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Preventing and Managing Diabetes Through Community Resources

Preventing and Managing Diabetes Through Community Resources. Liz Kitchen MS, RD, LD Diabetes Coordinator Ohio Department of Health 11.17.2016. Objectives. To have an understanding of: The difference between type 2 diabetes and prediabetes The Diabetes Prevention Program (DPP)

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Preventing and Managing Diabetes Through Community Resources

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  1. Preventing and Managing Diabetes Through Community Resources Liz Kitchen MS, RD, LD Diabetes Coordinator Ohio Department of Health 11.17.2016

  2. Objectives • To have an understanding of: • The difference between type 2 diabetes and prediabetes • The Diabetes Prevention Program (DPP) • The Diabetes Self-Management Program (DSMP) • The Diabetes Self-Management Education Program (DSME) • How to locate and refer to DPP, DSMP and DSME

  3. What is Type 2 Diabetes?What is Prediabetes?

  4. Type 2 Diabetes - Definitions

  5. Type 2 Diabetes - Process Source: http://www.nationwidechildrens.org/what-is-diabetes

  6. Type 2 Diabetes - Risk Factors Symptoms: • Blurry Vision • Increased Thirst • Increased Urination • Tired • Weight Loss • Infection • Slow to Heal • Loss of Feeling in Feet Risk Factors: • Age (> 45 years old) • Overweight/Obese • Physical Inactivity • Stress • Ethnicity • Gestational Diabetes • High Blood Pressure • High Cholesterol Source: http://www.cdc.gov/diabetes/pubs/statsreport14/diabetes-infographic.pdf

  7. Prediabetes - Definitions Source: https://www.niddk.nih.gov/health-information/diabetes/types/prediabetes-insulin-resistance

  8. Source: https://www.niddk.nih.gov/health-information/diabetes/diagnosis-diabetes-prediabetes

  9. Prediabetes – Risk Factors • Risk Factors for Prediabetes/Increased Risk for Type 2 Diabetes: • Age (> 45 Years Old) • Overweight • Family history of type 2 diabetes • High blood pressure • < 3x/week physical activity (physical inactivity) • Gestational diabetes or baby > 9lbs. Source: https://www.cdc.gov/diabetes/prevention/prediabetes-type2/index.html

  10. What is the Prevalence of Prediabetes and Diabetes?

  11. Untreated Prediabetes/Diabetes If Left Untreated: Prediabetes  Diabetes Increased Risk and/or Complications: Nerve Damage Hearing Loss Infection Oral Health Peripheral Artery Disease • Blindness • Kidney Failure • Heart Disease • Stroke • Amputation Source: http://www.cdc.gov/diabetes/pubs/statsreport14/diabetes-infographic.pdf

  12. 2014

  13. Prediabetes – National/State Stats • Without intervention, 15% – 30% of people with prediabetes will develop type 2 diabetes within 5 years • 35% of adults in Ohio have prediabetes • Prediabetes CAN be reversed Source: http://www.cdc.gov/diabetes/prevention/prediabetes-type2/index.html

  14. What Community Resources Are Available to Help Reduce Type 2 Diabetes?

  15. Diabetes Prevention Program (DPP) • CDC-recognized evidence-based lifestyle change program • Empowers individuals to take charge of their health and well-being • Helps make real lifestyle changes: • Eating healthier • Increasing physical activity • Improving problem-solving & coping skills

  16. DPP – Research • N-DPP is based on NIH Research • Structured lifestyle change program can reduce risk of developing type 2 diabetes by 58% • 71% in those over 60 years old • Program helped people lose 5-7% body weight • Even after 10 years, participants who completed the program were 1/3 less likely to develop type 2 diabetes • Aiming for 150 minutes of physical activity and eating healthy Diabetes Prevention Program Research Group. “Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin.” New England Journal of Medicine 346 (2002): 393-403. Web.16 May 2016 Diabetes Prevention Program Research Group. “10-Year Follow-up of Diabetes Incidence and Weight Loss in the Diabetes Prevention Program Outcomes Study.” Lancet 374.9702 (2009): 1677–1686. Web. 16 May 2016.

  17. DPP – Eligibility • Overweight Adults (18+) with a BMI > 24; >22 if Asian AND • No previous diagnosis of type 2 diabetes AND • Have a blood test in prediabetes range within past year (min. 50%) • HgA1c: 5.7% – 6.4% • Fasting Plasma Glucose: 100 – 125 mg/dL • Two-hour plasma glucose (75gm load): 140 – 199 mg/dL OR • Previous GDM diagnosis

  18. CDC/ADA Prediabetes Risk Assessment

  19. DPP – Program Structure • 12-Month Program • Months 1-6 : 1x/week • Months 6-12: 1-2x/month • Programs may run months 6-12 a variety of ways • Sessions are taught by a trained Lifestyle Coach • CDC developed curriculum • Programs may submit their own curriculum to CDC for approval

  20. DPP – Class Sessions Participants will learn: Program requires tracking of: Food Log Physical Activity Goals Weight • Healthy Eating • Adding/Increasing Physical Activity • Coping with Stress • Handling Challenges (i.e., dining out)

  21. Populations Coverage of CDC Recognized DPP locations within 15 and 30 minute drive times FYI: You will not count 19 DPPs, because many locations are within the vicinity of each other so, when looking at the statewide view, they appear as one dot.

  22. DPP – Locations in Ohio • Check Out The “ Find a Program Near You” Map • https://nccd.cdc.gov/DDT_DPRP/Programs.aspx • See a List of the 20 DPP Sites • https://nccd.cdc.gov/DDT_DPRP/Registry.aspx?STATE=OH

  23. What Media Resources Are Available to Help Reduce Type 2 Diabetes?

  24. Prediabetes Awareness Campaign Overview • National Public Service Advertising (PSA) campaign • Created by ADA/AMA/CDC in partnership with Ad Council • Campaign raises awareness about prediabetes • PSAs developed to encourage adults to take a simple online test to learn their risk of prediabetes and take steps to reverse the condition

  25. Prediabetes Awareness Campaign

  26. Prediabetes Awareness Campaign Target Audience • 40-60 year olds • Diagnosed or undiagnosed prediabetes • Taking the Prediabetes Risk Assessment allows them to learn their risk and know where they stand • Prediabetes diagnosis prompts people to make the lifestyle changes necessary to reverse the condition • DPP

  27. Prediabetes Awareness Campaign • Campaign Rolled Out: January 2016 • Campaign Expires: • TV and Radio: 1/21/2017 • Print, poster, outdoor and interactive: 7/31/2017 [Dates may be extended so stay tuned!]

  28. Prediabetes Awareness Campaign • Resources Available • Risk Assessments • Posters • Billboards/Bus Ads • Radio Spots • Newsletters • Facebook/Twitter • Postcards

  29. Prediabetes Awareness Campaign

  30. Prediabetes Awareness Campaign Print Materials

  31. Prediabetes Awareness Campaign Social Media Materials • http://socialmediakit.adcouncil.org/presskit/prediabetes/ • Share with partners and networks • Contains Facebook, Twitter, Hashtags, Statewide Stats/Graphics • English and Spanish

  32. Social Media Examples

  33. Prediabetes Awareness Campaign • Public Facing Site • https://doihaveprediabetes.org/ • Contains ADA Prediabetes Risk Assessment • Reversing Prediabetes • DPP page and link to CDC DPPs • Link to Lifestyle Tips and ADA Website • FAQs

  34. Prediabetes Awareness Campaign • How to use the resources? • Put posters in clinic exam, waiting rooms, churches, community centers • Hand out risk assessments to community members • Distribute postcards/resource cards at community events

  35. Prediabetes Awareness Campaign • Need additional print materials? • Complete the survey with your material request https://www.surveymonkey.com/r/PrediabetesResources Please Allow Time for ODH to Process and Mail your Request!

  36. What Community Resources Are Available to Help Manage Type 2 Diabetes?

  37. Diabetes Self Management Resources • Diabetes Self-Management Program (DSMP) • Stanford • Diabetes Self Management Education (DSME) • American Diabetes Association (ADA) • American Association of Diabetes Educators (AADE)

  38. DSMP (Stanford) • DSMP developed by Stanford University • Eligibility: Type 2 diabetes • Educates on the management of type 2 diabetes • Workshops take place in community settings Source: http://patienteducation.stanford.edu/programs/diabeteseng.html

  39. DSMP (Stanford) – Research • Original program developed in Spanish • Successful workshop • Grant received to offer workshop in English • Tested effectiveness of English speaking workshop • 6- & 12-month post English workshop • Improvements in depression, hypoglycemia, healthy eating, physician communication and reading food labels Source: http://patienteducation.stanford.edu/programs/diabeteseng.html

  40. DSMP (Stanford) – Program Structure • 6-Week Program • 1x/Week • 2.5 Hours • Facilitated by a pair of peer leaders • Curriculum developed by Stanford • Companion book: Living a Healthy Life with Chronic Conditions, 4th Edition Source: http://patienteducation.stanford.edu/programs/diabeteseng.html

  41. DSMP (Stanford) – Workshop Sessions Subjects covered include: • Techniques to deal with: • Diabetes • Fatigue • Pain • High/Low Blood Sugar • Stress • Emotional Problems Source: http://patienteducation.stanford.edu/programs/diabeteseng.html

  42. DSMP (Stanford) – Workshop Sessions Subjects covered include: • Exercise techniques for strength and endurance • Healthy eating • Medication use • Working with Healthcare Providers Source: http://patienteducation.stanford.edu/programs/diabeteseng.html

  43. DSMP (Stanford) – Locations in Ohio • Check out the “Organizations Licensed to Offer the DSMP” list • http://patienteducation.stanford.edu/organ/dsmsiteohio.html • See a list of Area Agencies on Aging (AAA) Regions • https://aging.ohio.gov/resources/areaagenciesonaging/

  44. Diabetes Self-Management Education (DSME) • Collaborative process for participants with diabetes to gain knowledge and skills to modify behavior and self-manage the disease and its conditions • Incorporates needs, goals, and life experiences • Guided by evidence-based standards • Eligibility: Type 2 diabetes Source: https://www.diabeteseducator.org/practice/diabetes-education-accreditation-program-(deap)

  45. DSME (ADA/AADE) – Research • Program can be self-developed by organization • Must meet National Standards for Diabetes Education and Support • Standards reviewed and revised every 5 years • Must meet standards for CMS reimbursement

  46. DSME (ADA/AADE) – Program/Sessions As long as programs meet AADE National Standards, they can vary based on structure and sessions Programs can be taught by a CHW, Diabetes Educator, Dietitian, RN Source: https://www.diabeteseducator.org/practice/diabetes-education-accreditation-program-(deap)

  47. DSME (ADA/AADE) – Locations in Ohio • Check out the AADE website for a list of accredited programs • https://nf01.diabeteseducator.org/eweb/DynamicPage.aspx?Site=aade&WebCode=DEAPFindApprovedProgram • Check out the ADA website for a list of accredited programs • http://professional.diabetes.org/erp_list?field_erp_state_value=OH&=Apply

  48. QUESTIONS? Ohio Department of Health Bureau of Health Promotion Liz Kitchen MS, RD, LD, Diabetes Coordinator Liz.Kitchen@odh.ohio.gov

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