Overview of Diabetes
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1 Overview of Diabetes Clinical Services Kena K. Desai MS, MD Diabetes Physician Consultant Alaska Native Tribal Health Consortium Date: 07/30/2015
2 Diabetes Services Our Vision: A life free of diabetes and its complications for all Alaska Native People. Our Mission: A multidisciplinary team of diabetes content experts who work in partnership with the Alaska Tribal Health Service to serve as a resource for diabetes care, prevention and surveillance
3 Diabetes Services Our Multidisciplinary Team Includes: I. Clinical Team: a. Physician Kena K. Desai MS, MD b. Nurse Practitioner Ann Marie Mayer MPH, NP c. Pharmacist and Diabetes Director Judy Thompson PharmD, CDE d. Nutritionist and Insulin Pump Trainer Angela Manderfeld RD, CDE e. Physical Therapist and Foot Expert - Sandy Graham PT
4 II. Research, Surveillance and Registry SDPI grant - monitoring pre-diabetes, diabetes and its complications years - Meera Narayanan RD, CDE - Cynthia D. Schraer MD III. Community Education Team Community and Health Aide Education - Luz Smeenk MS, RD - Theresa Hicks RD, CDE IV. Support Team: - Nurse Case Manager Jennifer Brusehaber RN - Diabetes Secretary Joan Hastie CAP
5 Our Patients have Pre-Diabetes or Diabetes: Self referred patients Consultations from Primary Care Providers - New Diagnosis of Type I Diabetes - Transition of pediatric patients with Diabetes to adult care - Difficult to treat Diabetes - Patient needing more education about Diabetes as a means of improving compliance - Education about medications or mitigating adverse effects of medications - Initiation of Insulin - Evaluation, Placement and Management of patients on Insulin Pumps and Continuous Glucose Monitors - Carbohydrate Counting Consultations from Inpatient Services - Admissions for Diabetic Ketoacidosis, Hypoglycemia, Diabetic foot ulcers - Complications of Diabetes, such as Coronary Artery Disease, Strokes, Severe Infections
6 Our Care Consists of: - Evaluation of risk factors for Diabetes and its complications - Setting appropriate goals for Diabetes Management - Tailoring Medications and Lifestyle Modifications to meet and maintain those goals - Diabetic Foot Exam - Consultation with Pharmacist for an evaluation of medications and vaccinations - Consultation with Nutritionist for dietary and lifestyle modifications - EDUCATION, EDUCATION, EDUCATION
7 EDUCATION: Patients, Providers, Health Aides, Administrators, Our Children, Our Families, Our Community, Our Country, Our World
8 In Person Visits For optimal patient visits, the following clinical workup is recommended before the referral/visit: A patient that is willing to learn A date of Diagnosis HgBa1c at time and diagnosis and most recent A complete list of all oral and injectable medications with doses History of hospitalizations for DKA, HHS or hypoglycemia History and date of complications of Diabetes Coronary Artery Disease, Strokes, Diabetic Foot Ulcers, Lower Extremity Amputations, Retinopathy, Nephropathy A Vaccination History ex. Pneumovax, Prevnar 13, Hep B series, TB testing or treatment
9 Field Clinic An Extension of our clinic at ANMC New Diagnosis of Pre-Diabetes or Diabetes Patients with Type I Diabetes Patients with poorly controlled Diabetes Well Establish Patients presenting for follow-up Patient Evaluations for Insulin Pumps Educational Lectures for Providers and Staff In the future: - Group Sessions for Patients
10 Video Tele-Conference Visits An Extension of our clinic at ANMC In the office Follow-up patients that have been evaluated and examined by Kena Desai MD or Ann Marie Mayer NP at ANMC (Diabetes Clinic), ANTHC (Inpatient) or in Diabetes Field Clinic New Patients only under special circumstances and with a firm plan for followup in person within the next 2 weeks Provider, Diabetes Coordinator and Health Aide - Guidance - Education - Questions
11 Advanced Diabetes Health Aide Course
12 Publications News You Can Use Diabetes Dispatch
13 Alaska Native Diabetes Conference Shares our vision Connects our partners Premiere resource for Evidence based Diabetes care Traditional foods Local Food resources 2015 will be our 31 st conference year
14 Contact Information Diabetes Clinic: Dr. Kena Desai: , - Judith Thompson (Diabetes Director and Pharmacist): , -
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