Diabetes Case Management

#1 - Oral Medications for the Diabetes Management – Part I

I. Causes of hyperglycemia
II. Benzoic Acid Derivatives (Prandin)
III. Meglitinides (Starlix)
IV. Alpha Glucosidase Inhibitors (Precose)
V. Biguanides (Metformin)
VI. Thiazolidinediones (Actos & Avandia)
VII. Sulfonylurea’s (Amaryl, Diabeta, Glucotrol)
VIII. Combination Therapy
IX. Case Studies

Behavioral/Learning Objectives:

1. State the mechanism of action for metformin use in treating diabetes.
2. List 2 combination medications for treating diabetes.
3. Define 2 potential side effects of using Actos or Avandia.

#2 - Options for Type 2 Diabetes, Part II

I. Incretin Mimetics

A. Exenatide (Byetta)
B. Sitagliptin (Januvia)

II. Pramlintide (Symlin)
III. Medication selection considerations
IV. When to consider insulin
V. Case Studies

Behavioral/Learning Objectives:

1. State the mechanism of action for Byetta for the treatment of diabetes.
2. Define 2 situations when insulin should be considered in the treatment of diabetes.
3. Define when Byetta should be considered versus Symlin in treating diabetes.
4. List 2 considerations for medication selection when treating diabetes.

#3 - Basic Carb Counting

I. Diabetes Meal Planning

A. Basic meal plan tips

B. Carb counting

1. Definition

2. Role of protein and fat

3. Pros and cons

4. What foods contain carbs?

5. Determining what is a carb serving/portion control

6. Determining carbs per meal and snack

A. Amount of carb

B. Type of carb

C. Food processing

D. Fat content

E. Pre-meal blood glucose

F. Other

A. What counts as a carb (grams vs servings/choices)

B. Which meals have more carb?

C. Using the nutrition facts label for carb counting.

1. Locating information on the label

2. Exercises using the nutrition facts information

1. Define carb counting. State 3 factors that can influence glycemic response to foods. Demonstrate basic carb county.
2. State 3 factors that can influence glycemic response to foods.
3. Describe basic carb counting.

#4 - Advanced Carbohydrate Counting

I. Advanced Carb Counting

A. Definition of a carb to insulin ratio

1. 500 rule for calculating carb to insulin ratios

B. Determining accuracy of carb to insulin ratios

1. Pre/post meal blood glucose testing

2. Case studies

C. Reasons for high and low blood glucose levels

A. Planned vs. unplanned activity

B. Adjusting carb for physical activity

1. Pre/post blood glucose levels

2. Level of intensity

3. Other factors influencing glycemic response (meal and med timing; where insulin injected; dehydration;)

4. Case studies

1. Calculate a carb to insulin ratio. List 3 factors to consider when adjusting carb for physical activity.
2. List 3 factors to consider when adjusting carbs for physical activity.

#5 - Injectable Meds for Diabetes Management Part I - Insulin & Symlin

II. Insulin Brands & types

A. Fast Acting

B. Short Acting

C. Basal insulins

D. Mixed insulins

III. Regime considerations

IV. Initial dosing

V. Insulin to Carbohydrate ratio’s

VI. Correction insulin

VII. Insulin storage

VIII. Case Studies
 

1. Define the onset, peak and duration of fast acting insulin.
2. List 2 situations when a mixed insulin may be a better alternative than a basal/bolus regime.
3. State how to calculate an insulin to carbohydrate ratio.
4. Identify proper insulin storage recommendations.

#6 - Injectable Meds for Diabetes Management Part II

II. Pens

III. Pumps

A. Benefits

B. Components

C. Dosing

D. Models

IV. Symlin

A. Functionsons

B. Administration

C. Side effects

D. Studies

1. 1. State 2 benefits of using insulin pens.
2. 2. List 2 benefits of using an insulin pump.
3. 3. Define the mechanism of action of symlin.
4. 4. Identify how to adjust insulin upon symlin initiation.

Accreditation Information

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.

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

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