National Diabetes Education Program (NDEP) Diabetes Education Materials Kathleen Wolff, APRN, MSN, BC-ADM Overview Purpose and goals of NDEP materials Tailor the materials to the patient -General Information -Information for elderly adults -Nutrition -Foot care -Cardiovascular disease -Hypertension and kidney disease -Information for family members 1
Development of NDEP Materials National Diabetes Education Program (NDEP) The National Diabetes Education Program (NDEP) is jointly sponsored by the Centers for Disease Control and Prevention and the National Institutes of Health Partners NDEP partners with more than 200 public and private organizations concerned about diabetes and the health status of their members Purpose Increase awareness and understanding of the seriousness of diabetes, its risk factors, and effective strategies for preventing diabetes and its complications among groups at risk. 2
General Diabetes Information Newly diagnosed or needs review of basic information More likely to read very brief 2 page hand out Needs narrow focus on blood sugar and A1c If you have diabetes..know your numbers! (2 pages) If you have diabetes.know your numbers Document was used with 17-18% of patients. Why so popular? 3
Comprehensive Diabetes Information Newly diagnosed or needs review of diabetes Desires more detailed information about comprehensive management of diabetes and the ABCs Can appreciate a 17-page handout Desires to keep records of blood sugar, lipids and BP 4 Steps to Control your Diabetes For Life (15 pages) 4 Steps to Control your Diabetes For Life Document used with only 7-9% of patients. Why is it unpopular? 4
General Diabetes Information with Focus on Elderly Patients Used in 15% of patients Is elderly Needs detailed information about blood glucose monitoring and blood sugar management Needs general info about the ABCs Needs information about Medicare coverage for diabetes management and supplies The Power To Control Diabetes Is In Your Hands: Information About Diabetes and Related Medicare Benefits (8 pages) The Power To Control Diabetes Is In Your Hands: Information About Diabetes and Related Medicare Benefits Used with 15% of patients 5
Detailed Nutrition Information and Recipes Has an interest in diabetes-friendly recipes Desires very detailed information about nutrition and eating a healthy diet Needs general information about diabetes management, making lifestyle changes, and the ABCs Tasty Recipes for People with Diabetes and Their Families (31 pages) Tasty Recipes for People with Diabetes and Their Families #1 Favorite handout! Given to 25% of pts. 6
Brief Overview of Nutrition and One Recipe Needs a very general and brief overview of healthy eating strategies Desires 1 fairly easy recipe for a heart-healthy, diabetes friendly main course A Diabetes Friendly Meal Everyone Can Enjoy (1 page) Comprehensive Foot Care Information Has pre-existing foot problems or risk factors (neuropathy, peripheral vascular disease, deformities, etc.) and is at risk foot ulcers and amputation Has no known foot problems Wants very detailed and comprehensive information on primary and secondary prevention of foot ulcers and amputation Take Care of Your Feet for a Lifetime (12 pages) 7
Take Care of Your Feet for a Lifetime Given to 15-20% of patients Cardiovascular Disease Prevention and Treatment Not too popular given to 1-2% of patients. Why? You are the heart of your family.take care of it (8 pages, Spanish and English on same page) The Patient Has existing cardiovascular disease Is at risk for cardiovascular disease Needs very general information about controlling cardiovascular disease risk factors 8
Hypertension and Renal Disease Has known kidney disease Is at risk for kidney disease Needs detailed information about the causes and treatment of HTN including medication and dietary management High Blood Pressure and Kidney Disease (5 pages, NIDDK) High Blood Pressure and Kidney Disease Not too popular. Given to 5-6% of patients. 9
General Diabetes Information For Family and Friends Tips for helping a person with diabetes (2 pages) Has a family member or friend who wants to be of assistance but is unsure of how to best do so New Additions Most were reviewed and updated in 2011 Most are only 1-2 pages 10
African Americans, Diabetes, and Heart Disease: How to Beat the Odds by the National Diabetes Education Program African Americans are at increased risk for type 2 diabetes, and two out of three people with diabetes die of a heart attack or stroke. This is serious business. But you can work to beat the odds. You can take action to help prevent heart attack and stroke. For people with diabetes, a key to preventing heart attack and stroke is to control the ABCs of diabetes: blood glucose ( sugar ), blood pressure, and cholesterol. A is for the A1C, a test measuring average blood glucose control over three months. B is for blood pressure. C is for cholesterol. Take control. Ask your health care provider what your ABC numbers are, what they should be, and what you can do to reach those goals. And during American Heart Month, the National Diabetes Education Program (NDEP) offers some lifestyle tips for how people with diabetes can help prevent heart attack and stroke and live a long, healthy life. Be physically active everyday. Playing sports, dancing, walking, or even doing household chores help you lose weight and lower your blood pressure. Aim to get at least 60 minutes of physical activity, most days of the week. Eat less fat and salt. Instead of reaching for the salty fries, choose a side salad. Add more fiber to your diet by choosing whole grains, vegetables, and beans. ATTENTION MEN! Control Your Diabetes. For Life And For Your Family. by the National Diabetes Education Program An estimated 13 million men age 20 or older currently have either diagnosed or undiagnosed diabetes in the United States. That s nearly 12 percent of males over the age of 20 in the U.S. If left undiagnosed or untreated, men with diabetes can face serious health problems associated with diabetes, such as heart attack and stroke. Diabetes can also lead to erectile dysfunction, kidney disease, loss of a toe or foot, and blindness. Taking good care of yourself and managing your diabetes can help you avoid the health problems associated with diabetes. Here are some important steps: Men with diabetes can lower their chances of having a heart attack, stroke, or other diabetes-related health problems by managing the ABCs of diabetes A1C, Blood Pressure, and Cholesterol. A is for the A1C test. It measures your average blood glucose level over the past three months. The goal for many people with diabetes is below 7. B is for blood pressure. High blood pressure makes your heart work too hard. The goal for most people with diabetes is below 130/80. C is for cholesterol. Bad cholesterol, or LDL, builds up and clogs your arteries. The LDL goal is below 100. Men with diabetes should take action to manage their diabetes. Develop a self-care plan 11
Healthy Eating During Winter Gatherings for People with Diabetes Follow these tips from the National Diabetes Education Program (NDEP) to help you eat healthy during gatherings throughout the winter season: Plan ahead. Check out the party food options before you begin eating, and make a mental note of what and how much you will eat. Your food choices should fit into your meal plan. Bring a dish. Share your healthy dish with family and friends. Move away from the buffet. Fix your plate, and then step away from a table of finger foods to avoid grazing while chatting. Savor the flavor. Eating slowly reduces your chances of overeating. ollow these tips if your goal is to serve healthy feasts to your guests: Trim it down. Eat smaller portions of food. Trim off extra skin and fat from meat. Drink H2O. Water is a healthy Easy on the toppings. Lighten your recipes by using reduced-fat or fat-free mayonnaise, butter, sour cream, or salad dressing. Increase fiber. Serve whole grain breads, peas, and beans as part of your meals. Bake it. Broil it. Grill it. Consider healthy alternatives to traditional meats. Control Your Diabetes. For Life. by the National Diabetes Education Program Here s what we know about controlling blood glucose (blood sugar) in people with diabetes: It s not easy, but it can be done. It requires vigilance and resolve. And it can save your life. A recent study by the National Institutes of Health (NIH) has answered one of the most important questions about diabetes: Can glucose control lower the risk of heart attacks and strokes? The answer is yes intensive glucose control can reduce the risk by more than half. From 1983 to 1989, the NIH-sponsored Diabetes Control and Complications Trial (DCCT) randomly assigned a large number of people with diabetes to an intensive or conventional treatment group. Those in the intensive group were held to a stricter level of glucose control and were required to self-monitor their own glucose levels throughout the day. The DCCT ended in 1993 after conclusively demonstrating that intensive control better protected against damage to the eyes (retinopathy), kidneys (nephropathy), and nerves (neuropathy) 12
Five Facts About Diabetes By Griffin P. Rodgers, M.D., M.A.C.P., Director, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) With so much health information readily available, it s often hard for the nearly 26 million Americans living with diabetes to separate fact from fiction. To help people with diabetes better understand how to manage the disease, the National Diabetes Education Program provides five facts about diabetes. Fact #1: Diabetes is a serious disease. It can lead to serious complications such as heart attack, stroke, blindness, kidney failure, and lower limb amputations. People with diabetes can take steps to manage it and lower their risk for complications. Make healthy food choices, be physically active, and stay at a healthy weight. Good diabetes care includes managing the ABCs of diabetes as measured by the A1C test, blood pressure, and cholesterol to help avoid having a heart attack, stroke, or other problems. Fact #2: The only way to know for sure what your levels are is Be Sweet to Your Feet if You Have Diabetes By the National Diabetes Education Program Taking care of your feet is very important for people with diabetes. Good foot care helps reduce your risk for serious foot problems that can lead to amputations. To decrease your risk of foot problems, learn to manage the ABCs of diabetes. This means keeping your blood glucose (as measured by the A1C test), blood pressure, and cholesterol in the target range recommended by your health care provider. Ask your health care provider about your diabetes ABCs and how to do a foot exam at home. Be sweet to your feet by following these foot care tips: Check your feet every day (evening is best) for cuts, blisters, red spots, swelling, and sore toenails. If you have trouble bending over to see your feet, use a plastic mirror or ask a family member or caregiver to help. Wash your feet every day in warm water, and be sure to dry well between the toes. Rub a thin coat of skin lotion on the tops and bottoms of your feet, but not between your toes. Trim your toenails carefully and straight across when needed. See your podiatrist if you need help. Never walk barefoot, and wear comfortable shoes that fit well and protect your feet. Nerve damage can cause loss of feeling. Look and feel inside your shoes before putting them on. Ask your team about getting special shoes. Keep the blood flowing to your feet by wiggling your toes and moving your ankles up 13
Implementation in Clinic Are materials currently stored in a place that is easily accessible? Who has been most likely to use the materials with the patient? (MD, NP, RD, RN, LPN) At what point in patient visit are the materials most likely to be used? (Waiting for visit, during vital signs, at the end of a clinic visit, after the clinic visit) Summary Collaboration between national health organizations to create diabetes education materials Collaboration between Vanderbilt University and Tennessee State Health Departments to improve the health of people with diabetes Enhance clinical care with good patient education materials 14
Questions or Comments? 15