Counselling diabetic patients

Counselling diabetic patients

1. Diabetic Counseling Rph/ Sara Saber Clinical ph diploma Ain Shams university Counseling Diabetic Patient Rph / Sara Saber Clinical ph diploma Ain Shams university

2. 1 in 11 adults has diabetes (425 million ). 1 in 2 adults with diabetes is undiagnosed (212 million ). 1 in 6 births is affected by hyperglycemia in pregnancy.

3. Over 1 million children and adolescents have type 1 diabetes . Three-quarters of people with diabetes are of working age ( 327 million) Two-thirds of people with diabetes live in urban areas (279 million

4. MIDDLE EAST AND NORTH AFRICA Prevalence Countries with highest age adjusted comparative diabetes are Saudi Arabia (17.7 %). Saudi Arabia is the highest number of people with type 1 diabetes in children and adolescents(0-19 years) in 2017. The countries which allocated the largest share to diabetes were Saudi Arabia (24 %).

5. Role of pharmacists in diabetes management Due the significant gaps between reaching the goal of “optimal medication therapy” and the current state of medication use. The pharmacist's role in caring for diabetic patients has expanded. Pharmacists utilize their clinical expertise in monitoring and managing diabetes medication plans to positively impact health outcomes and empower patients to actively manage their health. The pharmacist can educate the patients about the proper use of medication to assure safe, appropriate, cost-effective diabetes medication use.

6. I. Counseling regarding the disease

7. Essential components of diabetic counseling Counseling regarding the disease : The diabetic patients should be explained that the disease is lifelong, progressive and needs necessary modifications in the lifestyle pattern. strict compliance with the prescribed medication.

8. Type 1 Diabetes Body does not make insulin. Usually develops in children or young adults. Normal Weight. Must take insulin daily to live.

9. Why is Insulin so Important If the sugar stays in your blood – it doesn’t do your cells (body) any good . The sugar has to get inside the cells for the body to use it . Insulin is like a key that opens up the door and allows the sugar to get out of the blood and inside the cell where the cell can “burn” the fuel for energy!

10. . Without insulin. With treatment of insulin.

11. Type 2 Diabetes Cells do not use insulin properly. Not enough insulin being produced. Becoming more common in children due to obesity. Many people with type 2 diabetes may remain unaware of their condition for years as the symptoms become over a period of time.

12. Gestational Diabetes Mellitus ( GDM) High blood sugar during pregnancy in non-diabetic person Studies suggest the disease affects between 1 and 14 % of pregnancies in the United States each year Risk factors for gestational diabetes include Prediabetes (blood sugar that's elevated, but not high enough to be called diabetes) High blood pressure A family history of type 2 diabetes Hormone disorders obesity.

13. Can cause large birth weight babies Must tightly control sugar during pregnancy Goes away after pregnancy, but many women go on to develop type 2 diabetes All pregnant women should be screened for GDM between 24 and 28 weeks of pregnancy.

14. II. Counseling regarding medications:

15. Know why it is important to take your medicines as prescribed. Know the medications you are on for diabetes . Know the possible side effects of your meds.

16. All about Insulin Used in patients with type 1 and type 2 diabetes Used to replace the insulin your body is no longer able to make Available in different formulations Short-acting insulin to take with meals Long-acting insulin to provide baseline insulin Insulin mixes Come in vials or pens

17. Prandial (Meal) Insulin's Humulin R®, Novolin R® Actrapid ® pid ® N ovorapid ® , humalog ® apidra ® Apidra ® Clear Rapid-Acting Inject these 15 minutes before meals Can inject right before meal or immediately after finishing meal Regular” insulin Clear Short-acting Inject these 30 minutes before meals

18. Basal Cloudy Lasts about 12-18 hours Inject these at consistent times, as prescribed Usually taken twice a day Intermediate long-acting analogue Clear Longer acting, usually taken once or twice a day

19. Premixed insulin Cloudy Usually taken twice a day with meals. Longer-acting part tends to work better when taken later at night (8-10pm) than when taken with supper

20. Insulin Delivery Syringe Pen Device Pump Inhaler

21. https://www.youtube.com/watch?v=WWS4rw0hvlc

22. Insulin Pumps/Pods https://www.youtube.com/watch?v=t7ajHnpaLpk External insulin pumps connect to narrow, flexible plastic tubing that ends with a needle inserted just under the skin The insulin pump delivers both basal and bolus doses of insulin . Three programmable ways to deliver insulin Basal rates Bolus doses Correctional doses

23. I njection sites

24. .

25. Insulin Care Refrigerate all insulin vials while not in-use May keep individual insulin vial at room temperature once in-use Just avoid exposing vials to high temperatures (over 30 degrees C) for extended periods Never freeze insulin – do not use after it has been frozen. Whether kept in refrigerator or at room temperature, most insulin vials should be discarded 4 weeks after first dose was drawn from it Exception: Levemir is good until 42 days after first use

26. Insulin - Side Effects Hypoglycemia = low blood sugar If you experience these symptoms, you need a quick source of sugar: juice, hard candy or glucose tablets Soreness or redness at injection site You can minimize this by rotating the injection site each time you administer insulin

27. Diabetes Pills

28. Metformin Tells the liver to stop sending out sugar Can help people lose some weight Main side effects are upset stomach and diarrhea , vit B-12 deficiency. These usually get better after about 1 week Taking with food can help . Stop if undergoing procedures using iodinated contrast dye because risk of nephrotoxicity then initiate after 48hrs.

29. Sulfonylureas Main thing to watch out for is having too many low blood sugars , If this happens, your doctor will give you a lower dose. Take the same way everyday Glucotrol XL cannot be crushed or cut in half; might see its empty shell in toilet

30. Meglitinides These tell the pancreas to make more insulin These are taken with meals, so you skip a dose if you skip a meal. Main side effect to watch out for is low sugars

31. ( Gliptins) Usually given once a day and can be taken with or without food You may need a lower dose if you have kidney disease

32. III . Counseling regarding lifestyle modifications

33. A. Diet : Dietary control is the mainstay of treatment in type 2 diabetes and an integral part in type 1 diabetes Carbohydrates Fat: Fiber B. Exercise and physical activity : Exercise can help to promote weight loss and maintain ideal body weight when combined with restricted caloric intake C. Smoking :