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 of different types of Diabetes. List risk factors for developing type 2 diabetes List signs and symptoms of type 2 diabetes State complications to the body associated with uncontrolled diabetes.
Objectives Continued List three basic blood tests for the detection of diabetes including levels considered abnormal List three ways patients can control their diabetes Verbalize medical assistants role in the appointment of a diabetic patient.
What is
Types of Diabetes Type 1 Usually in children and young adults Only 5% of all diabetics are type 1 Body does not produce insulin Type 2 Most common form of diabetes Body does not use insulin correctly (insulin resistance) Used to be associated with adults only now more and more common in teens. Gestational Blood Sugar becomes too high during pregnancy As many as 9.2% of pregnant women develop this Cause is not understood
What is Prediabetes? Before people develop type 2 diabetes, they almost always have "prediabetes" blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes. This condition puts them at a higher risk for developing type 2 diabetes and cardiovascular disease.
Risk Factors for Developing Type 2 Diabetes Obesity Physical Inactivity Family History Diabetes Unhealthy Diet Uncontrolled Hypertension Smoking
Urinating often Weight Loss Feeling very thirsty Feeling very hungry - even though you are eating Extreme fatigue Blurry vision Cuts/bruises that are slow to heal Tingling, pain, or numbness in the hands/feet
How is Diabetes Diagnosed? A1C test, (also called hemoglobin A1c) 6.5% Fasting plasma glucose (fasting blood sugar) 126 (fasting) Oral glucose tolerance test 200 mg/dl (2 hours after ingesting glucose)
Diabetes effects the whole body Cardiovascular or Heart Disease Narrowing of blood vessels due to fatty deposits High Blood Pressure Stroke Blood Clots Heart works harder Poor circulation in extremities
Retinopathy or Eye Disease Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in American adults. It is caused by changes in the blood vessels of the retina. National Eye Institute
Renal or Kidney Disease The combination of high blood pressure and blood sugar levels increase risk for kidney disease in diabetics. Dialysis Transplant NIH
Dental Problems Infection Pain More Plaque Gum Disease Tooth Decay NIH
Studies show that people with diabetes have a greater risk of depression than people without diabetes. ADA Depression
Neuropathy (nerve damage) Nerve disorder Damage can be throughout the body. Some have no symptoms. Others may have pain, tingling, or numbness loss of feeling in the hands, arms, feet, and legs. NIH
Controlling Diabetes
Diet Variety of Healthy foods Whole grains Vegetables Fruit Lean Meats Low/non fat dairy Foods high in sugar and carbohydrates cause blood sugar to rise.
Exercise Daily Exercise makes cells more sensitive to insulin Lowers blood glucose Improves A1C Physical activity is also important for overall well being
Medications Oral Many different types Insulin Long, intermediate and short acting Syringe Pen Pump
Diabetic Appointments Role of the Medical Assistant
Diabetic Appointment (1) (MQIC guidelines) Height, Weight, BMI Blood pressure Assessment of Blood sugar log Medication Reconciliation
Diabetic Appointment (2) Foot Exam (yearly) Dilated Eye Exam (yearly) Depression Screening (yearly) Labs-A1C, urine dip, serum creatinine, fasting lipid profile, TSH, and LFT s. (every 3-6 months)
Diabetic Appointment (3) Check immunizations up-to-date At end of visit ensure patient has all scripts, referrals, and educational materials.
Diabetic Appointment (4) Educational Component Reinforce: Importance of healthy diet and exercise Working toward appropriate BMI Smoking cessation (avoid second-hand smoke) Checking blood sugar as ordered (review their target numbers example between 70-130 before each meal) ADA
Education Continued Review medication use Foot Care Encourage regular dental appointments Review signs and symptoms of high and low blood sugar and what to do if they occur. (sliding scale and glucagon) Review sick day management (sickness can cause blood sugar to rise) FOLLOW OFFICE PROTOCOLS!!!
Resources MQIC Guidelines http://mqic.org/ American Diabetes Association http://www.diabetes.org/ MDCH (Michigan Diabetes Prevention and Control Programs) http://www.michigan.gov/mdch/0,4612,7-132-2940_2955_2980---,00.html AADE (American Association of Diabetes Educators) http://www.diabeteseducator.org/ MPCA Diabetes webpage http://www.mpca.net/?page=diabetes
Contact Information Wendy Stricklin RN, BSN Clinical Quality Consultant 517-827-0889 wstricklin@mpca.net www.mpca.net