Care Beyond Medicine™

1.Cleveland Diabetes Statistics 2.Reducing Your Risk 3.Diabetes The Cost of Diabetes 5.Diabetes in the Workplace D IABETES

29.1 MILLION children and adults live with diabetes (9.3% of the population) 86 MILLION are at high risk for developing type 2 diabetes Centers for Disease Control and Prevention. National Diabetes Statistics Report, US D IABETES S TATISTICS

Age-adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults Obesity (BMI ≥30 kg/m 2 ) Diabetes No Data 26.0% No Data 9.0% CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at

CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at Obesity (BMI≥30 kg/m 2 ) Diabetes <4.5% Missing data 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% ≥9.0% 18.0%–21.9% <14.0% Missing Data 14.0%–17.9% 22.0%–25.9%≥26.0% Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults 2013

1.Having a parent, brother, or sister with diabetes 2.Being over 45 years of age 3.Being African American, American Indian, Asian American, Pacific Islander, or Hispanic American/Latino heritage 4.Having a prior history of gestational diabetes or birth of at least one baby weighing more than 9 pounds 5.Being overweight or obese 6.Having high blood pressure measuring 140/90 or higher 7.Having abnormal cholesterol with HDL ("good") cholesterol is 35 or lower, or triglyceride level is 250 or higher 8.Being physically inactive—exercising fewer than three times a week Centers for Disease Control and Prevention. Preventing Diabetes. D IABETES R ISK F ACTORS

1.Choose healthy foods 2.Make healthy meals 3.Be active 30 minutes a day 4.Keep blood pressure under control (120/80) 5.Quit smoking 6.Keep cholesterol under control 7.Maintain a healthy weight American Diabetes Association. CheckUp America. R EDUCING YOUR RISK FOR DIABETES

D IABETES

 Pre-diabetes  Gestational diabetes  Type 1  Type 2 T YPES OF D IABETES

D IABETES M ANAGEMENT

 Low blood glucose (sugar) (hypoglycemia)  High blood glucose (sugar) (hyperglycemia) H YPOGLYCEMIA /H YPERGLYCEMIA

 The employee should check their blood glucose if they have their meter with them  If 70mg/dl or less or symptomatic the employee should drink ½ cup juice, ½ cup of regular pop, 4 hard candies  Re-test blood glucose in 15 minutes H YPOGLYCEMIA

 If blood glucose is now above 100mg/dl the employee should have a snack if not eating a meal within an hour  If blood glucose is below 100mg/dl repeat treatment and re-test in 15 minutes  If still below 100mg/dl the employee should call their doctor for instructions H YPOGLYCEMIA

 If the employee carries a Glucagon Kit with them someone in the office should be aware and able to administer the medicine H YPOGLYCEMIA

 Blood glucose targets  Before meals mg/dl  Two hours after a meal – less than 180mg/dl  At bedtime – mg/dl H YPERGLYCEMIA

People with diabetes:  Visit their doctor 2-4 times per year  Have blood work drawn 2-4 times per year  Meet with the diabetes educator at least yearly  Visit the Ophthalmologist (eye doctor) every one to two years  Visit the Dentist twice a year D IABETES 24/7, 365 DAYS A YEAR

People with diabetes:  Test their blood glucose at least once a day  Eat healthy meals and count their carbohydrates  Take medicine as directed  Are prepared for low blood glucose by having a blood glucose meter at work and a carbohydrate to treat the low  Fit exercise into their day D IABETES 24/7, 365 DAYS A YEAR

$ 245 billion in 2012  $176 billion in direct medical costs  $69 billion in reduced productivity C OST OF D IABETES

Medical Expenditures  Inpatient care – 43%  Prescriptions medicine to treat complications – 18%  Diabetes medicine and supplies – 18%  Physician office visits – 9%  Nursing/Residential facility – 8% American Diabetes Association. The Cost of Diabetes. C OST OF D IABETES

Indirect costs  Increased absenteeism - $5 billion  Reduced productivity while at work billion American Diabetes Association. The Cost of Diabetes. C OST OF D IABETES

On average medical expenditures are approximately 2.3 times higher for people with diabetes American Diabetes Association. The Cost of Diabetes. C OST OF D IABETES

Lifetime medical spending for people with diabetes  Diagnosed at age 40 - $124,600 ($211,400 if not discounted)  Diagnosed at age 50 - $91,200 ($135,600 if not discounted)  Diagnosed at age 60 - $53,800 ($70,200 if not discounted)  Diagnosed at age 65 - $35,900 ($43,900 if not discounted) The Lifetime Cost of Diabetes and Its Implications for Diabetes Prevention. Diabetes Care. September Vol37, Number 9 C OST OF D IABETES

The Americans with Disabilities Act applies to private employers, labor unions, and employment agencies with 15 or more employees, and to state and local government. The Rehabilitation Act of 1973 generally covers employees who work for the executive branch of the federal government, or for any employer that receives federal money. D IABETES IN THE W ORKPLACE

1)May an employer ask a job applicant whether he/she has diabetes or about treatment related to diabetes? 2)Does the applicant need to disclose that they have diabetes before accepting a job offer? 3)If an applicant discloses that they have diabetes can the employer ask follow up questions? 4)The applicant discloses after an offer has been made that he/she has diabetes what can the employer do? U.S. Equal Employment Opportunity Commission. Questions & Answers about Diabetes in the Workplace and the Americans with Disabilities Act (ADA). D IABETES IN THE W ORKPLACE

Reasonable accommodation Adjustments or modifications to enable employees with disabilities to enjoy equal employment opportunities unless doing so would be an undo hardship. U.S. Equal Employment Opportunity Commission. Questions & Answers about Diabetes in the Workplace and the Americans with Disabilities Act (ADA). D IABETES IN THE WORKPLACE

Ways to keep employees healthy D IABETES IN THE WORKPLACE

St. Vincent Charity Medical Center Diabetes Education Program D IABETES