Know your Numbers The D5 Goals for Diabetes Care. Shelly Hanson RN, CNS, CDE Cuyuna Regional Medical Center November 6, 2014

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1 Know your Numbers The D5 Goals for Diabetes Care Shelly Hanson RN, CNS, CDE Cuyuna Regional Medical Center November 6, 2014

2 The D5 What is it 5 different treatment goals identified for optimal diabetes care. If all 5 goals are met successfully, risks for long term complications for diabetes are greatly reduced. Heart attack, stroke, nerve damage, kidney and eye damage. Diabetes patient and their healthcare team should know these five goals to work together for optimal diabetes care. State initiative State of MN collects data and publicly report how clinics are doing for optimal diabetes care.

3 What are the D5 goals Blood Pressure: 140/90mm/HG Cholesterol, LDL, less than 100mg/dl Blood Sugar, A1c, less than 8% Being tobacco free Taking an aspirin if appropriate These goals can be individualized as appropriate

4 Blood Pressure Blood Pressure is less than 140/90mmHG. Blood Pressure is how much force is exerted on arteries when a wave of blood is propelled from the heart. Two measurements taken: Systolic top number The amount of force on the arteries when the heart is contracting Diastolic bottom number The amount of force on the arteries when the heart is not contracting (during relaxation)

5 Blood Pressure cont d High blood pressure damages blood vessels and organs. Thicken, harden, weaken, bulge blood vessels. Signs & symptoms are usually absent. Lifestyle modifications can lower blood pressure. Medications.

6 Cholesterol Cholesterol, LDL, is less than 100mg/dl. LDL Bad Cholesterol. If there is more LDL in the blood stream than what our cells can absorb, then the LDL will lodge itself into the artery wall, contributing to athrosclerotic plaque heart disease. Lifestyle modifications can significantly lower LDL and significantly reduce risks for heart disease. Medications specifically statins very effective.

7 Blood Sugar Blood sugar, A1c, less than 8%. A1c shows blood sugar control over time, typically 3 months before blood draw. Shows how sugar-coated red blood cells are. High sugar levels in the blood damage blood vessels small vessels kidneys/eyes. Lifestyle modifications are pillars of treatment Medications

8 Blood Sugars Estimated Average Glucose (eag) A1c (%) eag (mg/dl) 5% % 111 6% % 140 7% % 169 8% % 197 9% % % % % % % 298

9 Tobacco Free Being tobacco free Smoking causes damage to blood vessels, thickens, narrows blood vessels, clots blood. Higher risk for having heart and stroke events. Smoking makes it harder to control diabetes. If nobody smoked, 1 out of 3 cancer deaths would not happen.

10 Aspirin Taking an Aspirin as appropriate. If a high risk of CVD and at least one additional major risk factor (high blood pressure, high cholesterol, smoking, protein in urine), Men over 50yrs, women over 60yrs. All of these areas damage blood vessels. Blood clots easier trying to repair vessels Aspirin keeps blood thinner, harder to clot harder to clog blood vessesls. Low dose aspirin (81mg) usually as effective as a regular aspirin dose & safer.

11 In Summary High blood pressure and high cholesterol are clear risk factors for cardiovascular disease. Smoking is a risk factor for CVD. Diabetes is a risk factor for CVD. For people living with diabetes, cardiovascular disease is the major cause of poor quality of life and death. (morbidity & mortality) Good news: there s evidence that the risk for heart disease & events in people with diabetes has improved significantly. D5 goals help lower chances of having cardiovascular event.

12 Cuyuna Regional Medical Center CRMC offers: Shared Medical Appointments 90 minute sessions. Meet 2 4 times/year. Patients with a diagnosis of diabetes. Healthcare team: clinician, certified diabetes educator, pharmacist. Both patient and healthcare team focus on D5 goals. Pertinent topics, guest speakers. Patient centered approach, comprehensive, meaningful.

13 For more information: If you have any questions about any of the services provided, feel free to contact the department directly at or visit

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