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    Counseling The Newly Diabetic Patient Final

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    This document provides guidance for counseling newly diagnosed diabetic patients. Key points discussed include identifying the patient's current knowledge and tailoring the counseling approach, explaining what diabetes is and why blood glucose monitoring is important, demonstrating how to use a glucometer and maintain logs, defining blood glucose goals, reviewing common medications and injection techniques, addressing fears about needles, discussing exercise and meal planning, and developing an appropriate screening plan. The counseling aims to empower patients to better manage their condition through education and addressing their specific needs and concerns.

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    © All Rights Reserved
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    Counseling The Newly Diabetic Patient Final

    Uploaded by

    api-546809761
    169 views33 pages
    This document provides guidance for counseling newly diagnosed diabetic patients. Key points discussed include identifying the patient's current knowledge and tailoring the counseling approach, explaining what diabetes is and why blood glucose monitoring is important, demonstrating how to use a glucometer and maintain logs, defining blood glucose goals, reviewing common medications and injection techniques, addressing fears about needles, discussing exercise and meal planning, and developing an appropriate screening plan. The counseling aims to empower patients to better manage their condition through education and addressing their specific needs and concerns.

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    This document provides guidance for counseling newly diagnosed diabetic patients. Key points discussed include identifying the patient's current knowledge and tailoring the counseling approach, explaining what diabetes is and why blood glucose monitoring is important, demonstrating how to use a glucometer and maintain logs, defining blood glucose goals, reviewing common medications and injection techniques, addressing fears about needles, discussing exercise and meal planning, and developing an appropriate screening plan. The counseling aims to empower patients to better manage their condition through education and addressing their specific needs and concerns.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    169 views33 pages

    Counseling The Newly Diabetic Patient Final

    Uploaded by

    api-546809761
    This document provides guidance for counseling newly diagnosed diabetic patients. Key points discussed include identifying the patient's current knowledge and tailoring the counseling approach, explaining what diabetes is and why blood glucose monitoring is important, demonstrating how to use a glucometer and maintain logs, defining blood glucose goals, reviewing common medications and injection techniques, addressing fears about needles, discussing exercise and meal planning, and developing an appropriate screening plan. The counseling aims to empower patients to better manage their condition through education and addressing their specific needs and concerns.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 33

    COUNSELING THE NEWLY

    DIAGNOSED DIABETIC PATIENT

    Molly Corder, PharmD


    PGY1 Ambulatory Care Pharmacy Resident, Saint Joseph Health System
    OBJECTIVES

    Identify pertinent counseling points for a newly


    Identify diagnosed diabetic patient

    Demonstrate Demonstrate proper insulin injection technique

    Develop Develop an appropriate screening plan for a patient


    Patients will have differing responses
    to their new diagnosis

    Assess knowledge first & target


    approach to patient
    PATIENT
    RESPONSE
    Empathy goes a long way

    Patient friendly terms


    WHAT IS DIABETES?

    Body has trouble managing sugar properly

    Type 1: insulin sensitive

    Type 2 : insulin resistant


    WHY DO WE MONITOR To identify high To identify low
    OUR BLOOD GLUCOSE? blood glucose and blood glucose and
    areas for treatment
    GLUCOMETER

    This might be brand new


    information to a patient

    Teach patient how to use


    glucometer & lancets

    Teach patient documentation


    skills
    BLOOD GLUCOSE LOGS
    HOW DO WE MONITOR OUR BLOOD
    GLUCOSE

    Wash • Wash hands

    Place • Place hands flat together

    Rotate • Rotate sites

    Avoid • Avoid nerve endings


    DEFINING BLOOD GLUCOSE

    A1C: 3 MONTH AVERAGE FASTING BLOOD GLUCOSE: POST PRANDIAL BLOOD


    BEFORE MEALS GLUCOSE: 2 HOURS POST
    MEAL
    HOW OFTEN DO WE MONITOR BLOOD
    GLUCOSE

    Type 2 vs Continuous
    It depends! Type 1 glucose
    patients monitoring
    AACE:

    • A1C <6.5%
    • Fasting blood glucose: 80-130 mg/dL
    • Blood glucose after a meal: <140
    BLOOD mg/dL
    GLUCOSE
    GOALS ADA:

    • A1C <7%
    • Fasting blood glucose: <110 mg/dL
    • Blood glucose after a meal: <180
    mg/dL
    Patients are not always the most
    interested in this, but it is
    important for them to know
    BASIC
    MEDICATION
    REVIEW The more they understand the
    benefit of their medication- the
    more likely they are to take
    medication correctly
    COMMON QUESTIONS

    Will I be on
    medication It depends!
    forever?
    Wash hands and clean site

    Prime the pen

    Dialing the pen

    INSULIN INJECTION Inject into subcutaneous tissue at 90 degree angle &


    TECHNIQUE hold in place for 5-10 seconds

    Rotate sites

    Proper disposal

    Changing needles
    Depends on which medication

    Some very similar to insulin pens


    GLP1 Trulicity is unique
    INJECTION
    TECHNIQUE Bydureon

    Your patient is even more confused than you are

    Practice, watch videos, become competent


    HOW TO VIDEOS

    • Fairview Physician Associates – Pharmacist Made Demonstration Videos


    • Insulin Kwikpen: FPA KwikPen demo – YouTube
    • Insulin FlexTouch: FPA FlexTouch Pen Demo - YouTube
    • Victoza: FPA Victoza Pen - YouTube
    • Trulicity: FPA Trulicity Pen demo - YouTube
    • Bydureon: FPA Bydureon Pen demo – YouTube
    OVERCOMING A FEAR OF NEEDLES

    Walk patient through

    Show videos

    First injection in office

    Offer support
    HYPOGLYCEMIA RISK
    <70
    mg/d
    L
    Irritability
    Shaking Sweating
    / anxiety

    Confusion Seizures Coma


    HYPOGLYCEMIA MANAGEMENT

    1. Check blood glucose to ensure it is a TRUE low

    2. 15 grams of carbs

    3. Wait 15 minutes

    4. Check blood glucose again

    5. Repeat if necessary
    COMMON QUESTIONS

    “Why do I feel like I have low blood


    sugar when I am not actually low?”

    “What can I do to stop this?”


    Carbohydrates

    HOW DOES FOOD


    EFFECT BLOOD Protein
    GLUCOSE?

    Fibers
    Low carb foods: veggies, lean
    proteins, eggs, nuts, greek yogurt

    High carb foods: candy, sweets,


    breads, pastas, potatoes
    MEALS
    Sugar free foods can be
    deceiving

    Basic concepts
    MOVEMENT

    Exercise can do Start slow and ensure


    Exercise does not
    wonders in terms of heart is healthy
    have to mean running
    blood glucose enough for more
    a marathon
    management intensive exercise

    Target heart rate zone 150 minutes per week


    Stay Stay hydrated

    Check Check blood glucose before intensive exercise

    TIPS FOR SAFE


    EXERCISING
    Take Take rescue with you when exercising

    Consider Consider wearing an ID band


    Depression and
    Depression and
    anxiety make it
    anxiety are
    more difficult to
    common
    control diabetes

    Patients should
    Normalize mental
    know they can
    MENTAL health for your
    and should ask for
    diabetic patients
    help

    Screen for
    depression
    STANDARDS OF CARE

    A1C: Every 3 months


    Urine albumin
    if uncontrolled, or
    Lipids: Annually creatinine ratio:
    making changes, 6
    Annually
    months if controlled

    Diabetic foot exam: Dental exam: Every 6


    Eye exam: Annually
    Annually months
    PPSV23 at diagnosis and after age 65

    Hepatitis B if injecting insulin, checking


    blood glucose often

    IMMUNIZATIONS
    Influenza vaccine annually

    Shingles (past age 50)

    Tdap every 10 years


    COMPLICATIONS

    Use Use caution not to scare patient

    Tool Tool to empower patient

    Reinforc Reinforce outcomes of controlled vs


    e uncontrolled diabetes
    SICK DAYS

    Continue Check Stay Contact


    Continue Check BG Stay Contact PCP
    taking more hydrated
    medication frequently
    KEY TAKEAWAYS

    Take a moment Break the Try not to Sometimes you Empower your
    to get to know information up if overwhelm will have to have patient to take
    the patient possible patient difficult control
    conversations
    Every patient is different

    REMEMBER

    Specialize care &


    education to each patient
    CITATIONS

    • Raz I. Guideline Approach to Therapy in Patients with Newly Diagnosed Type 2 Diabetes. Diabetes
    Care 2013 Aug; 36(Supplement 2): S139-S144.https://doi.org/10.2337/dcS13-2035

    • Newly Diagnosed. Diabetes Education Online. Diabetes Teaching Center at the University of
    California, San Francisco. 2021. Accessed 6 May 2021. Available at:
    Newly Diagnosed :: Diabetes Education Online (ucsf.edu)

    • Diabetes Self Management Patient Education Materials. John Hopkins Medicine. Accessed 6 May
    2021. Available at: Diabetes Self Management Patient Education Materials (hopkinsmedicine.org)

    • About Diabetes Education. ADCES. 2021. Accessed 6 May 2021. Available at


    Free Tools and Resources to Help Patients Manage Their Diabetes (diabeteseducator.org).

    • Pledger J, Hicks Debbie, Kirkland F, et al. Importance of Injection Technique in Diabetes. Diabetes &
    Primary Care Vol 14 No 1 2012. Accessed 6 May 2021.

    • Fairview Physician Associates. FPA Network. Accessed 6 May 2021. Available at


    FPA Network - YouTube

    • Get the most from your diabetes treatment. Fairview Physician Associates Network. 2018. Accessed 6
    May, 2021.
    QUESTIONS?

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