CDCES
2 statements of The Hunger Vital Sign: - ANS-"- ""inside the beyond 12m, we involved our
meals might run our before we got money to shop for greater""
- ""inside the past 12m, the meals we offered did not ultimate and we did not have cash to get
extra""
At threat for meals insecurity if answer ""frequently genuine"" or ""from time to time authentic""
for either or each"
2 statements of The Hunger Vital Sign: - ANS-"- ""in the past 12m, we concerned our food might
run our before we got money to buy extra""
- ""inside the beyond 12m, the food we offered failed to remaining and we did not have money to
get more""
At threat for meals insecurity if answer ""often authentic"" or ""every now and then authentic""
for either or both"
5 critical instances to offer & alter DSMES: - ANS-"- at DX
- while now not meeting tx dreams
- annually
- when complicating elements rise up
- whilst transitions in existence or care arise"
5 vital times to provide and adjust DSMES: - ANS-"- at DX
- whilst no longer assembly tx goals
- yearly
- while complicating elements expand
- whilst transitions in lifestyles and care arise"
five essential times to offer and alter DSMES: - ANS-"- at DX
- whilst no longer meeting tx desires
- annually
- while complicating elements expand
- when transitions in life and care occur"
6 middle elements of the Chronic Care Model: - ANS-"- delivery: proactive & team-based >
reactive
- scientific data systems: patient and population registeries
- community resources & policies
- self-control support
- selection aid: primarily based on proof
,- health systems: exceptional-orientated culture"
6 core elements of the Chronic Care Model: - ANS-"- transport: proactive & team-primarily
based > reactive
- medical information systems: patient and population registeries
- community sources & regulations
- self-management support
- selection help: based on evidence
- health systems: exceptional-oriented subculture"
504 plan for school safety: - ANS-"- provide DM schooling for team of workers
- shared responsibilities for care (assistance c insulin, BG assessments, food & adminstration of
glucagon PRN), management by means of college RN
- self-control allowed in school settings, consists of BG tracking, med admintrations & get
admission to to meals"
A1C in GDM: - ANS-"A1C falls d/t RBC turnover, might not seize postprandial hypergly
- lowest destructive consequences at <6-6.5%
- <6% if top of the line if secure, esp in 2d & 3rd trimester"
AABBCC of T1D: - ANS-"- age, <35yo, 75% <18yo
- autoimmunity, private or family hx
- frame habitus, BMI <25
- heritage, family hx T1
- control, ^BG stages on noninsulin therapies
- comorbitiies, different autoimmune situations or CA tx"
Activity desires for kids: - ANS-"- 60m physical pastime
- limit nonacademic display screen time to <2h/d"
Adult learner considerations: - ANS-"- self-directed, must feel need to
- problem oriented rather than subject oriented
- learn better when own experience is used
- prefer active participation"
AGP targets in pregnancy: - ANS-"- CGM may not be used as substitute for meter
- goal TIR, >70%
- purpose <sixty three, <4%
- aim <fifty four, <1%
- goal >140, <25%"
Alcohol recommendation: - ANS-"- men up to 2 drinks/d, women 1/d
- drink with food
- risks: hypogly, hypergly, wt gain, may worsen neuropathy"
,Alcohol recommendation: - ANS-"- men up to 2 drinks/d, women 1/d
- drink with food"
Ambulatory glucose profile (AGP) for those on CGM devices: - ANS-"- >70% of readings 70-180
- for the ones c frailty or ^hazard of hypo: time in variety at least 50% of the time & <1% time
beneath range
Lows:
- <four% <70
- <1% <fifty four
Highs:
- <25% >one hundred eighty
- <5% >250"
Ambulatory glucose profile for the ones on CGM devices: - ANS-"- >70% of readings 70-one
hundred eighty
- <4% <70
- <1% <54
- <25% >one hundred eighty
- <5% >250
- for the ones c frailty or ^danger of hypo: time in range as a minimum 50% of the time & <1%
time below range "
Antipsychotic meds & DM: - ANS-"- screen at baseline
- rescreen at 12-16w after RX initiation
- screen annually"
Are very rapid acting insulin analogs used in T1D or T2D? - ANS-- T1D, for those trying to fine
tune their blood sugars
Are very rapid acting insulin analogs used in T1D or T2D? - ANS-T1D, for those trying to fine
tune their blood sugars
ASCVD includes: - ANS-"- coronary heart dz
- cerebrovascular dz
- PAD
* with more aggressive goals, rates of CVD have over in past decade"
Aspirin therapy for preeclampsia: - ANS-"- PWD 2-4x increased risk
- s/s HTN, edema, proteinuria
- associated c decreased blood flow to fetus
- start aspirin therapy at 12-16w until birth, reduces morbidity, saves lives & lowers health care
costs"
, Aspirin therapy: - ANS-"- secondary prevention for those c DM + hx of CVD
- primary prevention for those >50 + ^CVD risk"
Assessing meds taking behaviors: - ANS-"- good enough med taking is eighty%+
- 23% of the time, if A1C/BP/lipid above goal d/t med taking conduct
- - check for limitations, target method for each
- if taking meds eighty% & desires not met, don't forget intensifying"
Assessing meds taking behaviors: - ANS-"- ok med taking is 80%+
- 23% of the time, if A1C/BP/lipid above target d/t med taking behavior
- - examine for limitations, goal technique for each
- if taking meds 80% & dreams not met, don't forget intensifying"
Bariatric/metabolic sx: - ANS-"- BMI >30
- complete intellectual fitness evaluation previous & ongoing intellectual fitness assist
- wishes lifelong scientific & behavioral guide & monitoring
- average DM remission 8y
- majority maintain widespread glycemic development 5-15y
- advanced glycemic & CVD chance for PWD & weight problems compared to nonsurgical
interventions
- may additionally reduce all purpose mortality"
Basal insulin + drip: - ANS-Studies display that low dose (0.15-zero.3u/kg) basal + IV insulin
may additionally reduce the period of insulin infusion and duration of medical institution stay and
save you rebound hypergly w/o ^chance of hypogly
Before preventing IV insulin: - ANS-Initiate subq basal based totally on insulin infusion fee final
6h or BW or domestic dose
BG goals in hospitals: - ANS-"- individualize
- start insulin if BG a hundred and eighty+
- if on insulin goal BG one hundred forty-one hundred eighty
- in ICU, purpose a hundred and ten-140, esp s/p CABG, basal/bolus or drip, careful to avoid
hypogly
- med surg, intention a hundred-a hundred and eighty
- - bad PO, basal + correction
- - good enough consumption, basal/bolus
- - restart home meds some days before DC"
BG management in hospitals: - ANS-"- BG >one hundred eighty 2x in 24h
- aim 140-a hundred and eighty
- - a hundred and ten-a hundred and forty in ICU, esp s/p CABG
- check A1C isn't checking in 3m
- use POC BG for insulin dosing and hypo evaluation
2 statements of The Hunger Vital Sign: - ANS-"- ""inside the beyond 12m, we involved our
meals might run our before we got money to shop for greater""
- ""inside the past 12m, the meals we offered did not ultimate and we did not have cash to get
extra""
At threat for meals insecurity if answer ""frequently genuine"" or ""from time to time authentic""
for either or each"
2 statements of The Hunger Vital Sign: - ANS-"- ""in the past 12m, we concerned our food might
run our before we got money to buy extra""
- ""inside the beyond 12m, the food we offered failed to remaining and we did not have money to
get more""
At threat for meals insecurity if answer ""often authentic"" or ""every now and then authentic""
for either or both"
5 critical instances to offer & alter DSMES: - ANS-"- at DX
- while now not meeting tx dreams
- annually
- when complicating elements rise up
- whilst transitions in existence or care arise"
5 vital times to provide and adjust DSMES: - ANS-"- at DX
- whilst no longer assembly tx goals
- yearly
- while complicating elements expand
- whilst transitions in lifestyles and care arise"
five essential times to offer and alter DSMES: - ANS-"- at DX
- whilst no longer meeting tx desires
- annually
- while complicating elements expand
- when transitions in life and care occur"
6 middle elements of the Chronic Care Model: - ANS-"- delivery: proactive & team-based >
reactive
- scientific data systems: patient and population registeries
- community resources & policies
- self-control support
- selection aid: primarily based on proof
,- health systems: exceptional-orientated culture"
6 core elements of the Chronic Care Model: - ANS-"- transport: proactive & team-primarily
based > reactive
- medical information systems: patient and population registeries
- community sources & regulations
- self-management support
- selection help: based on evidence
- health systems: exceptional-oriented subculture"
504 plan for school safety: - ANS-"- provide DM schooling for team of workers
- shared responsibilities for care (assistance c insulin, BG assessments, food & adminstration of
glucagon PRN), management by means of college RN
- self-control allowed in school settings, consists of BG tracking, med admintrations & get
admission to to meals"
A1C in GDM: - ANS-"A1C falls d/t RBC turnover, might not seize postprandial hypergly
- lowest destructive consequences at <6-6.5%
- <6% if top of the line if secure, esp in 2d & 3rd trimester"
AABBCC of T1D: - ANS-"- age, <35yo, 75% <18yo
- autoimmunity, private or family hx
- frame habitus, BMI <25
- heritage, family hx T1
- control, ^BG stages on noninsulin therapies
- comorbitiies, different autoimmune situations or CA tx"
Activity desires for kids: - ANS-"- 60m physical pastime
- limit nonacademic display screen time to <2h/d"
Adult learner considerations: - ANS-"- self-directed, must feel need to
- problem oriented rather than subject oriented
- learn better when own experience is used
- prefer active participation"
AGP targets in pregnancy: - ANS-"- CGM may not be used as substitute for meter
- goal TIR, >70%
- purpose <sixty three, <4%
- aim <fifty four, <1%
- goal >140, <25%"
Alcohol recommendation: - ANS-"- men up to 2 drinks/d, women 1/d
- drink with food
- risks: hypogly, hypergly, wt gain, may worsen neuropathy"
,Alcohol recommendation: - ANS-"- men up to 2 drinks/d, women 1/d
- drink with food"
Ambulatory glucose profile (AGP) for those on CGM devices: - ANS-"- >70% of readings 70-180
- for the ones c frailty or ^hazard of hypo: time in variety at least 50% of the time & <1% time
beneath range
Lows:
- <four% <70
- <1% <fifty four
Highs:
- <25% >one hundred eighty
- <5% >250"
Ambulatory glucose profile for the ones on CGM devices: - ANS-"- >70% of readings 70-one
hundred eighty
- <4% <70
- <1% <54
- <25% >one hundred eighty
- <5% >250
- for the ones c frailty or ^danger of hypo: time in range as a minimum 50% of the time & <1%
time below range "
Antipsychotic meds & DM: - ANS-"- screen at baseline
- rescreen at 12-16w after RX initiation
- screen annually"
Are very rapid acting insulin analogs used in T1D or T2D? - ANS-- T1D, for those trying to fine
tune their blood sugars
Are very rapid acting insulin analogs used in T1D or T2D? - ANS-T1D, for those trying to fine
tune their blood sugars
ASCVD includes: - ANS-"- coronary heart dz
- cerebrovascular dz
- PAD
* with more aggressive goals, rates of CVD have over in past decade"
Aspirin therapy for preeclampsia: - ANS-"- PWD 2-4x increased risk
- s/s HTN, edema, proteinuria
- associated c decreased blood flow to fetus
- start aspirin therapy at 12-16w until birth, reduces morbidity, saves lives & lowers health care
costs"
, Aspirin therapy: - ANS-"- secondary prevention for those c DM + hx of CVD
- primary prevention for those >50 + ^CVD risk"
Assessing meds taking behaviors: - ANS-"- good enough med taking is eighty%+
- 23% of the time, if A1C/BP/lipid above goal d/t med taking conduct
- - check for limitations, target method for each
- if taking meds eighty% & desires not met, don't forget intensifying"
Assessing meds taking behaviors: - ANS-"- ok med taking is 80%+
- 23% of the time, if A1C/BP/lipid above target d/t med taking behavior
- - examine for limitations, goal technique for each
- if taking meds 80% & dreams not met, don't forget intensifying"
Bariatric/metabolic sx: - ANS-"- BMI >30
- complete intellectual fitness evaluation previous & ongoing intellectual fitness assist
- wishes lifelong scientific & behavioral guide & monitoring
- average DM remission 8y
- majority maintain widespread glycemic development 5-15y
- advanced glycemic & CVD chance for PWD & weight problems compared to nonsurgical
interventions
- may additionally reduce all purpose mortality"
Basal insulin + drip: - ANS-Studies display that low dose (0.15-zero.3u/kg) basal + IV insulin
may additionally reduce the period of insulin infusion and duration of medical institution stay and
save you rebound hypergly w/o ^chance of hypogly
Before preventing IV insulin: - ANS-Initiate subq basal based totally on insulin infusion fee final
6h or BW or domestic dose
BG goals in hospitals: - ANS-"- individualize
- start insulin if BG a hundred and eighty+
- if on insulin goal BG one hundred forty-one hundred eighty
- in ICU, purpose a hundred and ten-140, esp s/p CABG, basal/bolus or drip, careful to avoid
hypogly
- med surg, intention a hundred-a hundred and eighty
- - bad PO, basal + correction
- - good enough consumption, basal/bolus
- - restart home meds some days before DC"
BG management in hospitals: - ANS-"- BG >one hundred eighty 2x in 24h
- aim 140-a hundred and eighty
- - a hundred and ten-a hundred and forty in ICU, esp s/p CABG
- check A1C isn't checking in 3m
- use POC BG for insulin dosing and hypo evaluation
