CV Disease Risk Management – ADA 2018 Update

After the American Heart Association set a new B/P target of 130/80, the diabetes world held their breath to see if the American Diabetes Association (ADA) would follow suit and lower it’s BP target. 

The ADA maintains the B/P target of 140/90, based on a comprehensive review of studies measuring the cost/benefit of blood pressure control in people with diabetes. They specifically summarized the ACCORD BP trial findings (see below paragraph*).

Current ADA Recommendations are as follows:

Hypertension, defined as a sustained blood pressure more than or equal to 140/90 is a major risk factor for both CV and microvascular complications. Numerous studies demonstrate  that antihypertensive therapy reduces CV events, heart failure, and microvascular complications.

*”In ACCORD BP, compared with standard blood pressure control (target systolic blood pressure <140 mmHg), intensive blood pressure control (target systolic blood pressure <120 mmHg) did not reduce total major atherosclerotic cardiovascular events but did reduce the risk of stroke, at the expense of increased adverse events. The ACCORD BP results suggest that blood pressure targets more intensive than <140/90 mmHg are not likely to improve cardiovascular outcomes among most people with type 2 diabetes but may be reasonable in selected patients who have been educated about added treatment burden, side effects, and costs.”

For more info please see the Cardiovascular Disease Management- American Diabetes Association Standard of Care – Jan 2018

 

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Want to learn more about this and other topics?

• Join our Standards of Care Webinar – Jan 19, 2018

• Cholesterol Medications Cheat Sheets 2016 

• Antihypertensive Meds Cheat Sheets 2016

• Join our Meds Update Webinar – Feb 19, 2018
• Download CDCES Coach App – FREE

Main Message from ADA – Individualize approach and focus on eating nutrient dense foods

The ADA Standards of Care, states that there is no ideal percentage of calories from carbs, protein and fat. The key is to individualize nutrition recommendations using a patient centered approach.  Emphasis is on healthy eating patterns which include nutrient dense foods and consumption of less added sugar and processed foods.

The ADA recommends a variety of eating plans based on available research.

Examples of Healthful Choices include:

• Mediterranean Diet
• DASH Diet
• Plant-based Diets
• Diabetes Plate Method

Common theme for the best diets includes more whole grains, fruits, vegetables, beans, nuts, fish and less processed foods and added sugars.

Resources

Best Diets for 2018 – Great NPR article that ranks diets from best to worse.

Joy of Six – Sugar Pledge Resource Page – Great tools and information to support eating less foods with added sugar.

Mediterranean Diet Info – from Oldways Website

Plant based eating resource page – Full of recipes, getting started resources and articles supporting the benefits of plant based eating.

DASH (Dietary Approaches to Stopping Hypertension). Here the NIH DASH Website provides research and links to patient and professional resources.

DASH Diet Info from US News

Oldways Website “inspiring good health through cultural food traditions”.  Oldways is a nonprofit food and nutrition education organization, with a mission to inspire healthy eating through cultural food traditions and lifestyles.  Includes cultural food info on plant based diets, Mediterranean Diet, Asian Diets and more. Lots of handouts and resources for patients and professionals.

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Want more info?

Visit our Diabetes Education Online University

Download our FREE CDE Coach App

The 2018 American Diabetes Association Standards of Care is here.

Interestingly, the ADA will update the Standards of Care even more frequently online, if new evidence or regulatory changes merit a critical update or addition.

In addition to some exciting new charts and verbiage, the Standards include an updated treatment algorithm for Type 2 diabetes and clarification around CV Risk and B/P management.

This version delves deeper into individualizing care, taking a patient centered approach and using language and phrases that put people first.

How to learn more:

2018 ADA Standards of Care Updated

This 90-minute course is an essential review for anyone in the field of diabetes. We summarize the 2018 updates to the American Diabetes Association’s Standards of Medical Care in Diabetes and provide critical teaching points and content for health care professionals involved in diabetes care and education.

The ADA Standards of Medical Care in Diabetes is a key resource for healthcare professionals involved in diabetes care, education, and support.

Topics Include:

• A review of changes and updates to the 2018 ADA Standards of Medical Care
• Identification of key elements of the position statement
• Discussion of how diabetes educators can
• Apply this information in their clinical setting

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Pre-Order 2018 ADA Standards of Care Booklet – $20

The book includes:

• ADA’s standards for diagnosing and treating diabetes
• Nutrition recommendations and principles
• Position statements on managing diabetes and its complications in various settings

 

 

Pre-Order 2018 ADA Standards of Care PocketChart – $4.99 

This small laminated folding chart includes the latest from the 2018 Standards of Medical Care in Diabetes.

The 2018 ADA Standards of Medical Care Pocket Chart is available in early January! Pre-order today and the chat will ship in early January.

 

 

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Download our FREE CDCES Coach App 

• ADA 2018 Standards of Care at your fingertips 

• Diabetes Medication and Insulin PocketCards™ 

• New interactive Question of the Week and CDCES Practice Tests

• Study Tools and Resources you need to prepare for the CDCES Exam

• Diabetes Online University—Earn CEs on your mobile device

“Childhood abuse, parental mental illness raise risk for type 2 diabetes in adulthood” 

Preventing diabetes starts with protecting our most vulnerable population, our children.

Childhood trauma, including sexual, physical and verbal abuse, raises the risk for developing type 2 diabetes in adulthood by as much as 57%, according to article in Journal of Diabetes and Its Complications. – Coach Beverly 

To learn more please read the article below:

Childhood abuse, parental mental illness raise risk for type 2 diabetes in adulthood – Heilo | in the journal plus

 

 

Holiday Survival Guide-10 Steps To Success >>

Even when everything goes according to plan, the holiday season can be stressful. We get out of our usual rhythms of sleep and work. There are travel negotiations, eating out, parties, counters filled with treats, kids on vacation and visitors.

What can we do to make it through the holiday season and be ready to embark on the new year feeling our best? We have ten strategies for you and your patients. And even if you can’t do all ten, just pick one or a few that you feel you can commit to and succeed with most of the time.

10 Steps to Survive the Holidays PDF – a handout that includes the info below to print and share with your friends, patients and colleagues!

1. Be a sleep warrior –
Americans are chronically under slept. Not getting enough sleep is associated with increased hunger, higher blood sugars, poor concentration, frequent illness and impaired problem solving. Make sure to give yourself the gift of at least 7 hours of sleep a night. This sleep will help you make the best choices for your health and will protect against illness and fatigue. You got this.

Goal:  Get at least 7 hours of sleep a night. You deserve it.
 

2. Keep active – Holidays can put our exercise plans to the test, but we have a few ideas for you. Invite friends and family to join you for an after meal stroll instead of plopping on the couch.   After meal walks lower post meal blood sugars and increase energy by getting muscles activated. And just 10 minutes of walking after meals can make a big difference.  Other ideas include; play catch or Frisbee, put on some music and get people dancing, rake leaves, organize a game of touch football, have family and friends sign up for a local walk event.

Goal:  Work toward 30 minutes of activity a day. 
 

3. Don’t forget the Fiber – With all the snacks and tempting foods, whole healthy foods may take a back seat.  Enjoy the abundance of seasonal vegetables, fruits, nuts and grains that are fiber rich and that decrease inflammation.  Examples include; yams, squash, mandarin oranges, almonds, pistachios, quinoa, kale, brown rice, warm oatmeal, salads and broth based soups.

Goal:  Strive to eat at least 25gms of fiber a day.
 

4. Enjoy the ultimate beverage – H20. 
Water is the perfect way to keep hydrated, replenished and keeps appetite in check. Add a splash of flavor with a jigger of fruit juice or fresh cucumbers, lime slices or a sprig of rosemary.  Be creative. Sparkling waters come in a vast variety of flavors, are calorie free and contain no artificial sweeteners.

Goal:  Keep hydrated by enjoying plenty of water.

5. Keep an eye on alcohol – While it’s true that red wine offers a beneficial anti-inflammatory compound called resveratrol, drinking too much alcohol can lead to unintended outcomes.  Studies show that we make poorer food choices if alcohol is on board. This can offer special challenges in party settings, where temptations are abundant. A drink of alcohol contains about 100 calories and mixed drinks have even more. In addition, alcohol can lead to low blood sugars, especially for those taking insulin or sulfonylureas.

Goal:  Limit alcohol to one drink a day women, two drinks a day for men.

6. You are already sweet enough – Holidays and sugar go hand in hand.  If possible, try and eat less than 6 teaspoons of added sugar (does not include natural sugars found in fruit and milk). This goal may not be realistic on all days, but aim for success 80% of the time.  Excess sugar intake can cause inflammation and buildup of fat in the liver. One strategy is to limit sugar intake during the day and save your 6 teaspoons for that special desert or parties.  When looking at labels, it is helpful to know that 1 teaspoon equals 4 gms of sugar. 

Goal: Limit sugar to 6 teaspoons a day.

7. Your teeth need extra special attention – Taking care of our teeth and gums improves health. Gum inflammation is associated with blood vessel inflammation. Swollen gums can also lead to increase in blood sugars. During the holidays, find time for regular oral hygiene. Your mouth (and dental team) will thank you.

Goal: Brush teeth at twice daily and floss at least one daily.

8. Keep connected to friends and family who love you just the way you are! – As enjoyable as holidays can be, reuniting with family can also cause stress and stir-up emotions. Feeling out of sorts can lead to stress eating and decrease self-care.  If possible, reach out to a trusted friend to share your feelings or keep a holiday journal. Consider bringing a favorite book along during your travels that you find inspiring and comforting.  Give yourself permission to steal away for some quiet time.

Goal: Self-care is important during the holidays.

9. Enjoy an Oxygen Cocktail – Studies show that when humans venture into natural outdoor settings, heart rate and blood pressure improve. Take a moment to appreciate the feeling of the air on your skin, take a deep breath of fresh air, try to find nests in leafless trees, listen to the animal sounds and bird songs and just enjoy that moment.

Goal: Step into nature daily.

10.   Take inventory of things that you are grateful for – 
 Find a moment each day to reflect on a few things that brought you joy or good feelings. Maybe it was your cousin who lent you her favorite sweater.  Or an Aunt who gave you the best hug.  Special moments with a best friend or an after dinner walk enjoying the fall leaves.  These small moments of connection and beauty are one of the most treasured gifts of the holiday season that linger in our hearts and memory long after we say our goodbyes.

Goal: Take note of special moments.

10 Steps to Survive the Holidays PDF – a great handout that includes the info above to print and share with your friends, patients and colleagues!

October 29th – World Stroke Day

“I never thought I could have a stroke, but I did! Let’s share these signs with our community. Early recognition and treatment saves lives. It saved mine.

Read my story here” -Coach Beverly

International Girl’s Day – October 11th

Here at Diabetes Education Services we believe in female empowerment and want to do everything we can to support the growth and well-being of our future generations. On International Girl’s Day, we want to celebrate our amazing sister organization Just One Person.

Just One Person is a model sustainable program that prepares girls in rural Kenya for post secondary opportunities, helping them develop economic independence that will guide them on the path out of poverty.

Diabetes Education Services partners with Just One Person to manufacture our Pancreas Partner. All profits from Pancreas sales are donated to Just One Person to help the girls pursue ongoing education and gainful employment. 

Mwanaidi, pictures here, helped create some of our beautiful Pancreas Partners, read her amazing story below:

“While Mwanaidi was waiting for admission to college she earned money by sewing the “pancreas pillows” that Diabetes Education Services sells in the US. She used a donated treadle sewing machine, a pattern designed by Just One Person (JOP) executive director, Emma Sisia and traditional “leso” cloth. After paying Mwanaidi for her labor, Diabetes Education Services donates the profit from the sale of the Pancreas Pillow to help fund school scholarships and seminars for other deserving girls in rural Kenya.   Other alumnae of JOP have followed suit and are continuing to produce these wonderful pillows to help ensure the sustainability of our program.”

 

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Pancreas Partner – A Fun Teaching Tool

All profits are donated to www.justoneperson.org

This pillow is soft and stuffed. The beta cells are represented by sparkly balls of different sizes. One side of the pancreas has a normal amount of beta cells, while the other side only has a fraction of normal cells to demonstrate the natural history of diabetes and beta cell loss. A great teaching tool when demonstrating the normal function of basal and bolus insulin. Kids, adults and health care professionals love the Pancreas Partner.

 

Victoza FDA approved to reduce heart attack and stroke! 

This medication update is available on our “Injectables that Lower Glucose” PocketCard.

You can download all of course medication PocketCards here:

To purchase our laminated accordion version please click here!

This new format will provide you and your staff easy access to all 4 cards at once!

Now get all 4 of our medication Pocketcards in a new accordion style format with 4 Insulin medications on one side and 4 Oral medications on the other side. 

Get your NEW pocketcards today – No shipping!  Each Accordion style card includes each of the following cards:

• Insulin Pocket Card
  • Front side: current insulins, including action times and dosing information
  • Back side: concentrated insulins with important teaching tips

• Injectables that Lower BG, Injectable/Insulin Combo and Inhaled Insulin
  • Front side: Listing of injectables with dosing and side effects info
  • Back side: Injectable/Insulin Combinations and Inhaled Insulin

• Oral Diabetes Medications – Complete listing of oral medications including dosing range and considerations.
• Combo Oral Medications –  Complete listing of all the combined oral medications including doses available