Back to Overview

David M. Kendall, MD
Medical Director and Chief – Clinical and Professional Services, International Diabetes Center
Adjunct Associate Professor of Medicine – University of Minnesota

In the last decade peptide hormones—including the incretin hormones—have emerged as key elements of both the pathophysiology and treatment of diabetes and obesity. International leader Dr. Kendall will share the risks, benefits and clinical applications related to glucagon-like peptide 1 (GLP-1) and other peptide therapeutics that investigators and clinicians are exploring.

UPN: 069-000-09-204-L01-P

Back to Overview

Jane Jeffrie Seley, MPH, MSN, CDE, GNP
Diabetes Nurse Practitioner
New York Presbyterian/Weill Cornell Medical Center, New York, NY

Linda S. Cohen, MPH, MSN, RN, CDE
Professor
Assistant Director of Nursing
SUNY Downstate Medical Center, Brooklyn, NY

This interactive session will focus on the art of inpatient diabetes management and the ever- evolving role of the diabetes educator. Creative strategies that target common challenges will be explored using practical examples. Simple solutions that facilitate translating research into practice and improving care delivery will be discussed. Participants will be encouraged to share their own best practices. Exemplary case studies will be reviewed and discussed. Diabetes educators currently working in inpatient settings and those that are interested in embracing the challenge are encouraged to attend.

UPN: 069-000-09-120-L01-P

Back to Overview

Marcie Draheim, RN, CDE
President
Draheim Dimensional Presentations, Lisbon, IA

Ginger Kanzer-Lewis, RN, BC-ADM, CDE
Consultant
Assistant Director of Nursing
GKL Associates, Marathon, FL

As the horizon of health care dramatically changes, so will we also need to focus more on leveraging entrepreneurial approaches providing diabetes education, diabetes management and ongoing patient support. We tend to gravitate toward what has been familiar to us and we become "stuck in the here and now." This often limits our capability of being futurists. The purpose of this presentation is to assist participants to more fully focus on their investigation of a variety of resource options that are enhanced by a variety of creative teaching techniques, computer technologies and software that are applicable through a number of devices currently available on the market and those that are soon to be launched. Communication, connectivity, sustainable support for our patients and their families has been, and will become even greater as we progress in providing health care.

UPN: 069-000-09-136-L01-P

Back to Overview

Greg Milliger, CPC, CPC-H, CEMC, CPC-p, CEC
Reimbursement Expert
Unique Healthcare Consulting, Lolo, MT

Dawn Sherr, RD, CDE, CNSD
Practice Manager
American Association of Diabetes Educators, Chicago, IL

DSME/T services have been provided through hospital-based outpatient and physician office -based programs. In recent years, many DSME/T programs have gone out into the community to provide education in local clinics and community-based organizations. Some DSME/T programs are leaving both a void in the marketplace and an opportunity for diabetes educators to become entrepreneurial. A number of diabetes educators are going into business on their own and/or finding a fit with physician practices and pharmacies. Before you start your own business or join forces with others, do your homework.

UPN: 069-000-09-157-L01-P

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Research Hypothesis, Purpose, or Objective: Children attending diabetes camp in 2008 have access to improved diabetes management and education compared to children attending diabetes camps in 1996 or 2002. As a result of using improved insulin pump technology and designer insulins, fewer hyperglycemic and hypoglycemic excursions should occur in 2008. Hemoglobin A1c values should also be closer to target levels in 2008 than in earlier years.

Study/Design Methods: Hemoglobin A1c values were recorded in 1996, 2002 and 2008 from children ages 8-16 who attended a residential diabetes camp for one week. Blood glucose levels were measured 4-6 times daily. All children included in the study were diagnosed with Type 1 diabetes and the daily activity regimen was held constant. The same camp facility was utilized in all years.

Results: Children who attended diabetes camp in 2008 were much more likely to be wearing an insulin pump than children who attended camp in 1996. More than half of all campers wore an insulin pump in 2008. Despite the improvements in insulin delivery via a pump, or the improvements in insulin management realized by the introduction of long-acting and short-acting insulin analogs over the past 12 years, the overall hemoglobin A1c values of diabetic children attending residential camp were not significantly improved in 2008 compared to those observed in 1996. The number of moderate or severe hyperglycemic events at camp per week per child were not significantly lower in 2008 than in earlier years. The use of insulin pumps did not provide a significant advantage the use of subcutaneous insulin injections in terms of the number of severe or moderate glucose excursions that occurred at camp.

Conclusions: Hemoglobin A1c values and glycemic excursions were compared from campers who attended residential diabetes camp in 1996, 2002 and 2008. No significant improvement in the hemoglobin A1c levels was observed over the 12 year period studied. The increase in the use of insulin pumps since 1996 has resulted in no significant improvement in either hemoglobin A1c values of children who attend camp or in the number of hyperglycemic and hypoglycemic excursions that occur at camp. The hemoglobin A1c data reflect general diabetes care that took place in the 2-3 months prior to attendance at camp. The glycemic excurions that occurred at camp reflected the day-to-day swings in glucose control that took place in the residential camp environment. Neither parameter showed a significant change over 12 years, an observation that was unexpected and that points out the fact that diabetes care in 2008 remains imperfect. Children who attend residential diabetes camp continue to derive benefit from educational programs and social interactions with other campers, as well as the opportunity to spend time away from home and foster a stronger sense of independence.

Back to Overview

Research Hypothesis, Purpose, or Objective: An on-line fitness program allowing participants to log their minutes of activity either as an individual or team member and that permits them to "virtually" walk across Georgia will result in increased levels of physical activity for these participants.

Study/Design Methods: Participants register for Walk Georgia on-line either as an individual or as part of a 4 member team. During registration each participant completes a questionnaire that documents their current level of activity. At the end of the 8 week session, they complete a similar questionnaire. During the 8-week session, participants log their minutes of doing various activities that are converted to miles. Teams and individuals compete against each other. As participants log miles they visit the different Georgia counties.

Results: 4,583 people enrolled, 3,204 actively participated and 1, 637 reported physical activity during at least 6 of the 8 weeks. About equal numbers participated on teams and as individuals. Youth participation was 14% of the total. Overall participants logged 511,000 miles of physical activity. The average person exercised the equivalent of 17 miles/week if they were not on a team and 22 miles/week if they were on a team. Seventy-three percent said they were more active during Walk Georgia than before the program started.

Conclusions: Walk Georgia is an effective way to motivate people to increase their physical activity. It enhances a sense of well-being and encourages people to be more active on a regular basis. "Walking" Georgia using a virtual map, helps maintain interest and serves as an intrinsic reward for being active and logging that activity.

Back to Overview

Research Hypothesis, Purpose, or Objective: The purpose of this randomized controlled trial was to evaluate the effect of an easily implemented automated telephone intervention on glycemic control and self-monitoring of blood glucose frequency in patients with type 2 DM. Previous research has not adequately examined the effects of isolated telephone interventions in patients with type 2 diabetes and the research that has been conducted has not been grounded in theoretical principles that regulate health-related behavior. This study attempted to address these gaps in the literature. The primary aim of this study was to determine the impact of a daily, automated telephone intervention on HbA1c levels compared to standard care in adults with type 2 DM. The secondary aim was to determine the impact of the automated telephone intervention on SMBG frequency in adults with type 2 DM. The tertiary aim of the study was to determine the impact of the automated telephone intervention on self-reported severity of diabetes, susceptibility to complications of diabetes, and the benefits and barriers of self-management of diabetes compared to standard care in adults with type 2 DM.

Study/Design Methods: An experimental pretest post-test design was used. A convenience sample of 120 participants was recruited from two clinics at the University of Minnesota, a primary care clinic and an endocrinology clinic. In addition to usual care provided by the clinics, participants randomized to the telephone intervention received a daily, automated, pre-recorded voice message relaying a short (less than one minute) message related to type 2 DM. Participants randomized to control condition received usual care provided to patients with diabetes by the clinics.

Results: No significant differences between the telephone and control groups on mean change HbA1c were found, suggesting no treatment effect. There was a significant difference in mean change in daily SMBG frequency between the telephone and comparison group. The telephone group had a mean increase in SMBG frequency of 0.66 ± 1.1 time per day and the comparison group had a mean increase in SMBG frequency of .05 ± 0.8 times per day (p = <.001). There was a trend in favor of the treatment group on changes in exercise barriers and changes in positive attitudes.

Conclusions: This study addresses a gap in understanding the effects of isolated telephone interventions on physiologic, behavioral, and psychosocial outcomes in adults with type 2 DM. No overall treatment effect was seen on change in HbA1c, but a significant dose effect was observed. Participants who listened to the majority of the phone messages showed significant improvements in HbA1c. The automated telephone intervention in this study had a significant impact on daily frequency of SMBG, suggesting that regular contact between scheduled clinic visits enhances adherence to this self-care behavior. The intervention showed positive trends in favor of changes in perceived severity to DM complications, improvement in favorable attitudes toward diabetes, and reductions in perceived exercise barriers. The findings from this study are clinically important and add to the body of literature that suggests that contacting people between regularly scheduled clinic appointments improves self-care behaviors.

Back to Overview

Back to Overview

T13
Taking Our Message to the Masses

Janis Roszler, RD, CDE, LDN
Manager
Diabetes Directions LLC, Miami Beach, FL

Nearly 24 million Americans have diabetes, yet very few get an opportunity to meet face-to-face with a diabetes educator. Janis Roszler, AADE's 2008-2009 Diabetes Educator of the Year, award-winning medical media producer, author, radio host and television consultant, will help explain how to use different forms of media to take valuable diabetes information to a much wider audience.

UPN: 069-000-09-183-L04-P

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Back to Overview

Back to Overview

What better place for health promotion/disease prevention than the kitchen? Rediscover the joy of cooking for yourself, and inspire your patients to cook healthful, fast meals with delicious new recipes. The Physicians Committee for Responsible Medicine has gathered a star panel to present the science and practical considerations behind low-fat, plant-based nutrition, and enthusiastic chefs to provide expert instruction and delicious samples. Useful resources and recipes for patient nutrition education will be provided.

Back to Overview

This case-based, interactive activity will emphasize a multidisciplinary team-based approach to optimize the care of patients with type 2 diabetes mellitus (T2DM). The program will include a review of current challenges and barriers to effective management of T2DM, an overview of the role of self-management in improving outcomes and quality of care, and a discussion of current recommendations and approaches to goal-setting, treatment, adherence, and counseling of patients with early T2DM.

Back to Overview

This case-based activity will introduce a pathophysiological-based treatment algorithm, and considerations beyond A2C and their importance to good outcomes will be discussed (ß-cell health, weight, cardio metabolic risk). A clinical psychologist will highlight patient motivation, behavior change and compliance. A registered dietician will discuss eating plans, continuous glucose monitoring, and postprandial glucose control. A nurse will review the continuum of treatment and summarize the role of OHAs, basal insulin, and GLP-2 analogs in a pathophysiological-based treatment approach.

Back to Overview

This program is designed to increase awareness and understanding of individualizing therapy in type 2 diabetes to achieve optimal glycemic control and the patient education aspects related to successful implementation of incretin mimetics in this approach. The program is designed to meet educational needs across the spectrum of healthcare providers (HCPs) involved in the treatment and education of patients with type 2 diabetes.

Back to Overview