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Title

Diabetes Mellitus: Patient Management (1 credit hours)

Abstract

The module describes the components of effective management of diabetes mellitus types 1 and 2. These components include nutritional therapy, pharmacological management, and physical activity planning. The module further details the combination and application of these components as appropriate to type 1 and 2 diabetes and to patient considerations. The role and limitations of self-monitoring of blood glucose in maintenance of near-normal glucose levels are detailed. Prior completion of the Diabetes Mellitus: Overview module is recommended. (Note: This course was originally authored by Joseph Giardullo, MS, RN).

This activity is approved for Category A credits by the ASRT/Approval Expiration date: October 1, 2010.

This activity may be available in multiple formats or from different sponsors. The ARRT does not allow CE activities such as internet courses, home study programs or directed readings to be repeated for CE credit in the same or any subsequent biennium.

Author

Cheryl Jefferies, RN, MSN

Cheryl Jefferies is an assistant professor at Sinclair Community College and teaches medical-surgical nursing. Mrs. Jefferies has been in nursing for thirty-one years and has previously taught in associate degree nursing programs in South Carolina and Tennessee. She is a former nationally certified diabetes educator and has significant experience working with patients with diabetes. Mrs. Jefferies has worked in acute care hospitals in medical-surgical care, surgery and in surgery and PACU. In addition, she has worked in home health care and has delivered public service education about diabetes through TV, radio, public speaking and health screening venues.

Objectives

After completion of the module the student will be able to:

Define and describe diabetes mellitus types 1 and 2 and cite important considerations of an effective disease management plan.
Identify and describe important nutritional therapy considerations for effective management of diabetes mellitus.
List and describe components of an effective pharmacological management plan for diabetes mellitus.
Cite the benefits and potential risk considerations of each aspect of an effective activity and exercise plan in the management of diabetes mellitus.
Define SMBG and describe important considerations related to an effective diabetes management plan.

Resources

Bibliography
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Dall T, Mann SE, Zhang Y, Martin J, Chen Y, and Hogan P of The Lewin Group, Inc., Falls Church, Virginia. ADA Statement: Economic Costs of Diabetes in the U.S. in 2007. Diabetes Care. 2008;31.

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Law BM. Avandia Meta-Analysis Sparks Confusion, Questions: Physicians Respond to Study�s CVD Findings with Wide-Ranging Treatment Decisions. DOC News. July 1, 2007 Volume 4 Number 7 p. 1.

White J. Pharmacological Therapies: A Core Curriculum for Diabetes Education. 3rd ed. Chicago: American Association of Diabetes Educators; 1998.

Webliography
American Diabetes Association. Home Page. Available at: http://www.diabetes.org. Accessed March 27, 2008.

Aventis Pharmaceuticals Inc. How LANTUS Works. Lantus insulin glargine (rDNA origin) injection. 2002-2006. Available at: http://www.lantus.com/professional/works_html.do. Accessed March 27, 2008.

Beckley ET. Research Elucidates Link Between Weight, Fat, Carbs, and Protein: STUDIES PRESENTED AT NORTH AMERICAN ASSOCIATION FOR THE STUDY OF OBESITY ANNUAL MEETING. DOC News. February 1, 2005; 2(2):16. Available at: http://docnews.diabetesjournals.org/cgi/content/full/2/2/16. Accessed March 27, 2008..

Beckley ET. FDA Approves First Form of Inhaled Insulin. DOC News. March 1, 2006; 3(3); 1. Available at: http://docnews.diabetesjournals.org/cgi/content/full/3/3/1-b. Accessed March 27, 2008.

Campbell KB and Braithwaite SS. Hospital Management of Hyperglycemia. Clinical Diabetes. , 2004; 22:81-88. Available at: http://clinical.diabetesjournals.org/cgi/content/full/22/2/81. Accessed March 27, 2008.

Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion. Division of Diabetes Translation. Diabetes Public Health Resource web site. Available at: http://www.cdc.gov/diabetes/index.htm. Accessed March 27, 2008.

Centers for Disease Contol and Prevention (CDC). National Diabetes Fact Sheet. Available at: http://www.cdc.gov/diabetes/pubs/factsheet.htm. Accessed March 27, 2008.

Diabetes Research in Children Network (DirecNet) Study Group. Accuracy of the GlucoWatch G2 Biographer and the Continuous Glucose Monitoring System During Hypoglycemia: Experience of the Diabetes Research in Children Network. Diabetes Care. 2004; 27: 722-726. Available at: http://care.diabetesjournals.org/cgi/content/full/27/3/722. Accessed March 27, 2008.

Esposito L. Tweaking Nutrition Labels: FDA aims for prominent calorie counts, realistic serving sizes. DOC News. April 1, 2005; 2(4):7. Available at: http://docnews.diabetesjournals.org/cgi/content/full/2/4/7. Accessed March 27, 2008.

Goldfarb B. Serving Up Culturally Sensitive Diets: Approaches must keep pace with demographic changes. DOC News. July 1, 2005; 2(7):8. Available at: http://docnews.diabetesjournals.org/cgi/content/full/2/7/8. Accessed March 27, 2008.

Hendry J. FDA Approves Exenatide: First-in-class drug controls type 2 diabetes without weight gain. DOC News (2), 6. Available at: http://docnews.diabetesjournals.org/cgi/content/short/2/7/1. Accessed March 27, 2008.

Herbst KL and Hirsch IB. Insulin Strategies for Primary Care Providers. Clinical Diabetes. 2002; 20:11-17. Available at: http://clinical.diabetesjournals.org/cgi/content/full/20/1/11. Accessed March 27, 2008.

Hirsch IB, Bergenstal RM, Parkin CG, Wright E Jr and Buse JB. A Real-World Approach to Insulin Therapy in Primary Care Practice. Clinical Diabetes. 2005; 23:78-86. Available at:http://clinical.diabetesjournals.org/cgi/content/full/23/2/78. Accessed March 27, 2008.

Holman JR. FDA Approves New Adjunct Treatment for Glucose Control. DOC News. 2005; (2), 5. Available at: http://docnews.diabetesjournals.org/cgi/content/full/2/5/9. Accessed March 27, 2008.

Kaufman FR. Surveillance and Treatment for CVD in Children With Diabetes. DOC News. May 1, 2005; 2(5):5. Available at: http://docnews.diabetesjournals.org/cgi/content/full/2/5/5. Accessed March 27, 2008.

Kimmel B, and Inzucchi SE. Oral Agents for Type 2 Diabetes: An Update. Clinical Diabetes. 2005; 23:64-76. Available at:http://clinical.diabetesjournals.org/cgi/content/full/23/2/64. Accessed March 27, 2008.

National Diabetes Information Clearinghouse. National Institute of Diabetes and Digestive and Kidney Diseases. 2003. Diabetes Dictionary. Available at: http://diabetes.niddk.nih.gov/dm/pubs/dictionary/ Accessed March 27, 2008.

Sigal RJ, Kenny GP, Wasserman DH and Castaneda-Sceppa C. Physical Activity/Exercise and Type 2 Diabetes. Diabetes Care 2004;27:2518-2539. Available at: http://care.diabetesjournals.org/cgi/content/full/27/10/2518?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1= SIGAL&searchid=1121204291303_10701&stored_search=&FIRSTINDEX =0&sortspec=relevance&journalcode=diacare. Accessed March 27, 2008.

Siminerio LM. Why Are We Still Failing to Prevent Diabetes? Reimbursement for lifestyle interventions remains critical. DOC News. July 1, 2005; 2(7)7: 4. Available at: http://docnews.diabetesjournals.org/cgi/content/full/2/7/4. Accessed March 27, 2008.

USDA: United States Department of Agriculture. MyPyramid.gov. 2005. Available at: http://www.mypyramid.gov/. Accessed March 27, 2008.

White JR Jr and Campbell RK. Recent Developments in the Pharmacological Reduction of Blood Glucose in Patients With Type 2 Diabetes. Clinical Diabetes. 2001; 19:153-159. Available at: http://clinical.diabetesjournals.org/cgi/content/full/19/4/153. Accessed March 27, 2008.

White JR Jr and Campbell RK. Inhaled Insulin: An Overview. Clinical Diabetes. 2001; 19:13-16. Available at: http://clinical.diabetesjournals.org/cgi/content/full/19/1/13. Accessed March 27, 2008.

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