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DIABETES
CASE MANAGEMENT |
Included
in this issue:
- Introduction
- Diabetes
Fact Sheet (article 1 for CE credit))
- Terms
and Definitions
- Warning
Signs
- Statistics
- Economic
Impact
- Equipment
– glucose meters, continuous glucose monitoring systems
and
Insulin pumps
- Treatment
Modalities
- Diabetes
Case Management
- Racial
and Ethnic Influences
- Resources
and Links
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National
Diabetes Fact Sheet
(pdf format)
Section
1: General Information
Section 2: National Estimates
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COURSE
OUTLINE |
| General
Information |
- What
is diabetes?
- Treating
diabetes
- Prediabetes:
Impaired glucose tolerance
and impaired fasting glucose
- Prevention
or delay of diabetes
- Prevention
of diabetes complications
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- Methods
- Total
prevalence of diabetes in the United States, all
ages, 2002
- Prevalence
of diagnosed diabetes among people under 20 years
of age
- Total
prevalence of diabetes among people aged 20 years
or older
- Total
prevalence of diabetes by race/ethnicity among people
aged 20 years or older
- Incidence
of diabetes
- Deaths
among people with diabetes
- Complications
of diabetes
- Cost
of diabetes in the United States
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TERMS
AND DEFINITIONS
WARNING
SIGNS --
-
Warning
Signs of Diabetes
- Study
Blames Corn Syrup for Rise of Diabetes in US
A study of nearly 100 years of data on what Americans
eat show a huge increase in processed carbohydrates and
a large drop in the amount of fiber from whole grains,
fruits and vegetables. It parallels a spike in the number
of cases of type-2 diabetes, caused by the body's increasing
inability to properly metabolize sugars.
DIABETES
COMPLICATIONS
Diabetes
Complications
Standards
of Medical Care for Patients With Diabetes Mellitus
(scroll down to find--)
-
Prevention and Management of Diabetes Complications
-
Screening and Management of Other Complications
STATISTICS
National Estimates on Diabetes
- Total
prevalence of diabetes in the United States, all ages,
2002
-
Total: 18.2 million people — 6.3% of the population
— have diabetes.
-
Diagnosed: 13.0 million people
-
Undiagnosed: 5.2 million people
http://www.defeatdiabetes.org/news.htm
Researchers predict the number of people with diabetes globally
will actually double over the next three decades
www.cdc.gov/diabetes/news/docs/lifetime.htm
Lifetime risk of developing diabetes for an average person
born in the United States in year 2000 until their death.
-
Males – 1 in 3 chance
-
Females – 2 in 5 chance
- Hispanic
females – 1 in 2 chance (high risk)
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ECONOMIC IMPACT
Cost of diabetes in
the United States:
- Total
(direct and indirect): $132 billion
- Direct
medical costs: $92 billion
- Indirect
costs: $40 billion (disability, work loss,
premature mortality)
- Inpatient
hospital care and nursing home care accounted for approximately
$40 billion in 2002
- nearly
17 million days of hospitalization and more than 82 million
nursing home days were attributed to diabetes in 2002.
EQUIPMENT
glucose
meters, continuous glucose monitoring systems,and Insulin
pumps
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Glucose
Meters & Diabetes Management
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Course
Outline
- Self-Monitoring
of Blood Glucose
- Choosing
a Glucose Meter
- Using
Your Glucose Meter
- User
Experiences with Glucose Meters
- New
Technologies: Alternative Site Testing
- Minimally-Invasive
and Non-Invasive Glucose Meters
- How
FDA Regulates Glucose Meters
- Reporting
Problems with Glucose Meters to FDA
- Performance
Goals for Blood Glucose Meters
- A
Brief History of Self-Monitoring of Blood Glucose
with Glucose Meters
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Laughter
is always the "BEST" Medicine
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www.CEUs4CaseManagers.com
ADVISORY BOARD |
|
| Toni
Cesta, PhD, RN, FAAN |
| Elaine
Cohen, EdD, RN, FAAN |
Vivian
Campagna,
Director , Case Management
St. Clare's Hospital & Health Center,
New York, NY |
| Interested
on being part of our Advisory Board? Contact us -
1-866-543-2273 |
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http://betterdiabetescare.nih.gov/index.htm
National Diabetes Education Program’s (NDEP) team
of diabetes experts asserts that systems change is essential
in order to provide the type of evidence-based patient-centered
care needed to effectively manage diabetes and prevent the
serious complications associated with this serious disease.
This site provides models, links, resources and tools to
help the professional.
There are certain things that everyone who has diabetes,
whether type 1 or type 2, needs to do to be healthy:
-
have a meal (eating) plan
-
pay attention to how much physical activity they engage
in, because physical activity can help the body use insulin
better so it can convert glucose into energy for cells.
Everyone
with type 1 diabetes, and some people with type 2 diabetes,
also need to take insulin injections. Some people with type
2 diabetes take pills called "oral agents" which
help their bodies produce more insulin and/or use the insulin
it is producing better. Some people with type 2 diabetes
can manage their disease without medication by appropriate
meal planning and adequate physical activity.
-
Everyone who has diabetes should be seen at least once
every six months by a diabetes specialist (an endocrinologist).
-
people with diabetes also need to learn how to monitor
their blood glucose
-
-
increased physical activity, and
-
Disease
Management is a system of coordinated healthcare interventions
and communications for populations with conditions
in which patient self-care efforts are significant
. Disease management:
-
supports
the physician or practitioner/patient relationship
and plan of care,
-
emphasizes prevention of exacerbations and complications
utilizing evidence-based practice guidelines and
patient empowerment strategies, and
-
evaluates
clinical, humanistic, and economic outcomes on an
going basis with the goal of improving overall health.
The
goals of disease management include:
-
Improving patient self-care through patient education,
monitoring, and communication with members of the
health care team.
-
Improving physician performance through feedback
and/or reports on patient progress in compliance
with protocols.
-
Improving communication and coordination of
services between patient, physician, disease
management organization, and other providers.
-
Improving access to services, including prevention
services and prescription drugs as needed.
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Strategies
for Reducing Morbidity & Mortality ffrom Diabetes
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The Task
Force on Community Preventive Services (the Task Force)
has conducted systematic reviews of seven population-oriented
interventions that can be implemented by health care
organizations and communities.
Two of
these interventions focus on health care systems (disease
and case management) and five focus on persons with
diabetes (diabetes self-management education delivered
in community settings).
On the
basis of these reviews, the Task Force has made recommendations
regarding the use of these seven interventions.
Course
Outline
- Background
- Introduction
- Methods
- Results
- Using
these Recommendations in Communities and Health
Care Systems
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Case
management is effective in improving both glycemic control
and provider monitoring of glycemic control. This evidence
is applicable primarily in the U.S. managed care setting
for adults with type 2 diabetes.
Case management is effective both when delivered in conjunction
with disease management and when delivered with one or more
additional educational, reminder, or support.
While
many programs have succeeded at reducing health care expenditures,
the potential for long-term savings is still not known.
This is due, in part, to the fact that to date, studies
that have found substantial cost-savings are generally confined
to a short duration of time, and are typically based on
the experiences of a single plan or program or are restricted
to certain areas of the country.
The
Case for Diabetes Case Management
A diabetes disease management program can improve patient
health, quality of life and productivity. In the short run,
costs may increase as patients are put on appropriate medications,
and have recommended exams and tests done. Conversely,
over time, savings can be substantial as high-cost events
(e.g., amputations) are averted and lost productivity reduced.
The
Effectiveness of Disease and Case Management for People
with Diabetes
Diabetes
Case Management: Effect on Glycemic Control
Case
Management, Care Management, Disease Management:
What are they and what is the evidence?
RACIAL
and ETHINIC
The highest risk groups:
Hispanics, Native Americans and African
Americans
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