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Morning session
Case Studies in Type 2 Diabetes: Achieving Goals Together—A Gluco-Patient Centric Approach
Scott Urquhart, PA-C, DFAAPA, James Madison University and George Washington University, and Lucia M. Novak, MSN, ANP-BC, BC-ADM, CDTC, The Uniformed Services University of the Health Sciences
Using case studies, Urquhart and Novak first reviewed how each case would be managed according to the latest American Diabetes Association and American Association of Clinical Endocrinologists guidelines and recommendations and then explained how management might be altered by assuming a more gluco-patient centric approach. The latter, they noted, engages patients as partners in choosing medications and pays special attention to the individual’s concerns and priorities in order to empower patients and optimize outcomes. “Patients come with their own terms/non-negotiables that will ultimately determine therapeutic choices, as well as overall success.” While metformin is a safe and effective first-line therapy choice, it is often necessary and appropriate to consider other agents that address the glycemic goals of the individual patient, possess secondary (nonglycemic) benefits, and are better suited to the patient’s lifestyle, fears, and/or preferences.
Diabetes Medications: Making Co$$tly Decisions
Scott Urquhart, PA-C, DFAAPA, James Madison University and George Washington University, and Lucia M. Novak, MSN, ANP-BC, BC-ADM, CDTC, The Uniformed Services University of the Health Sciences
Urquhart and Novak discussed the financial and clinical impact of barriers that interfere with optimal pharmacologic management of type 2 diabetes mellitus (T2DM) and the importance of evaluating the nonglycemic benefits, such as cardiovascular and renal protection, of diabetes medications when making treatment adjustments. When calculating cost, it is not enough to consider the face price of a drug and the patient’s insurance coverage; the cost equation must factor in the cost (risk to the patient) of complacency and the cost of not maximizing nonglycemic benefits. Complacency, on the part of the clinician, may be caused by clinical inertia; insufficient time, resources, or training; and being overwhelmed with information or confusing guidelines. Complacency on the part of the patient may stem from disease denial, burnout, or distress, or comorbidities. Urquhart and Novak also identified resources available to assist patients with managing medication costs.
Insulin Overview: Which Type and Why?
Davida F. Kruger, MSN, APRN-BC, BC-ADM, Wayne State University and Michigan State University
In reviewing the differences between the basal, prandial, and premixed/biphasic insulin products currently available for the treatment of T2DM in the United States, Kruger emphasized the importance of understanding differences in potency between available products and being able to identify the insulin contained in vials vs pens. Also included in the discussion were differences in physiologic action, pharmacokinetics, dosing, and their pros and cons in various patient populations. Kruger concluded with a look at insulin products on the horizon.
Case Studies continued: Moving Beyond your Comfort Zone
Donna Jornsay, MS, BSN, CPNP, BC-ADM, CDE, CDTC, Mills Peninsula Medical Center, and Davida F. Kruger, MSN, APRN-BC, BC-ADM, Wayne State University and Michigan State University
Using case studies, Jornsay and Kruger reviewed how to choose from among the various insulins available, when and how to initiate and titrate insulin, and the step-wise, trial insulin strategies used for each case before arriving at a treatment approach that worked. They emphasized the importance of recognizing potential barriers to starting insulin and the support and education patients require to be successful. Roadblocks to health care providers providing timely insulin initiation may include concerns about patient adherence, hypoglycemia, pain from glucose monitoring and/or insulin injections, and patient age. Patient roadblocks may include the belief that their T2DM is not sufficiently severe or that insulin will not help.
Continue to: Afternoon session
Afternoon session
Nephrology Secrets: Diabetic Kidney Disease (DKD) and Hypertension
Kim Zuber, PA-C, MS, Executive Director of the American Academy of Nephrology PAs
Zuber focused on the diabetic kidney, noting that 30 million Americans (15% of the population) have chronic kidney disease (CKD), and that many of these don’t know they have it. She talked about the effect of DM on the kidneys, the stages of CKD, and the significance of albumin and of decreasing proteinuria. Switching gears, Zuber then discussed management of patients with diabetes and hypertension, noting that patients with DM are twice as likely to die of cardiovascular disease as those without diabetes, and that CKD occurs 4 times more frequently in patients with hypertension than in those without. While disagreement about target blood pressure goals complicates treatment, she provided tips for step-wise pharmacologic management and for whether an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker should be first-line treatment.
Numb Toes and Other Woes: Diabetic Peripheral and Autonomic Neuropathies
Lucia M. Novak, MSN, ANP-BC, BC-ADM, CDTC, The Uniformed Services University of the Health Sciences
Novak emphasized that early and aggressive glucose stabilization and control is key to minimizing the neuropathic complications affecting patients with diabetes. She discussed recognizing the clinical manifestations of these underdiagnosed ailments and applying current screening recommendations so that patients receive timely care. In addition to diabetic peripheral neuropathy, she reviewed gastrointestinal and genitourinary autonomic neuropathies, including the use of flibanserin for female sexual dysfunction.
Type 2 Diabetes, Pre-Diabetes, and Reproductive Concerns
Donna Jornsay, MS, BSN, CPNP, BC-ADM, CDE, CDTC, Mills Peninsula Medical Center
Rates of childhood obesity and diabetes are rising, according to Jornsay. In the first of her afternoon sessions, she discussed screening obese children for diabetes, tests that help differentiate type 1 from type 2 DM in children, and some of the nuances of managing this population. For example, T2DM in children is not the same as type 1 or 2 in adults; youngsters are less insulin sensitive at all body mass indices. Jornsay also discussed the reproductive concerns of adults with DM, outlining the prenatal, natal, and postnatal needs of those with type 1 and type 2 diabetes, as well as the neonatal and childhood risks for offspring of those with DM.
Adult Onset Diabetes: Which Type is it?
Ji Hyun (CJ) Chun, PA-C, MPAS, BS-ADM, President, American Society of Endocrine PAs
When signs and symptoms of diabetes beset an adult, how do you know if it’s type 1, type 2, or something else? Chun answered this question through the use of case studies. He reminded that latent autoimmune diabetes in adults (aka type 1.5 or noninsulin-requiring autoimmune diabetes) tends to occur in people who have a personal or family history of autoimmune disease and tends to have a later onset and faster progression to insulin dependence. Secondary diabetes, like type 1, is responsible for about 5% of diabetes diagnoses. Monogenic diabetes, which is often incorrectly diagnosed as type 1 or 2, represents 1% to 2% of DM diagnoses. Chun mentioned that it often takes up to 10 years for a correct diagnosis of monogenic diabetes to be made.
Continue to: Up, Up, and Away! Grounding Glucocorticoid-Induced Hyperglycemia
Up, Up, and Away! Grounding Glucocorticoid-Induced Hyperglycemia
Lucia M. Novak, MSN, ANP-BC, BC-ADM, CDTC, The Uniformed Services University of the Health Sciences
Glucocorticoid-induced hyperglycemia is responsible for 40% to 56% of all inpatient consults with Endocrine Services, according to Novak, which is why it’s important to recognize the pattern of glucocorticoid-induced hyperglycemia. Features include a minimal effect on fasting glucose levels and an exaggeration of insulin resistance that leads to elevated blood glucose levels all day. Once the pattern is identified, next steps, according to Novak, are to determine the insulin product that is best suited to address the pattern, and dose the insulin using a weight-based approach. Prompt recognition and management can help counter the 1.5 to 2.5 odds ratio for developing new onset T2DM.
Key Points to Know for Emerging Adults with Type 1 Diabetes
Donna Jornsay, MS, BSN, CPNP, BC-ADM, CDE, CDTC, Mills Peninsula Medical Center
The prevalence of T1DM increased 23% between 2009 and 2013, according to Jornsay, who added that the number of young people with T1DM is increasing 5% per year. With so many new diagnoses, a new developmental stage was born—that of the emerging adult, who is usually someone aged 18 to 30 years, unmarried, and without children; who is often separated geographically and/or emotionally from family; and who often finds him/herself in a transition of care without focused health care delivery. These patients typically have poor control of glycemia, are at risk for complications, and are often lost to follow-up. Jornsay provided tips on what works in this population.
Tips for Effective Communication in Diabetes Management
Ellen D. Mandel, DMH, MPA, MS, PA-C, RDN, CDE, Pace University, and Donna Jornsay, MS, BSN, CPNP, BC-ADM, CDE, CDTC, Mills Peninsula Medical Center
With 1 in 5 US residents speaking a language other than English at home, Mandel and Jornsay wrapped up the day’s sessions by examining the language of diabetes. In addition to the importance of conveying information about diabetes in a language that’s understood by the patient, they suggested small word choice changes that can help empower patients. For example, instead of referring to patients as diabetics, use the language “people with diabetes.” They reminded that how we talk to, and about, people with diabetes plays an important role in engagement, conceptualization of the disease and its management, treatment outcomes, and the psychosocial well‐being of patients.
Morning session
Case Studies in Type 2 Diabetes: Achieving Goals Together—A Gluco-Patient Centric Approach
Scott Urquhart, PA-C, DFAAPA, James Madison University and George Washington University, and Lucia M. Novak, MSN, ANP-BC, BC-ADM, CDTC, The Uniformed Services University of the Health Sciences
Using case studies, Urquhart and Novak first reviewed how each case would be managed according to the latest American Diabetes Association and American Association of Clinical Endocrinologists guidelines and recommendations and then explained how management might be altered by assuming a more gluco-patient centric approach. The latter, they noted, engages patients as partners in choosing medications and pays special attention to the individual’s concerns and priorities in order to empower patients and optimize outcomes. “Patients come with their own terms/non-negotiables that will ultimately determine therapeutic choices, as well as overall success.” While metformin is a safe and effective first-line therapy choice, it is often necessary and appropriate to consider other agents that address the glycemic goals of the individual patient, possess secondary (nonglycemic) benefits, and are better suited to the patient’s lifestyle, fears, and/or preferences.
Diabetes Medications: Making Co$$tly Decisions
Scott Urquhart, PA-C, DFAAPA, James Madison University and George Washington University, and Lucia M. Novak, MSN, ANP-BC, BC-ADM, CDTC, The Uniformed Services University of the Health Sciences
Urquhart and Novak discussed the financial and clinical impact of barriers that interfere with optimal pharmacologic management of type 2 diabetes mellitus (T2DM) and the importance of evaluating the nonglycemic benefits, such as cardiovascular and renal protection, of diabetes medications when making treatment adjustments. When calculating cost, it is not enough to consider the face price of a drug and the patient’s insurance coverage; the cost equation must factor in the cost (risk to the patient) of complacency and the cost of not maximizing nonglycemic benefits. Complacency, on the part of the clinician, may be caused by clinical inertia; insufficient time, resources, or training; and being overwhelmed with information or confusing guidelines. Complacency on the part of the patient may stem from disease denial, burnout, or distress, or comorbidities. Urquhart and Novak also identified resources available to assist patients with managing medication costs.
Insulin Overview: Which Type and Why?
Davida F. Kruger, MSN, APRN-BC, BC-ADM, Wayne State University and Michigan State University
In reviewing the differences between the basal, prandial, and premixed/biphasic insulin products currently available for the treatment of T2DM in the United States, Kruger emphasized the importance of understanding differences in potency between available products and being able to identify the insulin contained in vials vs pens. Also included in the discussion were differences in physiologic action, pharmacokinetics, dosing, and their pros and cons in various patient populations. Kruger concluded with a look at insulin products on the horizon.
Case Studies continued: Moving Beyond your Comfort Zone
Donna Jornsay, MS, BSN, CPNP, BC-ADM, CDE, CDTC, Mills Peninsula Medical Center, and Davida F. Kruger, MSN, APRN-BC, BC-ADM, Wayne State University and Michigan State University
Using case studies, Jornsay and Kruger reviewed how to choose from among the various insulins available, when and how to initiate and titrate insulin, and the step-wise, trial insulin strategies used for each case before arriving at a treatment approach that worked. They emphasized the importance of recognizing potential barriers to starting insulin and the support and education patients require to be successful. Roadblocks to health care providers providing timely insulin initiation may include concerns about patient adherence, hypoglycemia, pain from glucose monitoring and/or insulin injections, and patient age. Patient roadblocks may include the belief that their T2DM is not sufficiently severe or that insulin will not help.
Continue to: Afternoon session
Afternoon session
Nephrology Secrets: Diabetic Kidney Disease (DKD) and Hypertension
Kim Zuber, PA-C, MS, Executive Director of the American Academy of Nephrology PAs
Zuber focused on the diabetic kidney, noting that 30 million Americans (15% of the population) have chronic kidney disease (CKD), and that many of these don’t know they have it. She talked about the effect of DM on the kidneys, the stages of CKD, and the significance of albumin and of decreasing proteinuria. Switching gears, Zuber then discussed management of patients with diabetes and hypertension, noting that patients with DM are twice as likely to die of cardiovascular disease as those without diabetes, and that CKD occurs 4 times more frequently in patients with hypertension than in those without. While disagreement about target blood pressure goals complicates treatment, she provided tips for step-wise pharmacologic management and for whether an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker should be first-line treatment.
Numb Toes and Other Woes: Diabetic Peripheral and Autonomic Neuropathies
Lucia M. Novak, MSN, ANP-BC, BC-ADM, CDTC, The Uniformed Services University of the Health Sciences
Novak emphasized that early and aggressive glucose stabilization and control is key to minimizing the neuropathic complications affecting patients with diabetes. She discussed recognizing the clinical manifestations of these underdiagnosed ailments and applying current screening recommendations so that patients receive timely care. In addition to diabetic peripheral neuropathy, she reviewed gastrointestinal and genitourinary autonomic neuropathies, including the use of flibanserin for female sexual dysfunction.
Type 2 Diabetes, Pre-Diabetes, and Reproductive Concerns
Donna Jornsay, MS, BSN, CPNP, BC-ADM, CDE, CDTC, Mills Peninsula Medical Center
Rates of childhood obesity and diabetes are rising, according to Jornsay. In the first of her afternoon sessions, she discussed screening obese children for diabetes, tests that help differentiate type 1 from type 2 DM in children, and some of the nuances of managing this population. For example, T2DM in children is not the same as type 1 or 2 in adults; youngsters are less insulin sensitive at all body mass indices. Jornsay also discussed the reproductive concerns of adults with DM, outlining the prenatal, natal, and postnatal needs of those with type 1 and type 2 diabetes, as well as the neonatal and childhood risks for offspring of those with DM.
Adult Onset Diabetes: Which Type is it?
Ji Hyun (CJ) Chun, PA-C, MPAS, BS-ADM, President, American Society of Endocrine PAs
When signs and symptoms of diabetes beset an adult, how do you know if it’s type 1, type 2, or something else? Chun answered this question through the use of case studies. He reminded that latent autoimmune diabetes in adults (aka type 1.5 or noninsulin-requiring autoimmune diabetes) tends to occur in people who have a personal or family history of autoimmune disease and tends to have a later onset and faster progression to insulin dependence. Secondary diabetes, like type 1, is responsible for about 5% of diabetes diagnoses. Monogenic diabetes, which is often incorrectly diagnosed as type 1 or 2, represents 1% to 2% of DM diagnoses. Chun mentioned that it often takes up to 10 years for a correct diagnosis of monogenic diabetes to be made.
Continue to: Up, Up, and Away! Grounding Glucocorticoid-Induced Hyperglycemia
Up, Up, and Away! Grounding Glucocorticoid-Induced Hyperglycemia
Lucia M. Novak, MSN, ANP-BC, BC-ADM, CDTC, The Uniformed Services University of the Health Sciences
Glucocorticoid-induced hyperglycemia is responsible for 40% to 56% of all inpatient consults with Endocrine Services, according to Novak, which is why it’s important to recognize the pattern of glucocorticoid-induced hyperglycemia. Features include a minimal effect on fasting glucose levels and an exaggeration of insulin resistance that leads to elevated blood glucose levels all day. Once the pattern is identified, next steps, according to Novak, are to determine the insulin product that is best suited to address the pattern, and dose the insulin using a weight-based approach. Prompt recognition and management can help counter the 1.5 to 2.5 odds ratio for developing new onset T2DM.
Key Points to Know for Emerging Adults with Type 1 Diabetes
Donna Jornsay, MS, BSN, CPNP, BC-ADM, CDE, CDTC, Mills Peninsula Medical Center
The prevalence of T1DM increased 23% between 2009 and 2013, according to Jornsay, who added that the number of young people with T1DM is increasing 5% per year. With so many new diagnoses, a new developmental stage was born—that of the emerging adult, who is usually someone aged 18 to 30 years, unmarried, and without children; who is often separated geographically and/or emotionally from family; and who often finds him/herself in a transition of care without focused health care delivery. These patients typically have poor control of glycemia, are at risk for complications, and are often lost to follow-up. Jornsay provided tips on what works in this population.
Tips for Effective Communication in Diabetes Management
Ellen D. Mandel, DMH, MPA, MS, PA-C, RDN, CDE, Pace University, and Donna Jornsay, MS, BSN, CPNP, BC-ADM, CDE, CDTC, Mills Peninsula Medical Center
With 1 in 5 US residents speaking a language other than English at home, Mandel and Jornsay wrapped up the day’s sessions by examining the language of diabetes. In addition to the importance of conveying information about diabetes in a language that’s understood by the patient, they suggested small word choice changes that can help empower patients. For example, instead of referring to patients as diabetics, use the language “people with diabetes.” They reminded that how we talk to, and about, people with diabetes plays an important role in engagement, conceptualization of the disease and its management, treatment outcomes, and the psychosocial well‐being of patients.
Morning session
Case Studies in Type 2 Diabetes: Achieving Goals Together—A Gluco-Patient Centric Approach
Scott Urquhart, PA-C, DFAAPA, James Madison University and George Washington University, and Lucia M. Novak, MSN, ANP-BC, BC-ADM, CDTC, The Uniformed Services University of the Health Sciences
Using case studies, Urquhart and Novak first reviewed how each case would be managed according to the latest American Diabetes Association and American Association of Clinical Endocrinologists guidelines and recommendations and then explained how management might be altered by assuming a more gluco-patient centric approach. The latter, they noted, engages patients as partners in choosing medications and pays special attention to the individual’s concerns and priorities in order to empower patients and optimize outcomes. “Patients come with their own terms/non-negotiables that will ultimately determine therapeutic choices, as well as overall success.” While metformin is a safe and effective first-line therapy choice, it is often necessary and appropriate to consider other agents that address the glycemic goals of the individual patient, possess secondary (nonglycemic) benefits, and are better suited to the patient’s lifestyle, fears, and/or preferences.
Diabetes Medications: Making Co$$tly Decisions
Scott Urquhart, PA-C, DFAAPA, James Madison University and George Washington University, and Lucia M. Novak, MSN, ANP-BC, BC-ADM, CDTC, The Uniformed Services University of the Health Sciences
Urquhart and Novak discussed the financial and clinical impact of barriers that interfere with optimal pharmacologic management of type 2 diabetes mellitus (T2DM) and the importance of evaluating the nonglycemic benefits, such as cardiovascular and renal protection, of diabetes medications when making treatment adjustments. When calculating cost, it is not enough to consider the face price of a drug and the patient’s insurance coverage; the cost equation must factor in the cost (risk to the patient) of complacency and the cost of not maximizing nonglycemic benefits. Complacency, on the part of the clinician, may be caused by clinical inertia; insufficient time, resources, or training; and being overwhelmed with information or confusing guidelines. Complacency on the part of the patient may stem from disease denial, burnout, or distress, or comorbidities. Urquhart and Novak also identified resources available to assist patients with managing medication costs.
Insulin Overview: Which Type and Why?
Davida F. Kruger, MSN, APRN-BC, BC-ADM, Wayne State University and Michigan State University
In reviewing the differences between the basal, prandial, and premixed/biphasic insulin products currently available for the treatment of T2DM in the United States, Kruger emphasized the importance of understanding differences in potency between available products and being able to identify the insulin contained in vials vs pens. Also included in the discussion were differences in physiologic action, pharmacokinetics, dosing, and their pros and cons in various patient populations. Kruger concluded with a look at insulin products on the horizon.
Case Studies continued: Moving Beyond your Comfort Zone
Donna Jornsay, MS, BSN, CPNP, BC-ADM, CDE, CDTC, Mills Peninsula Medical Center, and Davida F. Kruger, MSN, APRN-BC, BC-ADM, Wayne State University and Michigan State University
Using case studies, Jornsay and Kruger reviewed how to choose from among the various insulins available, when and how to initiate and titrate insulin, and the step-wise, trial insulin strategies used for each case before arriving at a treatment approach that worked. They emphasized the importance of recognizing potential barriers to starting insulin and the support and education patients require to be successful. Roadblocks to health care providers providing timely insulin initiation may include concerns about patient adherence, hypoglycemia, pain from glucose monitoring and/or insulin injections, and patient age. Patient roadblocks may include the belief that their T2DM is not sufficiently severe or that insulin will not help.
Continue to: Afternoon session
Afternoon session
Nephrology Secrets: Diabetic Kidney Disease (DKD) and Hypertension
Kim Zuber, PA-C, MS, Executive Director of the American Academy of Nephrology PAs
Zuber focused on the diabetic kidney, noting that 30 million Americans (15% of the population) have chronic kidney disease (CKD), and that many of these don’t know they have it. She talked about the effect of DM on the kidneys, the stages of CKD, and the significance of albumin and of decreasing proteinuria. Switching gears, Zuber then discussed management of patients with diabetes and hypertension, noting that patients with DM are twice as likely to die of cardiovascular disease as those without diabetes, and that CKD occurs 4 times more frequently in patients with hypertension than in those without. While disagreement about target blood pressure goals complicates treatment, she provided tips for step-wise pharmacologic management and for whether an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker should be first-line treatment.
Numb Toes and Other Woes: Diabetic Peripheral and Autonomic Neuropathies
Lucia M. Novak, MSN, ANP-BC, BC-ADM, CDTC, The Uniformed Services University of the Health Sciences
Novak emphasized that early and aggressive glucose stabilization and control is key to minimizing the neuropathic complications affecting patients with diabetes. She discussed recognizing the clinical manifestations of these underdiagnosed ailments and applying current screening recommendations so that patients receive timely care. In addition to diabetic peripheral neuropathy, she reviewed gastrointestinal and genitourinary autonomic neuropathies, including the use of flibanserin for female sexual dysfunction.
Type 2 Diabetes, Pre-Diabetes, and Reproductive Concerns
Donna Jornsay, MS, BSN, CPNP, BC-ADM, CDE, CDTC, Mills Peninsula Medical Center
Rates of childhood obesity and diabetes are rising, according to Jornsay. In the first of her afternoon sessions, she discussed screening obese children for diabetes, tests that help differentiate type 1 from type 2 DM in children, and some of the nuances of managing this population. For example, T2DM in children is not the same as type 1 or 2 in adults; youngsters are less insulin sensitive at all body mass indices. Jornsay also discussed the reproductive concerns of adults with DM, outlining the prenatal, natal, and postnatal needs of those with type 1 and type 2 diabetes, as well as the neonatal and childhood risks for offspring of those with DM.
Adult Onset Diabetes: Which Type is it?
Ji Hyun (CJ) Chun, PA-C, MPAS, BS-ADM, President, American Society of Endocrine PAs
When signs and symptoms of diabetes beset an adult, how do you know if it’s type 1, type 2, or something else? Chun answered this question through the use of case studies. He reminded that latent autoimmune diabetes in adults (aka type 1.5 or noninsulin-requiring autoimmune diabetes) tends to occur in people who have a personal or family history of autoimmune disease and tends to have a later onset and faster progression to insulin dependence. Secondary diabetes, like type 1, is responsible for about 5% of diabetes diagnoses. Monogenic diabetes, which is often incorrectly diagnosed as type 1 or 2, represents 1% to 2% of DM diagnoses. Chun mentioned that it often takes up to 10 years for a correct diagnosis of monogenic diabetes to be made.
Continue to: Up, Up, and Away! Grounding Glucocorticoid-Induced Hyperglycemia
Up, Up, and Away! Grounding Glucocorticoid-Induced Hyperglycemia
Lucia M. Novak, MSN, ANP-BC, BC-ADM, CDTC, The Uniformed Services University of the Health Sciences
Glucocorticoid-induced hyperglycemia is responsible for 40% to 56% of all inpatient consults with Endocrine Services, according to Novak, which is why it’s important to recognize the pattern of glucocorticoid-induced hyperglycemia. Features include a minimal effect on fasting glucose levels and an exaggeration of insulin resistance that leads to elevated blood glucose levels all day. Once the pattern is identified, next steps, according to Novak, are to determine the insulin product that is best suited to address the pattern, and dose the insulin using a weight-based approach. Prompt recognition and management can help counter the 1.5 to 2.5 odds ratio for developing new onset T2DM.
Key Points to Know for Emerging Adults with Type 1 Diabetes
Donna Jornsay, MS, BSN, CPNP, BC-ADM, CDE, CDTC, Mills Peninsula Medical Center
The prevalence of T1DM increased 23% between 2009 and 2013, according to Jornsay, who added that the number of young people with T1DM is increasing 5% per year. With so many new diagnoses, a new developmental stage was born—that of the emerging adult, who is usually someone aged 18 to 30 years, unmarried, and without children; who is often separated geographically and/or emotionally from family; and who often finds him/herself in a transition of care without focused health care delivery. These patients typically have poor control of glycemia, are at risk for complications, and are often lost to follow-up. Jornsay provided tips on what works in this population.
Tips for Effective Communication in Diabetes Management
Ellen D. Mandel, DMH, MPA, MS, PA-C, RDN, CDE, Pace University, and Donna Jornsay, MS, BSN, CPNP, BC-ADM, CDE, CDTC, Mills Peninsula Medical Center
With 1 in 5 US residents speaking a language other than English at home, Mandel and Jornsay wrapped up the day’s sessions by examining the language of diabetes. In addition to the importance of conveying information about diabetes in a language that’s understood by the patient, they suggested small word choice changes that can help empower patients. For example, instead of referring to patients as diabetics, use the language “people with diabetes.” They reminded that how we talk to, and about, people with diabetes plays an important role in engagement, conceptualization of the disease and its management, treatment outcomes, and the psychosocial well‐being of patients.