Diabetes Management and Cardiovascular Disease

#1 - 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

A. Central obesity measured by waist circumference
B. Elevated triglycerides (TG)
C. Elevated blood pressure
D. Low HDL-cholesterol
E. 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.

#2 - Heart Disease and Diabetes

I. Etiology

A. Definition of atherosclerosis
B. Symptoms
C. Incidence

II. Risk factors contributing to heart disease

A. Dyslipidemia
B. Hypertension
C. Smoking
D. Obesity
E. Sedentary lifestyle
F. Hyperglycemia
G. Elevated homocysteine
H. Lipoprotein (a)
I. C-Reactive Protein (CRP)

III. Interventions to reduce risk of heart disease

A. Medical Nutrition Therapy
B. Smoking cessation
C. Physical activity
D. Blood glucose control
E. Blood pressure control
F. Pharmacological therapy

1. Cholesterol
2. Blood pressure
3. Aspirin Therapy

Behavioral/Learning Objectives:

1. Describe the development of heart disease in diabetes
2. Identify 3 modifiable risk factors contributing to heart disease
3. Describe 3 interventions to reduce the risk of heart disease

#3 - Dyslipidemia

I. Diabetes link to cardiovascular disease

II. Prevalence

III. Risk Factors

A. Lipid abnormalities
B. Obesity
C. Physical inactivity
D. Nutrition
E. Insulin resistance
F. Hyperglycemia
G. Smoking
H. Blood pressure

IV. Atherrosclerosis and insulin resistance

V. Goals of hyperlipidemia therapy

A. LDL
B. HDL
C. Triglycerides
D. Apo-protein A & B
E. PAI- Activity

VI. Treatment Options

A. Statins
B. Fibrates
C. Ezetimide
D. Diet and exercise
E. Glitazones
F. Micronutrients

VII. New treatments for diabetes risk factors

Behavioral/Learning Objectives:

1. Identify goals of therapy for dyslipidemia in patients with diabetes.
2. List 2 lifestyle interventions to treat dyslipidemia.
3. State 2 pharmacologic treatment regimes for dyslipidemia.

#4 - High Blood Pressure and Diabetes

I. 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

II. Blood pressure classifications

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

III. Treatment options of hypertension in persons with diabetes

A. Lifestyle modification

1. Weight reduction
2. DASH eating plan
3. Sodium restriction
4. Regular physical activity
5. Moderation of alcohol

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

#5 - Nutrition Therapy for Heart Disease

I. Goals for heart health

A. HgbA1c
B. Blood pressure
C. Cholesterol

II. Dietary Approaches to Stopping Hypertension

III. Nutrient Considerations

A. Potassium
B. Calcium
C. Magnesium
D. Sodium

IV. Therapeutic Lifestyle changes

A. Calories
B. Carbohydrates
C. Fiber
D. Protein
E. Fats

V. Improving lipids

VI. Herbs/natural products

VII. Antioxidants

VIII. Alcohol

IX. Weight goals

Behavioral/Learning Objectives:

1. State 2 components of the DASH diet.
2. Identify the impact of low potassium diets on high blood pressure.
3. List 2 healthy food sources of fat.

#6 - Physical Activity for Heart Disease

I. Physical activity

A. Physiologic effects
B. Benefits

1. Glycemic control
2. Cardiovascular
3. Other

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

A. Hypoglycemia
B. Hyperglycemia
C. Dehydration
D. Assessing cardiovascular risk factors
E. Tips for Safe Activity

III. Activity prescription (frequency and type of program) in those with:

A. Type 1 diabetes
B. Type 2 diabetes
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. Discuss 3 tips for safe activity in persons with diabetes.
3. Describe 1 activity recommendation for persons with heart disease and diabetes.

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.  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, CA, 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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