MDP Highlights and Updates
The cost of an insurance copay on a 30-day supply of insulin will be capped at $35 starting in January 2024. This is thanks to a bill introduced by Senator Jason Small of Busby, the advocacy of Montanans with diabetes, and the diabetes professional community. The legislation was signed into law by Governor Greg Gianforte.
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Diabetes Care & Education
Managing Diabetes in the Heat
If you or your patients have diabetes, you may have noticed that it can be harder to manage diabetes in the heat of summer. Extreme heat can affect blood sugar control, including worsening blood glucose levels and even low blood sugar (hypoglycemia). How the heat affects a person depends on their current blood sugar control, whether and what they’ve eaten, if they’re hydrated, and their activity level.
If activity and heat make someone sweat a lot, they could become dehydrated leading to a rise in blood glucose levels. This can make them urinate frequently and can lead to further dehydration and even higher blood sugars. It can be a vicious cycle.
If someone has diabetes complications that include damage to the nerves to the sweat glands, they could sweat less and overheat, leading to heat exhaustion or heat stroke.
Heat can also damage medications and blood sugar checking supplies. Exposing insulin to high temperatures can degrade it, making it ineffective. The same goes for monitoring devices and test strips.
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But don’t let the heat keep anyone indoors. Here are some basic tips to share with patients and others for managing diabetes in the summer heat:
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Avoid becoming dehydrated. Drink lots of water.
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Adjust your insulin as needed. Talk to your provider or diabetes care and education specialist about how to be physically active in the summer.
- Check your blood sugar frequently.
- Keep items to treat low blood sugars with you at all times.
- Carry snacks.
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Protect your medication and supplies from the heat. Never leave them in the direct sun or in a hot vehicle.
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Protect your feet. Don’t go barefoot, even at the pool or at the beach. Closed toe shoes are best.
For more information on managing diabetes in the hot summer months, go to: Managing Diabetes in the Heat | Diabetes | CDC
Please reach out to Marci Butcher for help, support, or questions on Diabetes Education.
Diabetes Prevention
Gestational Diabetes
If your patients or someone you know have a history of gestational diabetes, they could be at risk for developing type 2 diabetes. Gestational diabetes increases the risk of developing type 2 diabetes later in life by 50-70%. The good news is steps can be taken to prevent it!
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STEP 1: KNOW THE RISK FACTORS take our online risk test test
- Being 45 years of age or older
- Being overweight
- Having a family history of type 2 diabetes
- Being physically active less than 3 times a week
- Having medical conditions like high blood pressure
- History of gestational diabetes
STEP 2: GET SCREENED REGULARLY
These individuals need regular checkups and to have their blood sugar checked by a doctor every 1 to 3 years.
STEP 3: JOIN A LIFESTYLE CHANGE PROGRAM
Joining a National Diabetes Prevention Program can help establish healthy habits and prevent and prevent type 2 diabetes. Find a class nearby.
STEP 4: MAKE HEALTHY LIFESTYLE CHOICES
Eat healthy foods, exercise regularly, and manage stress.
Please reach out to Ann Lanes for more information on the National Diabetes Prevention Program.
Social Determinants of Health
American Indian (AI) and Alaska Native (AN) adults are almost 3 times more likely than non-Hispanic White adults to be diagnosed with diabetes, the highest rate of any racial or ethnic group in the United States. It has not always been this way. Some AI/AN elders still recall a time when there was no word for diabetes in their language because the condition was so uncommon. Lessons on understanding how to stay healthy were imbedded in their traditional knowledge and cultural values/practices. However, by the 1980’s rates of diabetes had heavily impacted the AI population and by 2004 diagnosed diabetes more than doubled in Native adults 35 or younger.
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When promoting type 2 diabetes prevention and overall health with AI populations it is important that the culture, history and traditions of tribes are well integrated into the program’s activities. Recognize that perceptions and beliefs about diabetes can vary from one tribe to another and these differences can affect how, why, and if individuals seek treatment. By providing education in locations that are easily accessible and involve tribal citizens who can share stories and lessons learned, programs can empower and motivate others to take control of their diabetes.
Some considerations when educating AI populations:
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Learn about the culture and traditions specific to the tribal community where you work.
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Demonstrate courtesy and respect. Listen, listen, listen.
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Ask permission to inquire about patients' home and family.
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Appreciate nonverbal communication. Give people time to respond to your questions.
- Inquire about patients' understanding of diabetes.
- Determine patients' preferred learning styles.
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Consider patients' family demands and dynamics. Encourage family members' involvement.
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Involve lay health educators.
- Engage the support of community and tribal leaders.
Please reach out to Margaret Mullins for support or information on Health Equity or Social Determinants of Health.
Quality Improvement
Kidney Health Evaluation (CMS 951)
More and more healthcare facilities who bill for Medicaire are beginning to utilize CMS 951 instead of CMS134 to evaluate kidney health.
This tracks all patients 18-75 years with a diabetes diagnosis who have had both an estimated glomerular filtration rate (eGFR) and a urine albumin-creatinine ration (uACR) between January 1 and December 31.
This tends to be more extensive and inclusive testing of kidney health. You can help your facility and its quality scores by ensuring all patients with diabetes that you see have had these two tests done within the year.
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For questions or assistance with quality improvement please reach out to Jennifer Van Syckle.
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