Excellence in Care: Advances in Diabetes Management

Transcription

1 Excellence in Care: Advances in Diabetes Management Laura Abbey RN, BSN, MA, CDE INDEPENDENT STUDY Health Professions Institute for Continuing Education Austin Community College

2 The Austin Community College Health Professions Institute, Continuing Education 5930 Middle Fiskville Road, Austin, TX INDEPENDENT STUDY: Excellence in Care: Advances in Diabetes Management Description and Purpose: Laura Abbey RN, BSN, MA, CDE appears with Alyssa Monacelli RN, BSN, instructor and coordinator with the Health Professions Institute of Austin Community College (ACC), to discuss current clinical management of diabetes and provide an overview on current medications used to treat the disease. Ms. Abby is the Diabetes Center Program Coordinator at St. David s Medical Center in Austin, Texas and brings over 15 years of nursing experience in the field of diabetes education. The purpose of this activity is to enrich the participant s contribution to quality healthcare and the pursuit of professional career goals by providing current and updated information on clinical management of diabetes and includes discussion of the classifications of diabetes, current medications used to treat type II diabetes, and advancements in monitoring and treatment of diabetes. This offering is a self-paced learning activity developed to meet the individual needs of nurses, social workers, and emergency medical services personnel requiring continuing education for relicensure. Goals and Objectives: Upon completion of this activity, the student will be able to: 1. Discuss the demographic of diabetes among adults in the US. 2. Identify complications associated with diabetes. 3. Describe the classifications for diabetes. 4. List the methods used for diagnosing diabetes. 5. Explain the risk factors associated with Metabolic Syndrome. 6. Discuss updates in oral and injectable medications used for managing diabetes. 7. Describe advances in the treatment and management of diabetes. Requirements for Successful Completion: The packet you have received contains a pre-test, DVD, post-test and a program evaluation. To successfully complete this activity and earn continuing education the participant must: 1. Complete the pre-test 2. View the DVD 3. Complete the post-test (score an 80 or more) 4. And, complete the evaluation NOTE: Following the viewing of the DVD and completing the accompanying documents, questions may be addressed by contacting Elizabeth or eahuss@austincc.edu Submit all of the documents (pre/post-test, evaluation) along with your completed Registration Form (check or credit card), and payment to: Austin Community College Health Professions Institute Attn: Online Nursing Videos 5930 Middle Fiskville Rd. Austin, TX Fax:

3 Within two business weeks from receipt of your material at ACC, your certificate of completion will be available (to be mailed, fax, or picked up at the above address your choice). Upon successful completion participants will be awarded a certificate of successful completion worth 2.0 contact hours. Austin Community College is an approved provider of continuing nursing education by the Texas Nurses Association, an accredited approver by the American Nurses Credentialing Center s Commission on Accreditation. Contact hours for programs applicable to social work are approved for CEU s by the Texas State Board of Social Worker Examiners. This program is worth 2.0 contact hours or 0.2 continuing education units (CEU s). Continuing education for Emergency Medical Personnel is approved by the Texas Department of State Health Services. This program is worth 2.0 TDH (P) contact hours. Disclosure to Attendees: The presenters and planning committee members for this offering have completed Conflict of Interest forms and it has been determined that no conflict of interest exists or has been indentified in relation to this offering. Commercial Support: This offering has not received any commercial support. Non-endorsement of products: The discussion of generic or brand name items or medications does not constitute endorsement by the American Nurses Credential Center s Commission on Accreditation (ANCC), the Texas Nurses Association (TNA) or Austin Community College. Off-Label Use: Off-label use of medications refers to the prescribing of medications to treat a condition for which the medication has not been approved by the Food and Drug Administration. Medications presented in this activity will only be discussed in the context of their Federal Drug Administration (FDA) approval. Expiration: This continuing nursing education activity (Advances in Diabetes Management) will expire on Dec 1,2012.

4 Printed Name: Date: Address (where you would like to receive your certificate of completion): City: State: Zip code: Instructions: Complete this pre-test PRIOR to watching the video. Choose the best answer by circling the letter corresponding to your choice. Submit your post-test, completed evaluation, completed registration, and payment to: Austin Community College Health Professions Institute Attn: Online Nursing Videos 5930 Middle Fiskville Rd. Austin, TX Fax: Pre-Test: Advances in Management of Diabetes 1. Complications from diabetes usually develops years after having uncontrolled diabetes. This is also the time frame when individuals are usually diagnosed or present with complications. A. 3-5 years B years C years D years 2. A large portion of the US populations diagnosed with diabetes seems to be concentrated in the Southeastern part of the US. The reason for this is because: A. The food culture is associated with high fat, fried foods. B. A large portion of the population in this part of the US lives in rural areas where incidence of diabetes is higher. C. A large portion of the population in this part of the US is African-American women; a group known to be at high risk for diabetes. D. All of the above 3. Three (3) microvascular complications frequently associated with diabetes include: A. Neuropathy, Pylopathy, Anthropathy B. Retinopathy, Neuropathy, Nephropathy C. Nephropathy, Myopathy, Retinopathy D. None of the above

5 Diabetes Management Pre-test pg Generalized signs and symptoms of diabetes are sometimes ignored or frequently attributed to other issues such as the aging process. These generalized signs and symptoms include all of the following EXCEPT: A. Increased Thirst, Increased Urination B. Blurry Vision, Dry Itchy Skin C. Both A and B D. A only 5. If an individual is using insulin to control their blood sugar, it means they have Type I diabetes. A. True B. False 6. The etiology of Type I diabetes (presenting in children) is: A. Thought to be related to a virus. B. Not fully known. C. Caused by taking in too much sugar as an infant. D. Both A and B 7. Women who have gestational diabetes during a pregnancy are more likely to develop diabetes 5-10 years after giving birth if they do not return to a healthy weight and exercise habits. A. 60% B. 100% C. 20% D. 5% 8. There are three (3) methods for diagnosing diabetes and they include all of the following EXCEPT: A. Random blood sugar >200 B. Fasting blood sugars >126 C. 2-hour post-load glucose >200 D. All of the above are diagnostic indicators 9. A normal fasting blood sugar should be: A B. less than 100 C D. less than 110

6 Diabetes Management Pre-test pg A normal non-fasting blood sugar (random) should be: A. 150 or below B. 140 or below C. 120 or below D. 110 or below 11. Metabolic syndrome refers to five (5) risk factors associated with diabetes. If an individual has three (3) or more they are considered to be pre-diabetic. A. True B. False 12. Risk factors for pre-diabetes or metabolic syndrome include: A. Normal fasting glucose, elevated triglycerides, and elevated blood pressure B. Reduced HDL-C, elevated triglycerides, elevated blood pressure C. Elevated waist circumference elevated fasting glucose D. Both B and C 13. DPP-4 Inhibitors are the newest class of drugs used for the treatment of Type 2 diabetes. These drugs: A. Protect the hormone Incretin so that it can work efficiently. B. Inhibit the hormone Incretin so that insulin can be released in greater amounts. C. Prevent the hormone Incretin from being produced. D. Causes the body to increase the production of the hormone incretin. 14. Benefits associated with the use of an Insulin pen include: A. The pen records when Insulin was administered and the dose. B. Helps individuals remember when they took their Insulin. C. Assists the diabetes educator in helping the individual identify areas for improvement in compliance. D. All of the above. 15. The ABC s for preventing complications associated with diabetes are: A. A1C, Blood Pressure, Cholesterol B. Airway, Breathing, Circulation C. Action, Blood Glucose, Continuous Monitoring D. A1C, Blood Oxygen, Circulation

7 Written: Pre-Test Excellence in Care: Advances in Management of Diabetes Program Outline DVD Presentation: I. Introduction- brief introduction/discussion of what is new in the field of diabetes management A. New drugs B. Advances in equipment/technology II. Demographics of Diabetes in the US A. Costs B. Location/Concentration of diabetes populations in US C. National statistics D. Why important III. Complications Associated with Diabetes A. Generalized signs and symptoms B. Blindness C. Kidney Disease D. Stroke E. Nervous System Diseases F. Microvascular complications G. Deaths IV. Classifications A. Type I B. Type 2 C. Gestational diabetes D. Other types E. Impaired Glucose Classifications V. Diagnosis A. Overview of physiology of blood sugar/insulin B. Blood Glucose- random, fasting, 2-hour post load C. American Diabetic Association recommendations for diagnosis VI. Metabolic Syndrome A. Definition B. Risk factors/classifications C. Obesity VII. Oral Medications A. Sulfonylureas B. Biguanides C. alpha-glucosidase Inhibitors E. Meglitinides F. Thiazolidinediones (TZD) G. DPP-4 Inhibitors H. Avandia (Rosiglitazone Maleate) I. Januvia (Sitagliptin)

8 Diabetes Management Program Outline Pg. 2 J. Onglyza (Saxagliptin) K. Galvus (Vildagliptin) L. Combination drugs VIII. Injectables A. Incretin mimetics B. Amylin-analog IX. Diabetes Advancements A. Continuous glucose monitoring systems B. Insulin pens C. Injection ports D. Gastric electrical stimulation E. Continuous subq insulin pumps F. Bariatric surgeries X. Summary- ABCs A. A1C B. Blood pressure C. Cholesterol XI. Resources Written: Post-Test Evaluation

9 Evaluation Title of Education Activity: Excellence in Care: Advances in Management of Diabetes Location: DVD Video Format Date: Participants check out and complete on own time Purpose of this Activity: The purpose of this activity is to enrich the participant s contribution to quality healthcare and the pursuit of professional career goals by providing current and updated information on clinical management of diabetes and includes discussion of the classifications of diabetes, current medications used to treat type II diabetes, and advancements in monitoring and treatment of diabetes. Directions/Instructions: Please complete this evaluation questionnaire. Your anonymous responses will be used to revise this activity and to plan future educational activities. Circle the number that best fits your evaluation of this activity. 1 = Not at all 2 = Somewhat 3 = Almost completely 4 = Completely 1. Rate your achievement of these objectives: 1. Discuss the demographic of diabetes among adults in the US Identify complications associated with diabetes Describe the classifications for diabetes List the methods used for diagnosing diabetes Explain the risk factors associated with Metabolic Syndrome Discuss updates in oral and injectable medications used for managing diabetes. 7. Describe advances in the treatment and management of diabetes. 2. Rate the effectiveness of the teaching/learning resources? Please evaluate the guest speaker- Laura Abbey RN, BSN, MA, CDE a. Knowledge and currency of topic b. Ability to make points clear c. Ability to apply content to practice

10 Diabetes Management Eval. Pg Please evaluate the moderator- Alyssa Monacelli RN, BSN a. Guides the discussion b. Asks pertinent questions c. Fosters clarification of presented information Were the objectives relevant to the overall purpose? (see above) 6. How long (in minutes) did it take you to complete the entire activity (including taking the pre-test, watching the video, taking the post-test, and completing this evaluation tool)? Minutes 7. List two (2) ways you will integrate what you learned in this activity into your practice and/or employment environment. 8. The following were disclosed prior to the beginning of this activity either in writing or verbally? a. Requirements for successful completion Yes No b. Conflicts of Interest Yes No c. Commercial Support Yes No d. Non-endorsement of Products Yes No e. Off-label Use Yes No 9. Did you, as a participant, notice any bias that was not previously disclosed in this presentation? Yes No If Yes, please describe who was biased and how. 10. Comments: If you answered (1) to any of the above, please comment. 11. Please list any suggestions or topics for future programming.

11 Printed Name: Date: Address (where you would like to receive your certificate of completion): City: State: Zip code: Instructions: Complete this pre-test PRIOR to watching the video. Choose the best answer by circling the letter corresponding to your choice. Submit your post-test, completed evaluation, completed registration, and payment to: Austin Community College Health Professions Institute Attn: Online Nursing Videos 5930 Middle Fiskville Rd. Austin, TX Fax: Post-Test: Advances in Management of Diabetes 1. Complications from diabetes usually develops years after having uncontrolled diabetes. This is also the time frame when individuals are usually diagnosed or present with complications. A. 3-5 years B years C years D years 2. A large portion of the US populations diagnosed with diabetes seems to be concentrated in the Southeastern part of the US. The reason for this is because: A. The food culture is associated with high fat, fried foods. B. A large portion of the population in this part of the US lives in rural areas where incidence of diabetes is higher. C. A large portion of the population in this part of the US is African-American women; a group known to be at high risk for diabetes. D. All of the above 3. Three (3) microvascular complications frequently associated with diabetes include: A. Neuropathy, Pylopathy, Anthropathy B. Retinopathy, Neuropathy, Nephropathy C. Nephropathy, Myopathy, Retinopathy D. None of the above

12 Diabetes Management Post-test pg Generalized signs and symptoms of diabetes are sometimes ignored or frequently attributed to other issues such as the aging process. These generalized signs and symptoms include all of the following EXCEPT: A. Increased Thirst, Increased Urination B. Blurry Vision, Dry Itchy Skin C. Both A and B D. A only 5. If an individual is using insulin to control their blood sugar, it means they have Type I diabetes. A. True B. False 6. The etiology of Type I diabetes (presenting in children) is: A. Thought to be related to a virus. B. Not fully known. C. Caused by taking in too much sugar as an infant. D. Both A and B 7. Women who have gestational diabetes during a pregnancy are more likely to develop diabetes 5-10 years after giving birth if they do not return to a healthy weight and exercise habits. A. 60% B. 100% C. 20% D. 5% 8. There are three (3) methods for diagnosing diabetes and they include all of the following EXCEPT: A. Random blood sugar >200 B. Fasting blood sugars >126 C. 2-hour post-load glucose >200 D. All of the above are diagnostic indicators 9. A normal fasting blood sugar should be: A B. less than 100 C D. less than 110

13 Diabetes Management Post-test pg A normal non-fasting blood sugar (random) should be: A. 150 or below B. 140 or below C. 120 or below D. 110 or below 11. Metabolic syndrome refers to five (5) risk factors associated with diabetes. If an individual has three (3) or more they are considered to be pre-diabetic. A. True B. False 12. Risk factors for pre-diabetes or metabolic syndrome include: A. Normal fasting glucose, elevated triglycerides, and elevated blood pressure B. Reduced HDL-C, elevated triglycerides, elevated blood pressure C. Elevated waist circumference elevated fasting glucose D. Both B and C 13. DPP-4 Inhibitors are the newest class of drugs used for the treatment of Type 2 diabetes. These drugs: A. Protect the hormone Incretin so that it can work efficiently. B. Inhibit the hormone Incretin so that insulin can be released in greater amounts. C. Prevent the hormone Incretin from being produced. D. Causes the body to increase the production of the hormone incretin. 14. Benefits associated with the use of an Insulin pen include: A. The pen records when Insulin was administered and the dose. B. Helps individuals remember when they took their Insulin. C. Assists the diabetes educator in helping the individual identify areas for improvement in compliance. D. All of the above. 15. The ABC s for preventing complications associated with diabetes are: A. A1C, Blood Pressure, Cholesterol B. Airway, Breathing, Circulation C. Action, Blood Glucose, Continuous Monitoring D. A1C, Blood Oxygen, Circulation