Diabetes in Our Diet

Jennifer Poole, RN Community in Pictures

Community Health Needs; Nursing 4415July, 2014

Dying to Eat Diabetes is a killer. It is the

leading cause of heart attack, stroke, kidney failure, and blindness. (American Diabetes Association website, 2014)

ASSESSMENT⇛29.1 MILLION AMERICANS (9.3% OF THE POPULATION) HAD DIABETES IN 2012: PREVALENCE 12.3% OVER 11.3% IN 2011

⇛IN 2010, DIABETES WAS THE 7TH LEADING CAUSE OF DEATH IN THE UNITED STATES

⇛ $245 BILLION IN NATIONAL COST OF DIABETES, IN 2013

⇛ THOSE WITH DIABETES EXCEED THOSE THAT DO NOT BY MORE THAN DOUBLE IN MEDICAL COSTS ⇛ IN THE UNITED STATES, $69 BILLION IN LOST PRODUCTIVITY DUE TO DIABETES IN 2013

⇛ US POPULATION OF 32,394,000; 18,800,000 ALREADY DIAGNOSED; 1,900,000 NEW CASES IN PEOPLE 20 YEARS AND OLDER IN 2010; 7,000,000 UNDIAGNOSED; 79,000,000 ARE PREDIABETIC

⇛A CO-MORBIDITY OF DIABETES INCREASES RISK OF DEATH GREATLY

(American Diabetes Association website, 2014)

ASSESSMENT (CONTINUED)

⇛ADULTS OLDER THAN 20 YRS, 60% OF NON-TRAUMATIC LOWER LIMB AMPUTATIONS WERE DIABETICS

⇛ 49,677 OF ALL KIDNEY FAILURE DUE TO DIABETES IN 2011

⇛ 228,924 PEOPLE OF ALL AGES WITH KIDNEY FAILURE DUE TO DIABETES LIVE WITH CHRONIC DIALYSIS OR KIDNEY TRANSPLANT

⇛ 28.5%, OR 4.2 MILLION PEOPLE HAD DIABETIC RETINOPATHY FROM 2005-2008

⇛RISK FOR STROKE 1.5 TIMES HIGHER WITH DIABETES

⇛ FOR DIABETICS, RISK FOR HEART ATTACK INCREASE BY 1.8 TIMES(American Diabetes Association website, 2014)

ASSESSMENT (CONTINUED)

⇛ 80% OF TYPE 2 DIABETICS ARE OVERWEIGHT (National Diabetes Information Clearinghouse , 2014)

⇛ LOSING JUST 7% OF YOUR BODY WEIGHT CAN PREVENT TYPE 2 DIABETES

⇛ MODERATE EXERCISE 5 DAYS PER WEEK REDUCES RISK OF TYPE 2 DIABETES BY 58%

⇛ LIFESTYLE CHANGES CAN DELAY OR PREVENT TYPE 2 DIABETES FROM OCCURRING (American Diabetes Association website, 2014)

COMMUNITY ISSUE⇛DIABETES DIAGNOSIS AND THE PREVALENCE GOES UP YEARLY

⇛THE COST OF TREATING DIABETES IS ASTRONOMICAL, AS STATED PREVIOUSLY THAT $245 BILLION WAS SPENT AS A RESULT OF DIABETES IN 2013 IN THE US

⇛ THE HEALTH EFFECTS OF DIABETES ARE DEVASTATING , AS EVIDENCED BY THE NUMBEROF HEART, KIDNEY, EYE, AND VASCULAR DISEASE, INCLUDING STROKE, THAT ARE ATTRIBUTEDTO DIABETES

⇛ OUR COMMUNITIES AND SOCIETY PROMOTE A SEDENTARY LIFESTYLE (Centers for Disease Control and Prevention, 1996)

⇛ CHILDREN AND ADULTS ALIKE SIT FOR HOURS A DAY BEHIND THE SCREENS OF COMPUTERS, PHONES, IPADS, AND VIDEO GAMES. PHYSICAL EXERCISE IS BECOMING RARE

⇛ EVERY WHERE WE TURN THERE IS FAST FOOD, CANDY, SUGAR, SODAS, SUPER SIZES, AND COMBO MEALS. PORTION SIZE IN RESTAURANTS IS LARGER THAN EVER

⇛ WE MUST EDUCATE OUR COMMUNITIES ON THE DANGERS OF DIABETES. WE MUST GIVE OUR COMMUNITIES THE TOOLS TO FIGHT AGAINST DIABETES

⇛ CHANGING EATING HABITS AND LIFESTYLES AND LOSING WEIGHT COULD CONTROL AND EVEN REVERSE TYPE 2 DIABETES

ARKANSAS & FAULKNER COUNTY

⇛ IN ARKANSAS, DIABETES IS THE 6TH LEADING CAUSE OF DEATH

⇛ FAULKNER COUNTY IS NOT IN THE TOP TEN COUNTIES IN ARKANSAS FOR DIABETES AS A LEADING CAUSE OF DEATH

⇛ IN 2006, FAULKNER COUNTY WAS RANKED 64TH IN THE STATE IN DIABETES RELATED DEATHS, WITH 3 TOTAL DEATHS, AND A 6.4% DEATH RATE ATTRIBUTED TO DIABETES OUT OF A 60,503 POPULATION. (Healthy Arkansas, 2008)

NURSING PLAN

⇛ TO IMPLEMENT A FREE RISK ASSESSMENT SCREENING TO THE PUBLIC

⇛ TO EDUCATE THE PUBLIC ON NOT ONLY THE CAUSES OF TYPE 2 DIABETES, BUT ALSO, THE RISK FACTORS, HOW TO IDENTIFY TYPE 2 DIABETES, HOW TO TREAT TYPE 2 DIABETES

⇛ STRESS IMPORTANCE OF KNOWING INDIVIDUAL RISKS ANDKNOWING THE NUMBERS (FASTING BLOOD SUGAR, A1C, AND TARGET WEIGHT)

(Blood Glucose Levels website,

2014)

IMPLEMENTATION⇛ AN IMPLEMENTATION/RISK ASSESSMENT TABLE IS SET UP AT THE MCGEE CENTER IN CONWAY, AR

⇛ INDIVIDUALS INTERESTED TAKE A DIABETIC RISK ASSESSMENT SCREENING

⇛ INDIVIDUALS ARE WEIGHED IN ADDITION TO THE ASSESSMENT

⇛ IT WOULD BE OPTIMAL TO DRAW AN A1C LEVEL IF LABORATORY SERVICES WERE AVAILABLE

⇛ AFTER THE RISK ASSESSMENT IS TAKEN, THE RESULTS ARE DISCUSSED ONE ON ONE WITH THE INDIVIDUAL

⇛ THOSE INDIVIDUALS IDENTIFIED AS “AT RISK” ARE GIVEN HANDOUTS PER MILLIMAN CARE GUIDELINES AND FROM THE AMERICAN DIABETES ASSOCIATION ON THE CAUSES AND TREATMENT OF TYPE 2 DIABETES (WITH A DISCLAIMER THAT THIS IS FOR EDUCATIONAL PURPOSES ONLY AND CARE SHOULD BE DIRECTED BY INDIVIDUAL PRIMARY CARE PHYSICIANS)

IMPLEMENTATION: RISK ASSESSMENT

•Participants take the assessment•Participants are weighed• Participants have their BMI calculated on the interactive website shown on next slide• Results of Risk Assessment reviewed, weight, and BMI calculations are reviewed• Teach that healthy weight, healthy eating, and exercise all lower risk of Type 2 Diabetes.

(American Diabetes Association website,

2014)

(American Diabetes Association website, 2014)

EVALUATION⇛ THOSE IDENTIFIED AS “AT RISK” ARE WILLINGLY EDUCATED ON RISKS, COMPLICATIONS, AND TREATMENTS FOR TYPE 2 DIABETES

⇛ THOSE IDENTIFIED AS “AT RISK” ARE ABLE TO STATE 2 RISKS FACTORS FOR TYPE 2 DIABETES

⇛ THOSE IDENTIFIED AS “AT RISK” ARE ABLE TO STATE 2 MODIFIABLE RISKS FACTORS

⇛ THOSE IDENTIFIED AS “AT RISK” PARTICIPATE IN DISCUSSION REGARDING LIFESTYLE CHANGES WITH PARTICULAR REGARD TO DIET AND EXERCISE

⇛ THOSE IDENTIFIED AS “AT RISK” AGREE TO FOLLOW UP WITH THEIR PCP AND OBTAIN A1C AND FASTING GLUCOSE LEVELS

⇛ THOSE IDENTIFIED AS “AT RISK” UNDERSTAND THE IMPORTANCE OF LIFESTYLE CHANGES IN PREVENTING AND TREATING TYPE 2 DIABETES THROUGH MY EDUCATION

⇛ AN INTEREST IN COMBATING THE COMMUNITY HEALTH ISSUE OF TYPE 2 DIABETES IS SPARKED

⇛THROUGH THE INTEREST GENERATED, MORE RISK ASSESSMENT SCREENINGS AND EDUCATION BOOTHS ARE SET UP THROUGHOUT THE COMMUNITY OF CONWAY

⇛ DIABETES EDUCATION IS CONSIDERED THE FOUNDATION OF SUCCESSFUL DIABETIC CARE (Mulcahy et al., 2003)

EVALUATION⇛ DURING 2 SATURDAYS OF HOSTING INFORMATION BOOTHS AT A LOCAL FREE GYMNASIUM, MCGEE CENTER, IN CONWAY, ARKANSAS, I SCREENED 76 INDIVIDUALS.

⇛ OF THE 76 INDIVIDUALS THAT PARTICIPATED IN THE RISK ASSESSMENT SCREENING, 29 WERE IDENTIFIED “AT RISK”

⇛OVERALL, THE HEALTH ASSESSMENT SCREENING WAS EXTREMELY SUCCESSFUL. MY TARGET POPULATION (WHICH WAS ANYONE WILLING TO PARTICIPATE) WAS EXCITED TO LEARN IF THEY WERE “AT RISK” FOR TYPE 2 DIABETES. I WAS ABLE TO PROVIDE DETAILED AND INDIVIDUALIZED EDUCATION TO EACH PARTICIPANT. HANDOUTS FROM AMERICAN DIABETES ASSOCIATION WERE GIVEN OUT. GUIDELINES TO FOLLOW UP WITH PRIMARY CARE PHYSICIANS FOR A1C LEVELS AND FASTING GLUCOSE LEVELS WERE GIVEN OUT. PARTICIPANTS WERE ENCOURAGED TO DEVELOP A PREVENTION PLAN WITH THEIR PRIMARY CARE PHYSICIAN.

REFERENCESAmerican Diabetes Association. (2014). http://www.diabetes.org/in-my-community/awareness-programs/stop-diabetes-at-work/

Blood Glucose Levels. (2014). http://bloodglucoselevels.net/blood-glucose-levels-chart/

Centers for Disease Control and Prevention. (1996). http://www.cdc.gov/healthyplaces/healthtopics/physactivity.htm

Healthy Arkansas. (2008). http://www.healthy.arkansas.gov/stats/health-disparities/2008.pdf

Mulcahy, K., Maryniuk, M., Peeples, M., Peyrot, M., Tomky,S, Weaver, T., & Yarborough, P. (2003, September/October). Standards for outcomes measurement of diabetes self-management education. The Diabetes Educator, 29, 804-816. Retrieved from https://www.diabeteseducator.org/export/sites/aade/_resources/pdf/PS-Outcomes.pdf

National Diabetes InformationClearinghouse. (2014). http://diabetes.niddk.nih.gov/dm/pubs/overview/#who