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What Does A Diabetic Consultant Do

Guidance For Becoming A Diabetes Educator/cde

Guidance For Becoming A Diabetes Educator/cde

How do I become a diabetes educator? One must be a healthcare professional who has a defined role as a diabetes educator, not for those who may perform some diabetes related functions as part of or in the course of other usual and customary duties. Practice as a diabetes educator means actively employed for compensation, providing a direct or indirect professional contribution to the care and self-management education of people with diabetes. Diabetes education, also referred to as diabetes self-management education or diabetes self-management training, is performed by health care professionals who have appropriate credentials and experience consistent with the particular profession's scope of practice. Diabetes self-management education is defined as the interactive, collaborative, ongoing process involving the person with diabetes or pre-diabetes and/or the caregivers and the educator(s). The process includes: Assessment of the individual's specific education needs Identification of the individual's specific diabetes self-management goals Education and behavioral intervention directed toward helping the individual achieve identified self-management goals Evaluation(s) of the individual's attainment of identified self-management goals Proper documentation of all education encounters Diabetes educators can be found in a variety of settings: hospitals, physician offices, clinics, home health, wellness programs, to name a few. They most often work within accredited or recognized diabetes education programs. This means that the diabetes education program has met requirements set forth by the Centers for Medicare & Medicaid Services and can bill for diabetes self-management training through two different codes: G0108 and G0109, which are for individual and group diabetes ed Continue reading >>

What It’s Like To Be A Diabetes Nurse

What It’s Like To Be A Diabetes Nurse

Grace Vanterpool, consultant nurse in diabetes at Central London Community Healthcare, explains what it takes to specialise in diabetes nursing and how demand for the specialty is set to increase An ageing population and a national obesity crisis are just two of the many factors contributing to the rise of diabetes in the UK. According to Diabetes UK, 11.9 million people in the UK have an increased risk of developing type 2 diabetes, and around 345,000 people live with type 1 diabetes. Yet despite a growing need for healthcare professionals to specialise in treating the condition, research from Diabetes UK in 2016 revealed that there is a ‘profound mismatch’ between the demand for diabetes services and the supply of diabetes specialist nurses. So what is it like to be a diabetes specialist nurse? Grace Vanterpool has 30 years of experience in the field. She describes how diabetes nursing has evolved over the years and some of the biggest challenges she faces in her role. Why did you specialise in diabetes? I fell into it 30 years ago when my daughter was little and I needed to work regular hours. I worked in outpatient clinics at the time and then I did a diabetic clinic. I then became a diabetes nurse. How has diabetes nursing evolved? I did research alongside my caseload. We also ran the retinopathy unit. Then we added renal and cardiovascular clinics at different times of the month. Essentially, this was a forerunner for what’s happening with diabetes nursing today in a more structured way. I think change has been slow and investment in diabetes has been slow. But in the last five to eight years, we’ve had a plethora of new drugs for the condition, and lots of research confirming the importance of good glycaemic control and reducing risk factors like blood pr Continue reading >>

Diabetes Type 1

Diabetes Type 1

There are certain things that you should expect from your medical team. If you have just been diagnosed with Type 1 diabetes you should have: A full medical examination- this may also include a referral to a specialist eye clinic. A talk with a diabetes care nurse who will explain what diabetes is and about your treatment. Several sessions with your diabetes nurse for basic instruction on injection technique, looking after your insulin, blood glucose meter and pen, blood glucose testing and what the results of your own testing means. You should also expect to have a discussion about hypoglycaemia (hypos) and how to deal with it. After this initial help, you should have access to a diabetes care team where you will have the opportunity to talk to doctors, nurses and dieticians. They will assess your diabetes control and discuss any problems with you. You should also be given a contact number so that you are able to contact a member of the team for advice whenever you need it. Most diabetic clinics have a specialist nurse who will visit you at home between hospital appointments especially in the early days after your diagnosis. Each year you are entitled to an Annual Review assessment by the diabetes care team.This should include a blood pressure check, a measurement of height and weight, drawing blood to find out your cholesterol level and your HbA1c (average blood glucose over the last few weeks), plus a urine test to check whether your kidneys are working well. They should also examine your feet and reflexes to check that your nerves are okay, and they may ask you whether you smoke and offer help to give up if you would like to do so. In addition, the annual review should include an examination of your eyes, although this may be done at a specialist eye clinic. Drops w Continue reading >>

Specialist Diabetes Team: Role And Members

Specialist Diabetes Team: Role And Members

Specialist diabetes team: role and members Specialist diabetes team: role and members Working together to deliver a local model of care Specialist diabetes teams can best fulfil their potential when functioning in a complementary fashion to other parts of the healthcare system. Commissioners must ensure the delivery of services for their population that meets local health needs, and monitor the quality of those services and outcomes. Multidisciplinary primary care teams have a fundamental role in the prevention and identification of diabetes as well as in routine care at a level that fits with their competencies. This role will often include active case management of patients with multiple conditions. Specialists involved in the delivery of diabetes care must work in multidisciplinary teams for care to be truly effective. They should have received extensive training accredited at a national level. Specialist teams should comprise physicians, nurses, podiatrists, dietitians and clinical psychologists, who will also collaborate with many other specialists who might be incorporated into the team. Specialist teams provide direct care for people with diabetes with complex needs that cannot be met within the skill competencies of the general practice team. Examples include: People newly diagnosed with Type 1 diabetes. People with Type 1 diabetes (for carbohydrate counting and/or the use of insulin pumps/or continuous blood glucose monitoring). Pregnant women and those planning a pregnancy. Patients with significant and ongoing cardiovascular or peripheral vascular disease. Young patients with diabetes of an undefined nature. Patients with active foot ulcers or uncontrolled neuropathic pain. Patients with diabetes and renal disease or retinopathy requiring active management o Continue reading >>

The Role Of The Diabetes Specialist Nurse

The Role Of The Diabetes Specialist Nurse

Author(s): Susan Josephine Cable Diabetes Specialist Nurse, Ashford and St Peters NHS Foundation Trust, UK Correspondence: Susan Cable [email protected] Abstract The following article focuses upon the essential role of the Diabetes Specialist Nurse (DSN) in the care and management of patients with diabetes. The author is a DSN in the United Kingdom (UK), where the specialist nursing role has become a fundamental and crucial part of the diabetes multidisciplinary team (MDT) and service. The author draws upon her own experiences within the UK as a DSN and discusses ways in which the role could prove advantageous for a low income country such as South Sudan. The article considers key targets for developing countries and how the DSN role could help them to be achieved. There are two main types of diabetes: type 1 and type 2. Global statistics often do not differentiate between the two, therefore in this article the author refers to both types under the general term of ‘diabetes’. There is, however, a greater emphasis placed upon type 2. Key words: Role, Diabetes, Specialist, Nurse, DSN. Background Diabetes has become an increasingly serious health issue on a global scale, with the number of people living with diabetes rising significantly over the last 35 years. There are now reported to be 422 million adult diabetics (1 in 11) internationally, the majority having type 2 [1]. According to the World Health Organisation (WHO), the biggest increase is amongst low and middle income countries, such as South Sudan, where an estimated 7.43% of the population has diabetes [1]. The rise in diabetes in developing countries is suggested to be due to population growth, ageing and urbanisation: Urbanisation tends to result in physical inactivity and a greater risk of obesity [2] Continue reading >>

Diabetes Healthcare Team

Diabetes Healthcare Team

Tweet Depending on your own individual diabetes care needs, your healthcare team can vary considerably in size. This team will assist you in your diabetes management. At a very minimum your health team may just be your GP, however you should have access to a range of specialists as and when you need them. GP - general practitioner Your GP (general practitioner) is your first point of contact who will be kept updated of any changes in your care and is responsible for prescribing any medicines and supplies you need. Read more about your GP Consultant or diabetologist Depending on the set up at your medical centre, you may or may not have regular access to a consultant or diabetologist, however, you should have access to one if you have specialist questions that needs a consultant’s advice. Diabetes specialist nurse - DSN Diabetes specialist nurses, as the name suggests, are nurses with specialist knowledge of diabetes. Diabetes specialist nurses play a role in helping and supporting people with diabetes in managing their condition. Practice nurse Practice nurses play a key and varied role in medical centres. Practice nurses are trained to deal with a wide range of tasks from treating injuries to performing blood tests and vaccinations. Pharmacist Pharmacists receive specialist training in a wide variety of medical conditions, medications and treatments. If you have questions about your medication, such as side effects, your pharmacist can advise you. Optometrist and opthalmologist Optometrists and opthalmologists are both eye specialists and can help with your retinopathy screening and other eye conditions such as glaucoma and cataracts. The difference between the two is that an ophthalmologist is likely to have a deeper specialist knowledge and will be responsible for Continue reading >>

What Does Diabetes Have To Do With Patients With Stroke?

What Does Diabetes Have To Do With Patients With Stroke?

Q. Are persons with diabetes at risk for stroke? A. The risk of stroke is increased 2.9-fold among persons with diabetes, accounting for 15% to 27% of all incident strokes.1 Stroke risk is limited to ischemic, not hemorrhagic, events. In a separate systematic review and meta-analysis of 64 cohorts including 775,385 individuals, the relative risk of diabetes-related stroke was calculated at 2.28 in women and 1.83 in men.2 In a review of 5 cohort studies on people with prediabetes (defined as HA1c 6.1%-6.9%),3 there is a 21% increase in stroke risk after adjusting for other cardiovascular risk factors. In contrast, there is a reduced incidence of transient ischemic attacks (TIA) among people with diabetes. A person with diabetes with a TIA has a 2.1 to 5.6-fold greater risk of subsequent stroke.1 _______________________________________________________________________________________________________________________________________________________________________________________________________________________ Q. If a patient admitted with a stroke and has hyperglycemia, does this mean they have diabetes? A. In a systematic review of 33 studies, 8% to 63% of patients without diabetes were admitted with a glucose level of >6.1 mmol/L (>110 mg/dL) versus 39% to 83% of patients who had diabetes.4 Glucoses declined within the first 24 hours and increased again after 48 hours. Among hyperglycemic patients without diabetes, 27% to 37% developed impaired glucose tolerance within 3 months after discharge and one-third of these individuals went on to develop overt diabetes. Q. Does admission for hyperglycemia pose any additional risk to patients with stroke? A. The risk of death among patients with diabetes and a blood glucose level of >140 mg/dL is increased 2.7-fold; the risk of d Continue reading >>

Diabetes Clinics | Diabetes Uk

Diabetes Clinics | Diabetes Uk

Diabetes clinics give you the chance to meet medical experts who can check that you're well and give you highly specialised advice on how to look after your diabetes here's how they work. If so much of your diabetes care is up to you, why go to a diabetes clinic? One reason is to help you understand new things. Clinic staff have years of experience specialising in helping people with diabetes. It's the kind of expertise you're unlikely to find in a GP or practice nurse who deals in general healthcare. Clinic staff check how your diabetes is being managed, help you with any difficulties, and pre-empt any possible future health problems. You know what your blood test results are every day, but if you've had a really bad patch, it's hard to get things in perspective. Clinic staff will show you how well you are doing over a longer period. After your first visit, you'll probably go back on a regular basis usually about four times a year. Every year you'll have a big checkup to look you over completely. Every time you go, clinic staff should also give you the results of any tests and explain them to you. These results will help you with your diabetes control. If you're not given the results, or don't understand them, ask and keep asking if needs be. Depending on your age, you'll probably go to the clinic with a parent or guardian. But there might be parts of your clinic visit that you want them to come to, and other parts when you want to be alone. Don't be afraid to ask for this if you want it clinic staff will understand. When you move on to an adult clinic this can be quite different from a child or adolescent clinic. You should be offered a clinic where the children and adult teams work together and monitor your diabetes. Continue reading >>

Diabetes Doctors: Which Specialists Treat Diabetes?

Diabetes Doctors: Which Specialists Treat Diabetes?

Diabetes is a condition that affects a person's blood sugar levels and can require various treatments. Understanding which doctors help treat diabetes can simplify the process, making it less stressful. This article helps people with diabetes to understand the key differences between the various diabetes specialists. It also covers some common guidelines to follow for visiting each of these experts, to ensure you get the most out of your treatment. Which doctors help with treating diabetes? There are a number of diabetes specialists who may be involved in treating someone with this common condition. As each of these specialists has a slightly different role, there are some key things to be aware of before seeing each one. General care physicians A general care physician will often help in the treatment of people with diabetes. Regular check-ups will usually be carried out once every 3 to 4 months. If there is anything outside their area of expertise, a general care physician will frequently send an individual to an endocrinologist first of all. Endocrinologists The most common specialists in the field of diabetes are endocrinologists. Endocrinologists specialize in the glands of the body, and the hormones that are produced from those glands. The pancreas is a gland that comes under the spotlight when managing diabetes. It produces insulin that helps regulate blood sugar. In the case of people with diabetes, insulin is either not produced or does not work properly. People with type 1 diabetes are put under the care of an endocrinologist most of the time. People with type 2 diabetes, who have fluctuating blood sugar levels, will also need to see an endocrinologist. Visiting a doctor for diabetes When visiting a doctor about diabetes for the first time, it is important tha Continue reading >>

Your Diabetes Care Team

Your Diabetes Care Team

Your health care team helps you manage your diabetes and maintain your good health. According to the American Diabetes Association, your diabetes care team should include: You: You are the most important member of your diabetes care team! Only you know how you feel. Your diabetes care team will depend on you to talk to them honestly and supply information about your body. Monitoring your blood sugar tells your doctors whether your current treatment is controlling your diabetes well. By checking your blood sugar levels, you can also prevent or reduce the episodes of hypoglycemia (low blood sugar) you have. Primary doctor: Your primary care doctor is who you see for general checkups and when you get sick. This person is usually an internist or family medicine doctor who has experience treating people with diabetes, too. Because your primary care doctor is your main source of care, he or she will most likely head up your diabetes care team. Endocrinologist: An endocrinologist is a doctor who has special training and experience in treating people with diabetes. You should see yours regularly. Dietitian: A registered dietitian (RD) is trained in the field of nutrition. Food is a key part of your diabetes treatment, so yours will help you figure out your food needs based on your weight, lifestyle, medication, and other health goals (like lowering blood fat levels or blood pressure). Nurse educator: A diabetes educator or diabetes nurse practitioner is a registered nurse (RN) with special training and background in caring for and teaching people with diabetes. Nurse educators often help you with the day-to-day aspects of living with diabetes. Eye doctor: Either an ophthalmologist (a doctor who can treat eye problems both medically and surgically) or an optometrist (someone who Continue reading >>

When Should You See A Diabetes Specialist?

When Should You See A Diabetes Specialist?

Many people who have diabetes also have an experienced primary care (or family practice) doctor or nurse practitioner who can help them manage their diabetes. For example, people with uncomplicated type 2 diabetes may never need to see a specialist because they can easily manage it with their primary care doctor’s help. Other people, however, might choose to see a specialist. Here are 10 reasons why you might want to see an endocrinologist or diabetes care team: 1) Your doctor recommends you have an evaluation with a specialist. After you have been diagnosed with diabetes, your doctor may recommend you see a specialist to confirm the diagnosis and make sure you know your options for managing the disease. 2) Your primary care physician has not treated many diabetes patients. If your doctor has not treated many patients with diabetes or you are unsure about their treatment, you can choose to see a specialist. 3) You are having problems communicating with your doctor. If you feel your doctor is not listening to you or understanding your symptoms, you could see a specialist who will focus primarily on your diabetes. 4) You cannot find the right educational material to help you. Treatment for diabetes starts with learning to manage your diabetes. If you can’t find the right information to help you manage your diabetes, you might want to see a diabetes care team to receive diabetes education. 5) You are having complications or difficulty managing your diabetes. You should definitely see a specialist if you have developed complications. Diabetes typically causes problems with the eyes, kidney, and nerves. In addition, it can cause deformity and open sores on the feet. Diabetes complications only get worse with time, and can cause you to miss out on quality of life. In addi Continue reading >>

Diabetes Care Who Does What?

Diabetes Care Who Does What?

Weve updated our Privacy Notice. Take a moment to review it here. Diabetes is a common condition and medical services in the UK are well geared to care for people who have it. But this means there's a lot of information to take in when you're first diagnosed - so use our guide to find out about the health professionals you'll meet. Diabetes is a common condition and medical services in the UK are well geared to care for people who have it. But this means there's a lot of information to take in when you're first diagnosed so use our guide to find out about the health professionals you'll meet. The actions you take in day-to-day living, the lifestyle choices you make and how you get on with your prescribed treatment are all important parts of your care. The more comfortable you are with understanding the different aspects of diabetes and the basics of how to manage it, the less likely you are to have problems. For many people with diabetes, your primary care team will provide all the help and advice you need. GPs are used to monitoring diabetes, but general practice is a vast area of medicine and it's impossible to be an expert in everything. Some GPs do have a special interest in diabetes, and in some practices this GP will take the lead in the practice's arrangements for diabetes care. Newly diagnosed people with diabetes and those needing treatment adjustments will usually be seen at the local diabetes clinic. Children and younger Type 1 diabetics tend to be managed by hospital-based teams in diabetes centres. The extended primary care team is quite a large group of people. They may not be housed within the same building as your GP (practice nurses almost always will be), but they are essential to the smooth delivery of care. Practice nurse: has often completed extra Continue reading >>

Diabetes Consulting | Diabetes Coaching Services

Diabetes Consulting | Diabetes Coaching Services

Diabetes Consulting Services Integrated Diabetes Services 2017-06-14T21:35:20+00:00 Diabetes Management & Consulting Services Whether youd like a diabetes consultation over the internet, a mobile device, on the phone or in our office, we are here to guide you! Our office located near Philadelphia features all of the latest high-tech tools & gadgets, situated in a comfortable, down-to-earth setting that is conducive to sharing, learning and problem solving. No cubicles here just lots of bright open space and supportive/motivational surroundings. If you dont live near our office, no problem! We offer all of our diabetes consulting & coaching services remotely via phone, fax, e-mail, live chat, and video conference. Imagine expert guidance right in the comfort of your home, business, or wherever you happen to be. No driving, parking, or conforming to mass-transit schedules. Even people who live near our office enjoy the convenience of remote consultations! (please call for current pricing on all our services: toll-free in the US 877-735-3648; outside the US 011-1-610-642-6055) Completion and review of a comprehensive self-assessment Submission of questions/records prior to scheduled appt. Analysis of records/data downloads prior to scheduled appt. Design or fine-tune insulin/medication program Design custom record-keeping system & communication plan Primary self-management education based on assessment Follow-up planning with written instructions Free diabetes supply samples (as needed & available) 3 Scheduled (monthly) follow-up consultations, approx. 30-45 min. each Unlimited submission of questions, records (logsheets, data downloads) for review and adjustment between consultations (responses usually within 24 hours) 6 Scheduled (monthly) follow-up consultations, appro Continue reading >>

What Are Diabetes Specialist Nurses?

What Are Diabetes Specialist Nurses?

If you have recently been diagnosed with type 1 diabetes, or are having trouble managing your type 2 diabetes, you may be referred to a diabetes specialist nurse. Some 2.9 million people in the UK have diabetes, a condition that, if not well controlled, can lead to serious complications, such as heart disease, stroke, eye and kidney problems and nerve damage in the feet, which may in turn lead to foot ulcers and even amputation. Pioneering nurse, Janet Kinson, was the first to recognise the need to train nurses to educate and support people with diabetes and their families some 70 years ago. Today there are some 1300 diabetes specialist nurses (DSNs) working in hospitals, doctors’ surgeries and the community. There is also a growing number of diabetes nurse consultants, with a more extensive role in leading and planning services. Who are diabetes nurses? A trained nurse with special expertise in the care and treatment of diabetes, a DSN can be an invaluable source of information, advice and support, for example if you have to start using insulin, if your blood sugar becomes uncontrolled or if other health problems emerge that complicate your diabetes. They will liaise on your behalf with other healthcare professionals such as your GP, practice nurse, dietitian, podiatrist (foot specialist) and optometrist (eye screening specialist). You can talk to them on the phone, see them when you visit the diabetes or other clinic or they may visit you at home if you are housebound. What are the benefits of seeing a diabetes specialist nurse? Managing diabetes isn’t always easy and your needs may change over time as the condition progresses. “Usually DSNs work with people with diabetes who have complications, such as foot disease or kidney failure, and with people who need mo Continue reading >>

Endocrinology And Diabetes

Endocrinology And Diabetes

Endocrinologists and diabetologists (ED) are medical doctors who investigate, diagnose and treat disorders of the endocrine system. This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you. Nature of the work The main glands of the endocrine system are the adrenal glands, ovaries and testicles, pancreas, pituitary gland, parathyroid glands and thyroid gland. These glands secrete hormones (chemical messengers) into the circulation which have an effect on specific organs of the body. Endocrinology and diabetes is predominantly an outpatient specialty but a number of patients require hospital admission for complex investigations or the management of complications. Furthermore, at least 15% of hospital inpatients have diabetes mellitus or other endocrine conditions. Increasingly, hospital-based specialists manage diabetes patients jointly with colleagues in primary care and training has been adjusted to reflect this. Patients usually have chronic conditions and management is holistic and long term often in a multidisciplinary team fashion. Endocrinologists and diabetologists treat conditions such as: diabetes mellitus thyroid disease endocrine disorders of the reproductive system, such as polycystic ovary syndrome adrenal disease bone and calcium disorders pituitary disease endocrine late effects of cancer treatment Common procedures/interventions These include: programmed investigations for complex endocrine disorders pre and post-operative management of endocrine patients and patients with diabetes management of diabetic and endocrine emergencies such as ketoacidosis and hypercalcaemia management of diabetes and endocrine conditions during pregnancy multidisciplinary working Continue reading >>

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