Facilitating Lifestyle Changes in Persons with Diabetes

#1 - Preventing Type 2 Diabetes

I. Diabetes Epidemic

A. Prevalence/incidence
B. Economic burden
C. Contributing factors

1. Aging population
2. Cultural diversity
3. Sedentary lifestyle
4. Obesity/overweight
5. New diagnostic criteria

II. Diagnostic Criteria for Diabetes and Pre-Diabetes Screening

A. Adults
B. Children
C. Risk factors of diabetes

III. Prevention strategies

A. Diabetes prevention studies

1. Da Qing IGT and Diabetes Study
2. Finnish Diabetes Prevention Study
3. Diabetes Prevention Program (DPP)
4. DPP Outcomes Study (DPPOS)

B. Pharmacotherapy C. Lifestyle interventions

1. Smoking
2. Sleep
3. Physical Activity
4. Weight
5. Dietary factors (less saturated fat, more whole grains, less sugar beverages)
6. Moderate alcohol use

Behavioral/Learning Objectives:

1. List 3 factors contributing to the increase in diabetes in the US.
2. Describe the diagnostic criteria for diabetes and pre-diabetes screening for adults and children.
3. List 2 lifestyle interventions to help prevent diabetes.

#2 - Diabetes 101

I. Diabetes Mellitus

A. Definition
B. Prevalence
C. Review risk factors, screening recommendations and diagnostic criteria for

1. Type 1
2. Type 2 (adults and youth)
3. Gestational

II. Managing Diabetes

A. Personalized meal plan/Medical Nutrition Therapy
B. Personalized Physical Activity Plan
C. Medication/Insulin
D. Self-Monitoring of blood glucose
E. Diabetes Self-Management Education

III. ADA Standards of Medical Care in Diabetes. Discuss goals and frequency of testing.

A. Annual physical
B. A1C
C. Lipid profile
D. Blood Pressure
E. Dilated eye exam
F. Microalbuminuria/GFR calculation
G. Comprehensive Foot exam
H. Screen for autonomic neuropathy
I. Oral health exam
J. Flu and pneumococcal vaccination
K. Referrals: self-management education , Medical Nutrition Therapy (MNT) and specialists (if tests abnormal)

Behavioral/Learning Objectives:

1. Differentiate between type 1 and type 2 diabetes.
2. List 4 components of managing diabetes.
3. State the frequency for 2 ADA Standards of Medical Care in Diabetes.

#3 - Weight Management

I. Introduction

A. Defining obesity

1. Body Mass Index
2. Waist circumference

B. Incidence
C. Causes of obesity

1. Genetic
2. Environmental
3. Other (endocrine system disorders, medications)

D. Importance of Weight Loss in Disease Prevention

1. Diabetes Prevention Program

II. Health implications of obesity

A. Assessing co-morbidities 1. Pre-diabetes
2. Type 2 diabetes (adults and children)
3. Cardiovascular disease
4. Hypertension
5. Dyslipidemia
6. Gallstones
7. Sleep Apnea
8. Other

III. Therapeutic interventions for managing obesity

A. Assessing candidates for weight loss

1. BMI
2. Waist circumference
3. Risk status
4. Determine readiness to lose weight

B. Weight loss goals
C. Therapeutic lifestyle changes

1. Nutrition therapy
2. Physical activity
3. Behavior therapy
4. Adequate sleep
5. Stress management

E. Pharmacological
F. Surgical
G. Maintenance of weight loss

Behavioral/Learning Objectives:

1. Describe the role of genetics versus environment in the cause of obesity.
2. Describe 3 health implications related to obesity.
3. Explain 3 therapeutic interventions for the management of obesity.

#4 - 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.

#5 - Deciphering Diets: From Atkins to Zone

I. Introduction

A. Incidence of dieting
B. Candidates for weight loss

1. BMI >25
2. BMI 23-25 with family history of diabetes, heart disease or pre-existing conditions

II. Diet Trends: pros and cons

A. Fads/Novelty

1. current diet and lifestyle books
2. weight loss myths

B. Internet based diets
C. High protein, low carbohydrate diets (Atkins, Zone, etc.)
D. Vegetarian
E. Meal replacements
F. Commercial weight loss programs

III. Strategies for successful weight loss:

A. Lifestyle changes:

1. dietary therapy
2. physical activity
3. behavior modification
4. stress management

B. Resources

1. Dietary Guidelines for Americans
2. MyPlate.gov
3. National Weight Control Registry

Behavioral/Learning Objectives:

1. Identify 2 candidates for weight loss.
2. Compare the claims and nutrient composition for 3 current diets.
3. Identify 3 strategies for successful weight loss.

#6 - Goal Setting for Behavior Change

I. Perspectives on Behavior Change

A. Traditional medical model vs. chronic illness medical model
B. Definition of health belief model
C. Impact of diabetes/chronic disease on health beliefs

1. Feelings and coping mechanisms
2. Diabetes grieving process and feelings

D. Individual perceptions that influence self-care
E. Client-centered education

1. Creating a partnership
2. Assessing health beliefs
3. Assessing readiness to change

II. The Stages of Behavior Change and the health careprofessional's role

A. Precontemplation
B. Contemplation
C. Preparation
D. Action
E. Maintenance

III. Strategies to assist with goal setting

A. Activities that facilitate behavior change
B. Client-centered goal setting- what the person wants to do
C. Prioritize learning needs with the individual
D. Identification of learning barriers
E. Identification of the person’s stage of behavior change
F. S.M.A.R.T. goals (specific, measurable, attainable, realistic, and time-limited)
G. Tools

1. AADE 7 Self-Care Behaviors
2. Personal Action Toward Health (PATH) in Michigan

Behavioral/Learning Objectives:

1. Describe the role of health beliefs in behavior change.
2. Describe each of the stages of behavior change.
3. List 2 strategies to assist with goal setting.

Accreditation Information

Nurses – Academy Medical Systems is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s COA.

Academy Medical Systems (AMS) is also a provider approved by the California Board of Registered Nursing, provider #CEP14413.

AMS is also a provider approved by the Florida Board of Nursing, provider #50-19.

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.

9.0 contact hours will be rewarded to nursing professionals at the completion of this workshop.

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.

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).

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. This course is an intermediate education level.

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 and PTAs in the following states will receive 9 contact hours for completion of all 6 webinars: AK, AL, AZ, CA, CO, CT, GA (Class 1), HI, IA, ID, IN, KS (Cat 2), KY, MA, ME, MI, MN (Cat 2), MO, MS, MT, NE, NM, ND, OK (Cat 2), OR, RI, SC, SD, UT, VA (Type 2), VT, VI, WA, WI, WY.

We are an approved provider to offer continuing competency courses to CA PTs, approval date 4/5/10. The following state boards recognize other state’s approval: AL, AZ, GA (Class 1), KY, MO, MS, OK (Cat 2), 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.  See The Federation of State Boards of Physical Therapy website for more information.

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.

Social Workers - This course meets the qualifications for 9 hours of continuing education credit for MFCCs and/or LCSWs as required by the California Board of Behavioral Sciences, provider #PCE 4947. Please check with your state board’s requirements to determine if this program meets your continuing education requirements or call us at 866-414-3500 to assist you.

Academy Medical Systems has been approved by the TX State Board of Social Workers Examiners to provide continuing education activities for social workers, Provider # 5998.

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