Diabetes Mellitus in the Adult. Katie Davis & Liz DeJulius KNH 411: Medical Nutrition Therapy I
Type 1 Diabetes Mellitus in the Adult Katie Davis & Liz DeJulius KNH 411: Medical Nutrition Therapy I Diabetes Mellitus: Type I Genetic factor Sudden onset Majority children and adolescents with an increasing
Note to the healthcare provider: The information is intended to familiarize you with the content of the Bayer Know Your Patient Education Materials.
Note to the healthcare provider: The information is intended to familiarize you with the content of the Bayer Know Your Patient Education Materials. The Know Your material is intended for educational purposes
Helpful Hints for Taking Care of Your Diabetes. Farahnaz Joarder, MD and Don Kain, MA, RD,CDE Harold Schnitzer Diabetes Health Center
Helpful Hints for Taking Care of Your Diabetes Farahnaz Joarder, MD and Don Kain, MA, RD,CDE Harold Schnitzer Diabetes Health Center Objectives How big of a problem is diabetes? What is diabetes? How is
CASE STUDY Diabetes Mellitus FH: PMH: Social Hx PE: Labs: Rx: CAM: Dx: Plan:
CASE STUDY Diabetes Mellitus Patricia C. is a 30 yo Asian American woman with T1DM. She was diagnosed at age 13. Her insulin regimen is 50 units of insulin (Glargine) every evening and 3 units of Lispro
Preventive Services Explained
Preventive Services Explained Medicare covers many preventive care services without charge. Most of these services have been recommended by the U.S. Preventive Services Task Force. However, which beneficiaries
Page 0 of 20. Health Profiles. Diabetes Montgomery County, OH. Public Health - Dayton & Montgomery County Epidemiology Section
Page 0 of 20 Health Profiles Diabetes Montgomery County, OH Public Health - Dayton & Montgomery County Epidemiology Section January 2014 Page 1 of 20 Prepared by: Epidemiology Section of Public Health
RICHMOND PARK SCHOOL LIFESTYLE SCREENING REPORT Carmarthenshire County Council
RICHMOND PARK SCHOOL LIFESTYLE SCREENING REPORT 2016 Carmarthenshire County Council WHY LEAD A HEALTHY LIFESTYLE? A nutritious, well-balanced diet along with physical activity and refraining from smoking
This product was developed by the diabetes self management project at Gateway Community Health Center, Inc. in Laredo, TX. Support for this product
This product was developed by the diabetes self management project at Gateway Community Health Center, Inc. in Laredo, TX. Support for this product was provided by a grant from the Robert Wood Johnson
Diabetes Program Enrollment Questionnaire Please complete this questionnaire with as much information as possible
Diabetes Program Enrollment Questionnaire Please complete this questionnaire with as much information as possible Demographic Information Name: Insurance ID#: Address: City/State/Zip Code: Date of Birth:
Diabetes Medical Management Plan
Diabetes Medical Management Plan 1 School District: School: School Year: Grade: Student Name: DOB: Provider Name: Phone #: Fax #: Blood Glucose Monitoring at School Blood Glucose Target Range: - mg/dl
Rev. date Kaiser Foundation Health Plan of Washington
PE3620000-01-17 Rev. date 2014013 2017 Kaiser Foundation Health Plan of Washington Gestational diabetes Information to help you stay healthy during your pregnancy What is gestational diabetes? How gestational
Who s who on your healthcare team.
Who s who on your healthcare team. Your primary care or family physician (who may be a general practitioner or internist) will likely be at the center of your diabetes healthcare team. Depending on your
Know Your Number Aggregate Report Single Analysis Compared to National Averages
Know Your Number Aggregate Report Single Analysis Compared to National s Client: Study Population: 2242 Population: 3,000 Date Range: 04/20/07-08/08/07 Version of Report: V6.2 Page 2 Study Population Demographics
on the LEVEL Chicago Regional Council of Carpenters Welfare and Pension Funds How Can You Reduce Your Risk?
on the LEVEL Chicago Regional Council of Carpenters Welfare and Pension Funds Spring 2017 Type 2 Diabetes is on the Rise. How Can You Reduce Your Risk? Type 2 diabetes a condition in which the body does
Nutritional Recommendations for the Diabetes Managements
In the name of God Nutritional for the Diabetes Managements Zohreh Mazloom. PhD Shiraz University of Medical Sciences School of Nutrition and Food Sciences Department of Clinical Nutrition OVERVIEW Healthful
Fine-tuning of The Dose of Insulin Pump
Fine-tuning of The Dose of Insulin Pump The manual does not guarantee specific individual or specific applicability of the environment, there is no express or implied warranties. Contents of this manual
Children s Hospital of Philadelphia Diabetes Center for Children. Learning to Manage Diabetes at Home. Cystic Fibrosis Related Diabetes
Children s Hospital of Philadelphia Diabetes Center for Children Learning to Manage Diabetes at Home Cystic Fibrosis Related Diabetes Page 1 of 22 This page left intentionally blank Page 2 of 22 General
New You Weight Management Program
New You Weight Management Program Initial Evaluation Form (All questions MUST be answered to be considered for the program. Patients are NOT chosen on a first-come, first- served basis. The information
Screening Results. Juniata College. Juniata College. Screening Results. October 11, October 12, 2016
Juniata College Screening Results Juniata College Screening Results October 11, 2016 & October 12, 2016 JUNIATA COLLEGE The J.C. Blair Hospital CARES team screened 55 Juniata College employees on October
Endocrinology TeleECHO Clinic Case Presentation Form
Endocrinology TeleECHO Clinic Case Presentation Form Complete ALL ITEMS on this form and fax to 503.228.4801 PLEASE NOTE that case consultations do not create or otherwise establish a provider-patient
QOF Indicator DM013:
QOF Indicator DM013: The percentage of patients with diabetes, on the register, who have a record of a dietary review by a suitably competent professional in the preceding 12 months Note: the bold signposts
Elizabeth Zak. Nutrition Therapy II: 3246:11692 CASE 13: TYPE 2 DIABETES IN AN ELDERLY MAN. Dr. Alireza Jahan-mihan.
Elizabeth Zak Nutrition Therapy II: 3246:11692 CASE 13: TYPE 2 DIABETES IN AN ELDERLY MAN Dr. Alireza Jahan-mihan January 28, 2015 1 1. What is his IBW, % IBW, and BMI? Estimate caloric requirements to
The National Diabetes Prevention Program in Washington State March 2012
The National Diabetes Prevention Program in Washington State March 2012 Session Objectives 1. Overview of pre-diabetes. 2. Describe the Diabetes Prevention Program (DPP). 3. Eligibility for the DPP. 4.
Diabetes Emergency Kit
Diabetes Emergency Kit for: Last updated on / / Courtesy of www.laurenshope.com Diabetes General Information TREATMENT If the child is awake and can swallow, provide sugar immediately. Give 1/2 cup of
Living well with diabetes
T A K E A C T I O N! Living well with diabetes Read this guide then call your doctor, the American Diabetes Association or a local diabetes educator for more information. BY THE NUMBERS: $12.8 billion
Test5, Here is Your My5 to Health Profile with Metabolic Syndrome Insight
Test5, Here is Your My5 to Health Profile with Metabolic Syndrome Insight Quest, Quest Diagnostics, the associated logo, and all associated Quest Diagnostics marks are the registered trademarks of Quest
Maryland-National Capital Park Police Prince George s County Division DIVISION DIRECTIVE DISTRIBUTION
Maryland-National Capital Park Police Prince George s County Division DIVISION DIRECTIVE TITLE PROCEDURE NUMBER SECTION DISTRIBUTION EFFECTIVE DATE REVIEW DATE Administrative Procedures A 12/01/04 REPLACES
How to Fight Diabetes and Win. Diabetes. the Basics NUTURNA. Advance Diabetic Support
How to Fight Diabetes and Win Diabetes the Basics NUTURNA TM Advance Diabetic Support Diabetes: the Basics Diabetes affects over 29 million people in the United States and nearly one-third of these people
On at am/pm for an individual appointment a group appointment at the following location:.
501 New Karner Road, Suite 1A Albany, NY 12205 (518) 452-1337 Option 1 www.capcare.com Hello and Welcome to the CapitalCare Medical Group Nutrition and Diabetes Program. Living with diabetes requires dedicated
Your Name & Phone Number Here! Longevity Index
Your Name & Phone Number Here! Longevity Index Your Health Risk Analysis is based on a variety of medical and scientific data from organizations such as the American Heart Association, American Dietetic
CASE STUDY #3 - NUT 116AL Diabetes Mellitus DUE Monday 12/9/13 (by 1:00pm in Meyer 3241)
Last Name Reagan First Name Jason Section 2_ CASE STUDY #3 - NUT 116AL Diabetes Mellitus DUE Monday 12/9/13 (by 1:00pm in Meyer 3241) Patricia C. is a 30 yo Asian American woman with T1DM. She was diagnosed