Diabetes Management & Cardiovascular Disease

#1 - Heart Disease and Diabetes

I. Etiology

II. Types of heart disease

a. Cerebral vascular disease
b. Coronary artery disease
c. Peripheral artery disease

III. Risk Factors

a. Dyslipidemia
b. Hypertension
c. Smoking
d. Obesity
e. Inactivity

IV. Interventions

a. Medical nutrition therapy
b. Smoking cessation
c. Physical activity
d. Blood glucose control
e. Blood pressure control
f. Pharmacological therapy

Behavioral/Learning Objectives:

1. Identify 3 risk factors contributing to heart disease in diabetes.
2. List 2 types of heart and vessel diseases in diabetes.
3. Describe 2 interventions to reduce the risk of heart disease.
   

#2 - Metabolic Syndrome

I. Definition: collection of metabolic risk factors that accelerate the onset of diabetes, heart disease, stroke and certain cancers

A. Incidence/Prevalence
B. Causes

II. ATP III Clinical Criteria: any 3 of the following 5 features Central obesity measured by waist circumference

A. Elevated triglycerides (TG)
B. Elevated blood pressure
C. Low HDL-cholesterol
D. Elevated fasting glucose

III. Managing metabolic syndrome

A. Lifestyle interventions

1. Tobacco cessation
2. Physical activity
3. Weight loss
4. Healthy eating

B. Treat lipid and other risk factors

1. Obesity
2. Hypertension
3. Elevated TG
4. Low HDL-cholesterol
5. Impaired fasting glucose

Behavioral/Learning Objectives:

1. Define metabolic syndrome.
2. State the diagnostic criteria for metabolic syndrome.
3. List 2 components of managing metabolic syndrome.
   

#3 - Dyslipidemia and Diabetes

I. Prevalence

II. Lipid Patterns in Diabetes

a. LDL
b. HDL
c. Triglycerides

III. Goals of Therapy

IV. Treatment Options

a. Statins
b. Fibrates
c. Nicotinic acid
d. Ezetimide
e. Medical Nutrition Therapy
f. Physical activity
g. Weight loss

V. Benefits of treatment

VI. Screening recommendations

Behavioral/Learning Objectives:

1. List 2 lifestyle interventions to improve lipid abnormalities.
2. State 2 pharmacologic treatment options for dyslipidemia.
3. State the lipid screening recommendations for those with diabetes.

#4 - High Blood Pressure and Diabetes

I. Blood pressure classifications

A. Normal
B. Pre-hypertension
C. Stage 1
D. Stage 2
E.Current ADA goals of therapy

II. Hypertension

A. Incidence
B. Categories
C. Consequences of high blood pressure
D. Benefits of controlling blood pressure
E. Methods of assessing blood pressure

1. In office monitoring
2. Ambulatory
3. Self-measurement

III. Treatment options of hypertension in persons with diabetes

A. Lifestyle modification

1. Weight reduction
2. Medical Nutrition Therapy (DASH eating plan)
3. Regular physical activity

B. Pharmacological therapy

1. Diuretics
2. Angiotensin converting enzyme (ACE) inhibitors
3. Angiotensin II receptor blockers (ARBs)
4. Beta blockers
5. Calcium channel blockers
6. Combination medications

Behavioral/Learning Objectives:

1. State the blood pressure goal for persons with diabetes.
2. Describe 1 method to obtain a blood pressure.
3. Describe 3 treatment options of hypertension in persons with diabetes.
   

#5 - Nutrition Therapy for Heart Disease

I. Dietary Approches to Stopping Hypertension (DASH)

II. Nutrient considerations for hypertension

a. Sodium
b. Potassium
c. Calcium
d. Magnesium
e. Substitutes for salt

III. Medical Nutrition therapy for dyslipidemia

a. Fats
b. Cholesterol
c. Fiber
d. Plant stanols/sterols
e. Sugars
f. Proteins

IV. Looking at Food Labels

V. Dining out healthier

Behavioral/Learning Objectives:

1. List 2 sources of omega-3 fatty acids.
2. State 2 dietary recommendations of the DASH eating plan.
3. Describe the impacts of trans fats on LDL cholesterol.

#6 - Physical Activity and Diabetes

I. Physical activity

A. Physiologic effects
B. Benefits
C. Risks
D. Surgeon General Recommendations

II. Medical considerations/interventions for the following risks of physical activity

A. Hypoglycemia
B. Hyperglycemia
C. Dehydration
D. Cardiovascular disease
E. Neuropathy
F. Nephropathy
G. Retinopathy
H. Screening

III. Activity prescription (Frequency and type of program) for those with:

A. Type 1
B. Type 2
C. Older adults with diabetes
D. Cardiovascular disease and diabetes

Behavioral/Learning Objectives:

1. State 3 benefits of regular physical activity for persons with diabetes.
2. Identify 3 considerations for risks associated with activity in persons with diabetes.
3. Describe 1 activity recommendation for persons with diabetes.

Accreditation Information

Certified Diabetes Educators – Academy Medical Systems' approved Provider Status with the ANCC (nurses) and the CDR (dietitians) is recognized by the National Certification Board of Diabetes Educators (NCBDE).

Nurses – Academy Medical Systems is an approved provider of continuing nursing education by the Illinois Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. 9.0 contact hours will be rewarded to nursing professionals at the completion of this workshop.

Academy medical Systems is also a provider approved by the California Board of Registered Nursing, provider #CEP14413, for 9.0 hours. And we are also a provider approved by the Florida Board of Nursing, provider #50-19, for 9.0 hours.

Iowa Nurses - The Iowa Board of Nurses will recognize the recorded webinars as a home study program. They recognize our ANCC approved provider status as well as our CA and Fl Board of Nursing provider approval for home study products for nurses in Iowa.
All other states recognize our approved provider status listed in the above text for continuing education credit for nurses.

Dietitians - Academy Medical Systems is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR). Registered dietitians (RDs) and dietetic technicians, registered (DTRs) will receive 9.0 continuing professional education units (CPEUs) for completion of this program/material.

Occupational Therapist - Occupational Therapist will receive 9, continuing education hours for completion this program and a test score of 70% or better. AMS is an approved provider for the AOTA , provider # 5470.

Exercise Physiologist – ACSM recognizes AMS’s approved provider status with the ANCC and will honor our continuing education for Certified Exercise Physiologist recertification purposes.

Certified Athletic Trainers – Academy Medical Systems is recognized by the Board of Certification (BOC) to offer continuing education for certified athletic trainers. 9 hours will be awarded at the completion of this program.

Physical Therapists - PTs in the following states will receive 9 contact hours for completion of all 6 webinars: AK, CO, CT, HI, IA, ID, IN, KS (Cat 2), MA, ME, MI, MN (Cat 2), MT, NE, NM, ND, OR, PA, RI, SC, SD, UT, VA (Type 2), VT, VI, WA, WY.

We are an approved provider to offer continuing competency courses to CA PTs, approval date 4/5/10.

The AR Board of Physical Therapy has approved this course for 9 Contact hours. The following state boards recognize other state’s approval: AL, AZ, GA (Class 1), KY, MO, MS, OK (Cat 2), TN (Cat 1), WI.

Because each state’s continuing education requirements for physical therapists is subject to change, please verify this information with your state board. Thank you.

Respiratory Therapists - This course meets the requirements for continuing education for Respiratory Care Professionals in AL, CA, CT, DE, FL, ID, IL, IN, IA, KS, LA, ME, MA, MN, MS, MT, NE, NV, NY, OH, OK, OR, RI, SC, TN, TX, WA, WV, WY.

Because each state’s continuing education requirements for respiratory therapists is subject to change, please verify this information with your state board. Thank you.

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