Manis-Conversation map - Slides by KevenMealamu

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									                                                            Why refer patients to DSMT

New approaches to Diabetes                                     Greater longevity/ fewer complications
                                                               Reduced hospitalization rates- 25% for those
Self Management Training                                       with diabetes education vs. 38% for those
                                                               without education- 25% reduction
        Betsy Manis, RD, LD, CDE                               Reduced hospital bills-$11,571 fewer hospital
        Hillcrest Center for Diabetes                          charges ( Diabetes care, 2008)
                Management                                     5% reduction in per member per month cost,
                                                               from $959 to $ 905/month
                                                               ADA Standard of care for newly diagnosed




What is Diabetes Self Management
                                                            Diabetes self management training
Training (DSMT)?
   Empowers person with diabetes to learn self care            Healthy eating
   skills and control their diabetes
                                                               Being active
   Team includes dietitian/nurse trained in diabetes .
   Exercise physiologists, pharmacists and health
                                                               Monitoring
   behavior specialists as resource instructors. Many are      Taking medication
   Certified diabetes educators (CDE’s)
                                                               Problem solving
   HCDM has been an ADA Recognized programs since              Reducing risks
   1994 and meets National Standards for excellence in
   diabetes education                                          Healthy coping




Is DSMT a covered benefit?                                  Criteria for Diagnosis of diabetes

  Medicare covers 10 hours of initial education                A1C greater than 6.5- new
  the first year after referral and 2 hour refresher
  annually                                                     Fasting BG greater than 126 on 2
  Medicare also covers 3 hours of Medical                      separate occasion
  Nutrition Therapy first year/2 hours every year              Random BG of over 200 with poly
  afterward
                                                               symptom
  Most payors cover DSMT ( House Bill 3021)
  Diabetes centers must be ADA recognized to                   2 hr. BG greater than 200 during OGGT
  receive reimbursement                                        Prediabetes- Fasting- 100-125 or 2 hr. of
  Insurance coverage verified prior to apt.                    140-199




                                                                                                               1
Diabetes Conversation Maps               Overview of Diabetes

                                           Explains diabetes and resolves common
  Visual learning with active dialogue     myths
  between patients and educators
  Enables patients to explore key
                                           Explains blood glucose and insulin
  information on a personal level
  Encourages active listening and
  engagement                               Encourages the use of a plan, a support
                                           network, and a health care team
  Patient centered approach




                                         Diabetes Myths




Diabetes Myths                           Diabetes Myths




                                                                                     2
Diabetes Myths                   Healthy Eating

                                    Describes the relationship between food
                                    and diabetes
                                    Describes how what one eats, how much
                                    one eats and when one eats can affect
                                    blood glucose
                                    Discusses meal planning and other
                                    strategies for healthy eating




Healthy Eating Map               New Diabetes Nutrition Guidelines

                                    No “ADA diabetic diet” or cookie cutter
                                    approach
                                    Carbohydrates turn to bg 100% in 20
                                    minutes-1.5 hours, protein 50%,fat 10%
                                    Space out carbs- 2-3 portions (30-45
                                    grams) per meal/ women: 3-4 portions
                                    (45-60grams) per meal/men as a start
                                    Healthy eating




                                 Monitoring Your Blood Glucose and
Plate Method of Healthy Eating
                                 Using the Results

                                    Explains blood glucose targets and how
                                    to recognize levels
                                    Explains what can make blood glucose
                                    go up and down and how to prevent big
                                    excursions
                                    Explains how the manage diabetes by
                                    using test results




                                                                              3
             Natural Course of Diabetes

                Explains the natural course of diabetes

                Explains the potential long-term
                complications of diabetes

                Helps a person with diabetes to check
                for long-term complications




             In summary

                DSMT makes a difference – It lowers AIC’s

                Over the long term, a single % decrease in
                A1C is associated with 25% in diabetes
                related deaths, 18% reduction in MI, 35%
                reduction in risk of macro vascular disease

                A single % increase in A1C is associated with
                an increase of 10% in ischemic heart disease
                and 17% in stroke




Questions?




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