Diabetes Counseling & Case Management
CEUs available at: https://allceus.com/member/cart/index/product/id/1369/c/
~	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.
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