Building a New Diabetes Payment Model with Primary Care, Diabetes Educators and Health Plans. Donna Zazworsky, RN, MS and Roxanne Butler, RN, MS, CDE share how the Carondolet Diabetes Continuum of Care was built on the chronic care model at the Carondolet Health Network. This network has quickly shown that their continuum of care, which includes diabetes educators, has improved care, reduced costs and created sustainability for DSMT programs which now includes integration into home health, rural care and primary care practices.

Type 1 diabetes and eating disorders is a dynamic duo. It is more common than we think, or would like to know. Joy Pape interviews Marcia Meier BAN, RN, CDE, Program Manager at the International Diabetes Center, Minneapolis, MN, who presented, Type 1 Diabetes and Eating Disorders: Assembling the Treatment of This Complicated Dual Diagnosis. Learn how common it is, how to recognize it, and how to put together a team to help.

Real People, Real Stories, Real Results. Joanne Rinker, RD, CDE shares the details of how DSMT has been integrated into 65 public health departments throughout North Carolina. They've accomplished this with public health and diabetes champions at the helm. Rinker notes these programs are operating under one umbrella program recognized through the American Diabetes Association. Rinker feels this model could be used throughout the country and could be a source of much needed revenue.

Vitamin D! Everyone is talking about it. And so are we. Joy Pape interviews Dr. Ranti Akiyode, PharmD., BCPS, BC-ADM, associate professor of pharmacy at Howard University, School of Pharmacy in Washington, DC. Do you know the science behind it? Learn what you need to know for your patients, your loved ones, and you, about Vitamin D.

Author Megrette Fletcher, MEd, CDE, RD, shares with us the important role of offering PWD tools to develop mindful eating skills. As a practitioner who has long been involved in mindful eating work, Megrette has been focusing on bringing these tools to PWD. She shares how mindful eating skills and practices can transform people's relationships with food and eating as well as their body image and self-esteem.

In this interview, CEO Ryan Sysko and Malinda Peeples, RN, CDE and V.P. for Health Care Integration (and past president of AADE) at WellDoc, Inc., join Hope Warshaw to share more about their DiabetesManager, their exciting recently published study (Diabetes Care), their future plans and their crystal ball thoughts about what’s likely to happen on the diabetes and technology front.

In this must see interview, Joy Pape teams up with the dynamic Christine Kessler, MN, CNS, ANP, BC-ADM, Department of Endocrinology & Metabolic Medicine, Walter Reed Army Medical Center, Washington DC, whose presentation, Food, Fat, & Satiety, Exploring the "New" Entero-Endocrine-Brain Axis, was the talk of the conference. Learn how the biochemical signaling between fat, intestinal biopeptides, and brain neurotransmitters & satiety regions, communicate with one another to help with weight and diabetes management.

Hope Warshaw teams up with the kings (David Edelman of diabetesdaily.com and Manny Hernandez of tudiabetes.com) and queen (Amy Tenderich of diabetesmine.com and diabeticconnect.com) to help educators learn more about how people with diabetes (PWD) are getting supported, being supported and seeking and providing information online. We encourage diabetes educators to engage people with diabetes they counsel and to engage themselves. The ability to reach and impact people with diabetes around the globe is at our fingertips

Back by popular demand, we kick off these interviews with R.Keith Campbell, B.Pharm, MBA, CDE, FAADE, Disstinguished Professor in Diabetes Care/Pharmacotherapy, Washington State University College of Pharmacy, Pullman, WA. Keith Campbell always has the latest information about what's happening now, what the latest controversies are, and the low down on what's to come. We hope you enjoy these highlights from the AADE 2011 annual meeting in Las Vegas, NV and without further ado R.Keith Campbell, What's New in Diabetes Medications 2011.

Joy -

WOW! In about six minutes you and Keith Campbell, the go-to pharmacist in diabetes care, capture the essence of what's happening with BG lowering meds.

Thanks (watch out Diane Sawyer, Ann Curry!) and I look forward to more!

Hope Warshaw, MMSc, RD, CDE

Nutrition Section Editor, PRESENTdiabetes.com

I love this resource! I was especially interested in the comments about hypoglycemia being a chronic complication, and it's potential role in inflammation. I'll definitely do some research on this topic.

Thank you both for your comments.

Yes Hope, Keith has the resources in his head to keep us updated. What a reference he is!

And Lynn, I found it interesting that the hypoglycemia being inflammatory, and how it got me to thinking how we need to look at it as a chronic complication, stood out to you. For me, that was my take home message from the conference.

To come is my interview with Dr. Moghissi, I'm sure you will find interesting.

EnJOY!

Joy

Joy and Hope,

'Glad to see some discussions on hypoglycemia and its risks.  As a type1 for the past 63 years, and being hypo-unaware, I believe the problem stems from the fast-track FDA approval used by Lilly and Novo for the genetically engineered human insulins to increase their profits.  When animal based insulins were available, (about 23 years ago) I always had very noticeable signals that my BG level was going low.  That disappeared when I started on Humalin N & R, and I understand there are about 3.5% of us type 1's that are similarly hypo-unaware.  There have been several severe accidents and at least 1 jail lock-up as a result, but since they were able to gain the FDA's approval via the "Fast-Track" channel, there's nothing we can do about it now, and finding animal based insulins is just about impossible, so we're SOL.

Lee

Lee -

So pleased you are enjoying the video highlights from AADE. They're fun to do!

On your comment about human insulins and hypoglycemia unawareness. I've never before heard this connection made. To my knowledge and understanding, having been involved in diabetes care for 30+ years is that hypoglycemia unawareness is most often related to long standing diabetes and the loss of neurological response to the symptoms of hypoglycemia.

Congratulations to you for doing all you can to live healthfully with type 1 for 63 years. Wow - I'm sure you have interesting stories to tell. And you have lived through such an interesting time with the developments in diabetes care that we've seen over the past few years.

Thanks,

Hope Warshaw, MMSc, RD, CDE

Nutrition Section Editor, PRESENTdiabetes.com

Wow! I just watched Hope's interview of David Edelman, Amy Tenderich and Manny Hernandez and frantically took notes during the entire conversation. I thought I was fairly up on social media for folks with diabetes, but learned how much is available that I'm not aware of. I'm now in the process of putting together some info on this topic for our patients. Once again the live interview gives me a taste of all the information available during the AADE meeting in a way that gives me practical and usable information I can put to immediate use. Thanks!

Hope:

There's been quite a bit of discussion (years ago) on hypo-unawareness linkages to engineered insulins on both alt.­support.­diabetes (an old usenet group that’s still active) <http://groups.google.com/group/alt.support.diabetes/> and <http://health.groups.yahoo.com/group/diabetes/>.

Most are comments by persons who have diabetes, not peer reviewed studies that the academic community puts its faith in, so you may not have ventured into this area, but I for one have far more faith in real-life experiences than I do in studies that are funded by those who have a vested interest in the outcome.

Lee

Thank you for posting these briefs.  I just watched the third one with Joy Pape and Christine Kessler and found it very interesting to learn about the axis of brain, gut, and fat.  I definitely want to learn more.  I missed this session at AADE and it sounds like an excellent topic for a future ezine!  Another topic from the meeting that would be good for future ezines is online blogging sites.  I definitely need to be learn more about those to share with my patients who express an interest in them.  I would like to learn more about how to determine those that are worthy or valid vs those that are not.  Another topic of interest is fructose and cardiovascular disease.  I have patients who have good cholesterol levels but elevated triglycerides and would like to learn more about specific recommendations for them.  Thanks for all your work with the AADE briefs and the ezines.  You are working hard to keep us professionals up-to-date and professional!  

Extremely interesting interview with Joy and Chris Kessler. I definitely need to hear/read more about this to understand the concepts more completely and then be able to help my clients put this information into practice. Does anyone have any must-read articles on this topic? Was Chris's talk taped at AADE, and is it availble for purchase?

  Hi Joy
Grest interviews with Christine kessler and Keith Campbell.  Your questions were perfect and gave Christine and keith the opportunity to share with us their unique perspectives regarding the future of diabetes........surely a stay tuned topic!

Thank you Pat, and thank you to the others who have watched and commented. Keith always has his finger on the pulse of what is happening in the diabetes and pharmacology world. I'm so glad he gives me the opportunity to interview him. As for Christine Kessler's talk, I am following up with her to share more information with so many that have asked. I plan to write my next NurZine on the topic. Lynn, I think her talk is available. I'll look into it this week and let you know. There is a lot more to come. EnJOY!

Thanks for looking into the availablity of Chris Kessler's talk, and including this info in the next NurZine. One of the reasons I like working in the field of diabetes education is that there's always something new to learn!

Thanks for the interview and update re: hypoglycemia Joy.  There is so much we DON"T know about diabetes I am continually amazed.  I think we forget sometimes that what we know now is only a small amount of all there is to know about diabetes and its' effects on the body.  Chronic hypoglycemia and cardiac effects sounds like another great idea for a future ezine!  The AADE was a treasure trove this year!  

Just wanted to share a very interesting item I read yesterday on Hypoglycemia.  I was reading the book "50 Secrets of the Longest Living People with Diabetes" by Dr. Sheri Colberg and Dr. Steven Edelman, and on page 92 there is mention of a supplement (over hyped for use in wt. loss but rather ineffective) called pyruvate (a metabolite that is produced from glucose).  This can prevent nuronal cell death after a severe low if given within 3 hours.  Apparently the glucose starved neurons in recovery phase are unable to use metabolize glucose for several hours after a low and therefore end up dying.  Pyruvate can be a usable fuel during the recovery phase and has been shown to significantly reduce cell death and prevent cognitive impairment.  I can't figure out why I haven't heard of this?  Does anyone else know of this being used?  Just curious. 

There was no mention of study references in the book, however when I googled "pyruvate and hypoglycemia"  I got a links to info on  a study. 
http://diabetes.diabetesjournals.org/content/54/5/1452.full  http://www.ncbi.nlm.nih.gov/pubmed/15855333

Lee, just another interesting note, when I was looking at the research on pyruvate and hypoglycemia, I also happened to note another research article stating the history of  recurrent "moderate" hypoglycemia seemed to be associated with less neuronal cell death when a severe hypoglycemia occurred.  That may be of little consolation but an interesting tidbitl!   I will just add a little personal antedotal experience with hypoglycemic unawareness.  I had a year of reoccuring issues with unawareness the year I used Lantus.  Once I switched to an insulin pump with humaog my unawareness events seemed to resolve.  When I had determined my basal needs-I had/have five differing basal rates in a 24 hour period.  I consistantly  have a significantly lower insulin need in the afternoons and higher overnight needs.  When you inject a long acting insulin you can't reduce your dose for that period of time when you need less insulin.  I don't know what you are using now but monitoring with a continous glucose monitor for a while could detect that and if this is your case, that would be a strong indication that a pump would be beneficial.  Just something to consider.  It made a big difference for me.

http://diabetes.diabetesjournals.org/content/59/4/1055.full

Members in the Media

VDA Member, Hope Warshaw, MMSc, RD, CDE, BC-ADM is a nationally recognized dietitian and diabetes educator offering  practical, realistic solutions for healthier eating to millions through varied communication vehicles including best-selling books, magazine articles, and interviews.  As the Nutrition Section Editor for PRESENTdiabetes.com, Hope and her nurse educator colleague, Joy Pape, RN recently conducted a series of interviews from the American Association of Diabetes Educators' Annual Conference in Las Vegas.  Check them out here.  For fellow VDA members, Hope recommends viewing the spot she did with Joanne Rinker, RD, CDE from North Carolina which will be posted within days. As seen in the VDA News Blast from EatRightVirginia.org

Thank you Joy and Hope for all the interviews from American Association of Diabetes Educators Annual Meeting.

You are expert interviewers and were able to get a summary of the important points of each lecture from the speakers.