Treatment and Support

November is diabetes 

awareness month, and it is the perfect time to review the key role that pharmacists play in helping patients manage this chronic condition.

 

Diabetes has widespread effects, especially in the United States, with 11.3% of those 20 and older having type 2 diabetes mellitus (DM). And this percentage is growing. For every 4 people who have type 2 DM, about 1 is undiagnosed. Some of the factors that put a person at risk for diabetes include a family history of the disease, obesity, physical inactivity, high blood pressure, and high cholesterol. Pharmacists are in a prime position to identify these and other risk factors in patients. However, not all patients have textbook presentations. The disease can sometimes go undetected and without symptoms until it reaches an emergency state. This is particularly true in patients who do not receive routine medical care or have an established relationship with a primary-care physician. Routine and simple tests such as blood glucose testing conducted at health fairs and wellness clinics at pharmacies across the country are an example of how a simple test conducted in the pharmacy or by the pharmacy team may provide an efficient method for identifying a patient with a potential diagnosis and help direct them to appropriate medical attention.

 

Because pharmacists are the most accessible health care providers, they are key players in the betterment of patients’ health, not just in terms of screening but in the lifelong management of the disease. For those who are diagnosed, pharmacists are able to provide counseling about monitoring glucose levels and how to manage out-of-range levels, including developing an action plan for what to do if sugar levels go too low. Pharmacist can help patients select the most appropriate hypoglycemic management strategy on an individual basis. Pharmacists can counsel on an appropriate diet and exercise routine to compliment medication management in treating diabetes. This can be especially useful in underserved areas where access to nutritionists or dieticians may be unavailable. The number of treatment options for diabetes has increased substantially over the past few years, and pharmacists are best positioned to help patients understand the fundamentals and intricacies regarding the medication as well as helping them understand which medications may be best suited for them. Pharmacists can also help guide patients through the management of adverse effects, knowing when and how to treat these so that therapy can be continued and when it might be better to switch to an alternative treatment regimen. For patients requiring insulin, the pharmacist can help instruct the patient on how to administer the medication, as well as answer common questions and concerns.

 

With prompt diagnosis, proper lifestyle changes, and appropriate pharmacotherapy, patients can minimize and/or delay the complications that uncontrolled diabetes can cause. Integrating simple ways to ensure that pharmacists follow up with diabetic patients, not just when new medications are prescribed but at each and every refill, can help improve the health and quality of life for these patients and make every month, not just November, one where they are aware of, understand, and are invested in the best possible management of the disease.

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Source: pharmacytimes.com

 

This article was co-written by Lauren Speakman, PharmD candidate at the Harrison School of Pharmacy at Auburn (Alabama) University.

There’s a lot to do to manage diabetes. Starting with daily care you do yourself, to lab tests and visits with your health care team, all are important for diabetes management.

Use this list to stay on schedule with self-checks, exams, and appointments throughout the year.

Got questions about everyday diabetes care? Ask your doctor about a referral for diabetes self-management education and support (DSMES) services. If you already have a referral, find a diabetes care and education specialist.

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Every Day

• Blood sugar checks
  Check up to several times a day as directed by your doctor. Keep a record of your numbers and share with your health care team during your next visit.

• Foot check
  Use a mirror if you can’t see the bottom of your feet or ask a family member for help. Let your doctor know immediately if you have any cuts, redness, swelling, sores, blisters, corns, calluses, or other change to the skin or nails.

• Diabetes medicines
  Take the amount prescribed by your doctor, even when you feel good.

• Physical activity
  Get at least 150 minutes a week of moderate activity, such as brisk walking or riding a bike.

• Healthy eating
  Eat healthy foods that give you the nutrition you need and help your blood sugar stay in your target range.

Every 3 Months

• A1C test
  If your treatment has changed or if you’re having trouble meeting your blood sugar goals, have this test every 3 months.

• Doctor visit
  If you’re having trouble meeting your treatment goals, visit your doctor every 3 months. Your blood pressure and weight will be checked, and your self-care plan and medicines will be reviewed. Ask your doctor to check your feet if you’ve ever had diabetes-related foot problems.

Every 6 Months

• Dental exam
  Get your teeth and gums cleaned at least once a year (more often if your doctor recommends), and let your dentist know that you have diabetes.

• A1C test
  If you’re meeting your treatment and blood sugar goals, have this test every 6 months.

• Doctor visit
  If you’re meeting your treatment goals, visit your doctor every 6 months. Your blood pressure and weight will be checked, and your self-care plan and medicines will be reviewed. Ask your doctor to check your feet if you’ve ever had diabetes-related foot problems.

Every Year

• Flu shot

• Kidney tests

• Cholesterol test

• Dilated eye exam
  You may need this exam more often if you have diabetes-related eye problems.

• Hearing check

• Complete foot check

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Learn More HERE

Source: cdc.gov

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Endocrinologists are doctors who specialize in glands and the hormones they make. They deal with metabolism, or all the biochemical processes that make your body work, including how your body changes food into energy and how it grows.

They may work with adults or kids. When they specialize in treating children, they're called pediatric endocrinologists.

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What Do Endocrinologists Do?

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They cover a lot of ground, diagnosing and treating conditions that affect your:

• Adrenals, glands that sit on top of your kidneys and help to control things like your blood pressure, metabolism, stress response, and sex hormones

• Bone metabolism, like osteoporosis

• Cholesterol

• Hypothalamus, the part of your brain that controls body temperature, hunger, and thirst

• Pancreas, which makes insulin and other substances for digestion

• Parathyroids, small glands in your neck that control the calcium in your blood

• Pituitary, a pea-sized gland at the base of your brain that keeps your hormones balanced

• Reproductive glands (gonads): ovaries in women, testes in men

• Thyroid, a butterfly-shaped gland in your neck that controls your metabolism, energy, and brain growth and development.

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Training

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Endocrinologists are licensed internal medicine doctors who have passed an additional certification exam.

They go to college for 4 years, then medical school for 4 more years. Afterward, they work in hospitals and clinics as residents for 3 years to get experience treating people. They'll spend another 2 or 3 years training specifically in endocrinology.

The whole process usually takes at least 10 years.

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Where to Find One

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An endocrinologist can work in:

• A medical practice with other endocrinologists

• A group with different kinds of doctors

• Hospitals

You can search for one on the American Association of Clinical Endocrinologists website.

Some don't see patients. They may work in universities or medical schools, where they teach medical students and residents or do research.

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When to See an Endocrinologist for Diabetes

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Your regular doctor can treat diabetes, but they might refer you to an endocrinologist when:

• You're brand new to diabetes and need to learn how to manage it.

• They don't have a lot of experience treating diabetes.

• You take a lot of shots or use an insulin pump.

• Your diabetes has gotten tough to manage, or your treatment isn't working.

• You have complications from diabetes.

You can always ask to go to an endocrinologist, too, even though your doctor doesn't suggest it first. When you see one, you'll still need to visit your primary doctor as well. They'll work together.

 

Source: Medical News Today

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Managing blood sugar is the key to living well with diabetes, and eating well is the key to managing blood sugar. But what does it mean to eat well? Simply put, eat healthy foods in the right amounts at the right times so your blood sugar stays in your target range as much as possible.

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Work with your dietitian or diabetes educator to create a healthy eating plan, and check out the resources in this section for tips, strategies, and ideas to make it easier to eat well.

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A meal plan is your guide for when, what, and how much to eat to get the nutrition you need while keeping your blood sugar levels in your target range. A good meal plan will consider your goals, tastes, and lifestyle, as well as any medicines you’re taking.

A good meal plan will also:

• Include more nonstarchy vegetables, such as broccoli, spinach, and green beans.

• Include fewer added sugars and refined grains, such as white bread, rice, and pasta with less than 2 grams of fiberexternal icon per serving.

• Focus on whole foods instead of highly processed foodsexternal icon as much as possible.

Carbohydrates in the food you eat raise your blood sugar levels. How fast carbs raise your blood sugar depends on what the food is and what you eat with it. For example, drinking fruit juice raises blood sugar faster than eating whole fruit. Eating carbs with foods that have protein, fat, or fiber slows down how quickly your blood sugar rises.

For more information, see Carb Counting.

You’ll want to plan for regular, balanced meals to avoid high or low blood sugar levels. Eating about the same amount of carbs at each meal can be helpful. Counting carbs and using the plate method are two common tools that can make planning meals easier too.

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Counting Carbs

Keeping track of how many carbs you eat and setting a limit for each meal can help keep your blood sugar levels in your target range. Work with your doctor or a registered dietitian to find out how many carbs you can eat each day and at each meal, and then refer to this list of common foods that contain carbs and serving sizes. For more information, see Carb Counting.

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It’s easy to eat more food than you need without realizing it. The plate method is a simple, visual way to make sure you get enough nonstarchy vegetables and lean protein while limiting the amount of higher-carb foods you eat that have the highest impact on your blood sugar.

Start with a 9-inch dinner plate (about the length of a business envelope):

• Fill half with nonstarchy vegetables, such as salad, green beans, broccoli, cauliflower, cabbage, and carrots.

• Fill one quarter with a lean protein, such as chicken, turkey, beans, tofu, or eggs.

• Fill one quarter with carb foods. Foods that are higher in carbs include grains, starchy vegetables (such as potatoes and peas), rice, pasta, beans, fruit, and yogurt. A cup of milk also counts as a carb food.

Then choose water or a low-calorie drink such as unsweetened iced tea to go with your meal.

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Source: CDC

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