Manage episode 278775173 series 2460299
Diabetes Counseling & Case Management
~ By the time they’re diagnosed, 50% of people with type 2 diabetes already show signs of complications.
~ Diabetes (destruction or malfunction of beta cells) may begin 10 years before the diagnosis and complications may start 5 years before the diagnosis
~ Cardiovascular disease causes 52% of death and disability in people with type 2 diabetes
~ People with type 2 diabetes have a 200% increased risk of stroke
~ Kidney disease impacts 33% of people with type 2 diabetes and accounts for 11% of deaths in people with type 2 diabetes.
~ Depression is approximately 200% higher in people with diabetes than in the general population.
~ Diabetes is associated with lower dopamine levels
~ Serotonin (central and peripheral) is implicated in regulation of blood glucose. SSRIs may improve A1C in people with diabetes and depression
~ Neuropathy (nerve damage) impacts up to 50% of people with diabetes contributing to slow wound healing, lack of awareness of wounds, erectile dysfunction and chronic pain.
~ Limb amputation occurs in approximately 1:40 people with diabetes will develop a foot ulcer which results in the amputation of a foot or leg.
~ Up to 70% of people die within five years of having an amputation.
~ Life expectancy is reduced, on average, by up to 10 years in people with type 2 diabetes
Function of the Counselor-Case Manager
~ Clinicians may need to deal with diabetes in clients
~ Who have not yet been diagnosed (precontemplation / contemplation)
~ Who have been recently diagnosed and are grieving, anxious about the diagnosis
~ Who have been diagnosed for a while and are either treatment noncompliant or are having increasing difficulties managing their blood sugar and complying with treatment
~ Being active to modulate blood sugar, improve insulin resistance mood and self-esteem (150 minutes/week)
~ Blood sugar monitoring and pattern identification
~ Healthful eating
~ A1C of <7% to prevent microvascular disease ~ Taking Prescribed Medications ~ Aspirin (salicylate) to address CVD risk and inflammation and help with blood sugar regulation ~ Blood pressure monitoring and management ~ Problem solving (preparing for the unexpected) ~ Oral Health ~ Smoking cessation ~ Alcohol moderation or cessation ~ Sleep improvement and sleep apnea treatment ~ Illness prevention: Health education, Motivation for prevention and mindfulness & early intervention ~ Quality of life (dialectics/and) Summary ~ Diabetes impacts people multidimensionally (PACER) ~ Counselors, social workers and case managers can assist through ~ Screening ~ Health education ~ Goal setting and planning ~ Motivational enhancement and maintenance ~ Addressing grief and anxiety issues associated with having a chronic illness