August Newsletter
America has seen a 48% increase from 2007 to 2012 rising from $218 billion to
$322 billion in the cost of diabetes and pre-diabetes which sparks an urgent need
for prevention. Novo Nordisk.
When Should You Refer Your Patients to a Certified Diabetes Educator?
American Diabetes Association (ADA), American Association of Diabetes Educators (AADE) and the
Academy of Nutrition and Dietetics (AND) joint position statement....
There are four times the need for diabetes self-management education and support should be assessed: at
diagnosis, annually, when there are new complications and during transitions of care.
Research shows that diabetes self-management education has a positive effect in reducing A1C (The A1C test is a
blood test that provides information about a person’s average levels of blood glucose, also called blood sugar, over
the past 3 months. The A1C test is sometimes called the hemoglobin A1c, HbA1c, or glycohemoglobin test. The A1C
test is the primary test used for diabetes management and diabetes research), minimizing complications, improving
diet and has shown to reduce costs associated with hospital admissions.
On June 5th the American Diabetes Association (ADA), American Association of Diabetes Educators (AADE) and the
Academy of Nutrition and Dietetics (AND) released a joint statement at the 75th ADA Scientific Sessions to help
guide physicians as to when they should refer patients for education.
"Referrals influence patient behavior a great deal," said Linda Siminerio, RN, PhD, CDE, Chair of the National
Diabetes Education Program and Professor of Medicine at the University of Pittsburgh. "When providers refer
patients to diabetes education, we see an 83% participation rate, but without those referrals participation is
abysmally low. If patients believe their physicians think diabetes education is important, they take it a lot more
seriously. Patients trust their providers."
Patients with diabetes have an enormous responsibility in managing their disease outside of just taking medicine
alone. Education is key in diabetes and knowing when to refer and how this is benefitting the patient may have
been the missing link. This algorithm can really benefit patients and help us to decrease the costs associated with
readmissions due to complications.
New safety warnings for two classes of diabetes drugs: This spring,
FDA called attention to two classes of diabetes drugs and potential serious risks
associated with them. In April, the Endocrinologic and Metabolic Drugs Advisory
Committee advised FDA to add a heart failure warning to labels on dipeptidyl
peptidase–4 (DPP-4) inhibitors, also known as gliptins. A month later, FDA issued a
drug safety communication warning that another diabetes drug, sodium–glucose
linked transporter–2 (SGLT-2) inhibitors, could cause euglycemic diabetic
ketoacidosis. When FDA has new information on the safety of a drug, the agency
may issue a drug safety communication, or it could deem a label change necessary.
In some but not all cases, these warnings warrant a change in the way pharmacists
advise prescribers and counsel patients. All medications come with benefits and
risks, and every decision for type II diabetes should be based on the patient-specific
advantages and disadvantages of the different options available. The potential risks
with these two medication classes are something we must consider.
New drug safety information: FDA has issued 15 drug safety communications this
year. There were 16 in 2014 and twice that many in each of the two preceding years.
Health care providers learn about these warnings on FDA’s website or through
MedWatch Safety Alerts, the Drug Information Listserv, e-mail newsletters,
podcasts, and social and traditional media. The communications are distributed to
about 573,000 subscribers to e-mail distribution listservers and 451,000 followers
to FDA social media accounts. (APhA’s DrugInfoLine at www.aphadruginfoline.com
also publishes FDA alerts and recalls.)
Pharmacists and other health care providers teach patients to recognize signs and
symptoms of heart failure, which include shortness of breath with exertion or when
lying down; fatigue; weakness; swelling in the legs, ankles, or feet; and rapid or
irregular heartbeat, and signs and symptoms of euglycemic diabetic ketoacidosis,
which include headache, nausea, vomiting, malaise, and abdominal pain.
Education instead of medications CALL US 954-650-2147.