1. Shared Medical Appointments for Diabe Session 4 Created by Rebecca Bates, DNP(c), RN, CFNP

2. Objectives 1. Participants will understand the natural course of diabetes. 2. Participants will articulate long-term complications of diabetes. 3. Participants will learn to check for complications and know their ABCs. 4. Participants will plan goals and support network. 3. Natural Course of Diabetes Loss of beta cells that make insulin Diabetes is a life-long disease Activity: 1. How long have you been living with diabetes and how things have changed since diagnosis? 2. What challenges to you managing diabetes as the disease progresses? 4. Glucose Management Challenges Fasting blood glucose before meals Blood glucose 2 hours after meals A1C goals Reducing complications Short term complications Long term complications Activity What are some short-term and long-term complications of 5. Diabetes Complications 6. Complications of Diabetes Short-term complications Hyperglycemia Hypoglycemia Long-term complications Activity: Ask participants to share their experiences with complications of diabetes. 7. Complications Click to play video. 8. Delaying Complications Healthy Eating Keeping Active Medicine 9. Medicine Oral Diabetes Medicines (ODM) Biguanides Thiazolidinediones Alpha-glucosidase inhibitors Sulfonylureas Meglitinides DPP-4 inhibitors SGLT-2 inhibitors Other Diabetes Medicines Anylin analogs Incretin mimetics Insulin Rapid (within 5 minutes; lasts for 2 to 4 hours) Short-acting (within 30 minutes; lasts for 3 to 6 hours) Intermediate-acting (within 2 to 4 hours; lasts for 12 to 18 hours) Long-acting (within 6 to 10 hours; lasts for 20-24 hours) Mixed (within