Managing Diabetes Complications

#1 - 8/4/10 - Diabetes and Nephropathy

I. Incidence
II. Five Stages
III. Screening

a. Blood pressure
b. Urinary Albumin

IV. Treatment

a. Hypertension
b. Glycemic Control
c. Protein Intake

V. Treatment of End Stage Renal Disease

a. Hemodialysis
b. Peritoneal Dialysis
c. Kidney Transplant

VI. Prevention

Behavioral/Learning Objectives:

1. List 2 ways to prevent retinopathy.
2. State the name of the test that detects protein in the urine the earliest.
3. List 2 treatment options for end stage renal disease.

#2 - 8/11/10 - Diabetes and Cardiovascular Disease

I. Development of cardiovascular disease (CVD) in diabetes

A. Incidence
B. Macro/micro-vascular changes contributing to CVD

II. Risk factors contributing to CVD

A. Non-modifiable

1. Heredity
2. Age
3. Gender
4. Race/ethnicity

B. Modifiable

1. Hypertension
2. Dyslipidemia
3. Overweight/Obesity
4. Diabetes/Hyperglycemia
5. Albuminuria
6. Smoking/Tobacco use
7. Lifestyle factors: physical inactivity, unhealthy eating

III. Interventions to manage CVD in persons with diabetes

A. Metabolic control (A1C, blood pressure, lipids)
B. Medical Nutrition Therapy
C. Physical activity
D. Pharmacological therapy

Behavioral/Learning Objectives:

1. Describe how cardiovascular disease (CVD) develops in persons with diabetes.
2. Identify 3 modifiable risk factors contributing to CVD.
3. Describe 3 interventions to manage CVD in persons with diabetes.

#3 - 8/18/10 - Weight Issues in Diabetes

I. Introduction

A. Incidence
B. Causes of obesity

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

C. Defining obesity (Body Mass Index; Waist circumference

II. Health implications of obesity

A. Mortality
B. Cardiovascular
C. Endocrine
D. Respiratory
E. Other

III. Interventions for managing obesity

A. Assessing candidates for weight loss
B. Weight loss goals
C. 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. State 3 health implications of obesity.
3. Explain 3 interventions for the management of obesity.

#4 - 9/1/10 – Diabetic Ulcer and Neuropathy

I. Prevalence and Incidence
II. Risk Factors
III. Possible Progression
IV. Neuropathy – Sensory, Autonomic, and Motor
V. Osteomyelitis
VI. Charcot Foot
VII. Wound and Infection
VIII. Prevention
IX. Diabetes Management
X. Off-Loading
XI. Treatments
XII. Dressings

Behavioral/Learning Objectives:

1. State the Common Diabetic Ulcers
2. Describe an evaluation of a Diabetic Foot
3. Explain the Diabetic Plan of Care

#5 - 9/8/10 -Acute Complications and Diabetes

I. Hypoglycemia

A. Causes
B. Signs/symptoms
C. Prevention
D. Treatment

II. Hyperglycemia

A. Causes
B. Signs/symptoms
C. Prevention
D. Treatment

III. Ketoacidosis

A. Causes
B. Signs/symptoms
C. Prevention
D. Treatment

IV. Hyperosmolar Hyperglycemic Nonketotic Syndrome

A. Definition
B. Signs/symptoms
C. Causes
D. Prevention
E. Treatment

V. Managing illness

A. Blood glucose control
B. Carbohydrate intake
C. Medication adjustments

VI. Case examples

Behavioral/Learning Objectives:

1. State 2 ways to prevent hypoglycemia.
2. List 2 signs and symptoms of ketoacidosis.
3. Define hyperosmolar hyperglycemic nonketotic syndrome.
4. Identify how to appropriately treat hypoglycemia.

#6 - 9/8/10 - Inpatient Diabetes Management

I. Glucose management Options

a. Blood glucose monitoring

1. Frequency
2. Targets

b. Insulin
c. Oral meds

II. Insulin protocols
III. Special Situations

a. TPN use
b. Enteral feeding
c. Glucocorticoid therapy
d. Surgery

IV. Prevention of Hypoglycemia

a. Uniformity of insulin orders
b. Accuracy of insulin dosing
c. Patient self management
d. Staffing knowledge
e. Carbohydrate intake
f. Steroid use
g. NPO status
h. Treatment

V. Discharge considerations
VI. Outcomes

Behavioral/Learning Objectives:

1. State 2 ways to prevent hypoglycemia in the inpatient setting.
2. State the BG goals for inpatients with diabetes.
3. List 2 reasons why insulin may be preferable to oral diabetes agents in the inpatient setting.
   

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.  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 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 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.

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