RUSH COPLEY OUTPATIENT DIABETES CENTER Donna Carter RN

RUSH COPLEY OUTPATIENT DIABETES CENTER Donna Carter RN CDE

This is what we know This is how much we can still learn

History of Diabetes Earliest known record of diabetes mentioned on 3 rd Dynasty Egyptian papyrus mentions polyuria (frequent urination) as a symptom. 11 th Century Diabetes was commonly diagnosed by 'water tasters, ' who drank the urine of those suspected of having diabetes; the urine of people with diabetes was thought to be sweettasting. 1921 Insulin is 'discovered'. A de-pancreatized dog is successfully treated with insulin. 1970 Blood glucose meters and insulin pumps are developed.

History of Diabetes 2018 Continuous Glucose Sensors Insulin pumps 288 readings a day No finger pokes! Can give meal time insulin based on the reading seen on the graph 10 – 14 day wear Medtronic 670 G adjusts basal insulin according to blood sugar levels. Tslim will suspend insulin delivery when blood sugars are low. New insulin Higher concentration Pens that hold higher doses Faster acting meal time insulin

Statistics More than 30 million people in the United States have diabetes, and 1 in 4 of them don’t know they have it. More than 84 million US adults—over a third— have prediabetes, and 90% of them don’t know they have it. Diabetes is the 7 th leading cause of death in the United States (and may be underreported). Type 2 diabetes accounts for about 90% to 95% of all diagnosed cases of diabetes; type 1 diabetes accounts for about 5%. In the last 20 years, the number of adults diagnosed with diabetes has more than tripled as the American population has aged and become more overweight or obese.

Who Are We? There are 3 CDE’s working at the Rush Copley Diabetes Center We have 1 part time dietitian who is working towards her CDE We are open Monday – Friday and have evening hours on Tuesday We are recognized by the American Diabetes Association We are certified in Insulin Pumps and Continuous Glucose Sensors

What Do We Do? The Rush Copley Diabetes Center sees: Type 1 patients Type 2 patients Gestational diabetes High Risk patients admitted to the hospital We teach: Diabetes Education Diabetes self management Medical nutrition therapy Insulin teaching and administration Insulin pump set up and management Continuous Glucose Sensor set up and management Medical Nutrition Therapy Safe at School Act Community health fairs

Who Are We Helping? In 2017 we had a total of 1150 patient visits Of those patients seen, a total of 153 patients used our charitable resources This amounted to 352 patient visits or 1/3 that used charitable resources More than ½ are in their 20’s and 30’s More than ½ are Hispanic More than 1/3 (38 patients) have Gestational Diabetes

Gestational Diabetes Rush Copley is the 6 th busiest Birthing Center in the state. GDM can cause Increased birth weights Shoulder distocia Cord compression Can lead to Type 2 diabetes in 5 -10 years

Why diabetes education is important DIABETES EDUCATION REDUCES RISKS of readmission/complications In a systematic review that included 118 unique interventions, data analysis revealed an average reduction in A 1 C of 0. 57 for persons with type 2 diabetes who received diabetes self-management education (DSME) compared to those who did not; this statistically significant reduction demonstrated that engagement in DSME results in substantial and significant improvements in glycemic control in persons with type 2 diabetes. Chrvala CA, Sherr D, Lipman RD. Patient Educ Couns. 2016 Jun; 99(6): 926 -43.

Diabetes Education The burden of diabetes among hospitalized patients, however, is substantial, growing, and costly, and readmissions contribute a significant portion of this burden Reducing readmission rates of diabetic patients has the potential to greatly reduce health care costs while simultaneously improving care

INSURANCE COVERAGES REIMBURSEMENT Commercial insurance most often covers outpatient diabetes education The cost of diabetes education at Rush Copley Diabetes Center is $128. 00 per uninsured/underinsured patient If we successfully treat them and prevent admission/readmission we are saving $1, 141. 00 per patient

GRANT FUNDING We have more patients who are being seen by their PCP via the expansion of Medicaid More patients are being referred and seen Budget for this program is estimated to be $19, 600 for 2019 Our sustainable income each year is approximately $9, 000 This year were able to partner with …. Rush Copley Foundation’s Rock The Heart $5, 000 Last Friday in September and held at Bally. Doyle Janssen Pharmaceutical donated $2, 500 Medtronic diabetes donated $1, 150 Employee Giving Campaign $4, 000

NEED IS GROWING Over the last 3 years we have seen an increase in the number of patients seen who are uninsured or have Medicaid insurance that does not reimburse for diabetes/gestational diabetes education Cy 15 85 Cy 16 106 CY 17 153 CY 18 141 (YTD - 1/1/2018 – 11/9/2018)

Story When Stephanie was admitted to Rush Copley several summers ago, her blood sugar level was out of control – nearly 14% When she got out of the hospital, she was referred to our Outpatient Diabetes Education Center where we worked with her one-on-one to give her the personalized support she needed to manage her diabetes Poverty complicated the challenges she was facing. Imagine trying to focus on a healthy diet, regular exercise and glucose monitoring when you aren’t sure you can cover your basic living costs from one month to the next With our help, her blood sugar level dropped to a healthy 6. 2% within six months. She has continued to improve her lifestyle and has maintained an A 1 c less than 7%

Future CURE! Continue to raise funds that will allow the Rush Copley Diabetes Center to see patients who are uninsured/underinsured Reduce the risks of long-term complications by offering evidence based education CURE!!!

My diahero’s!! Cole Smythe Age 10 Cole Edelman Age 5