1. Care Beyond Medicine™

2. 1.Cleveland Diabetes Statistics 2.Reducing Your Risk 3.Diabetes 365 4.The Cost of Diabetes 5.Diabetes in the Workplace D IABETES

3. 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, 2014. US D IABETES S TATISTICS

4. Age-adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults Obesity (BMI ≥30 kg/m 2 ) Diabetes 1994 2000 No Data 26.0% No Data 9.0% CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics 2013

5. CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics 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

7. 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. http://www.cdc.gov/diabetes/basics/prevention.html D IABETES R ISK F ACTORS

8. 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. http://www.diabetes.org/diabetes-basics/prevention/checkup-americahttp://www.diabetes.org/diabetes-basics/prevention/checkup-america R EDUCING YOUR RISK FOR DIABETES

9. D IABETES

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

12. D IABETES M ANAGEMENT

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

14.  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

15.  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

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

17.  Blood glucose targets  Before meals 80-130mg/dl  Two hours after a meal – less than 180mg/dl  At bedtime – 110-150mg/dl H YPERGLYCEMIA

18. 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

19. 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

20. $ 245 billion in 2012  $176 billion in direct medical costs  $69 billion in reduced productivity C OST OF D IABETES

21. 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. www.diabetes.org/advocacy C OST OF D IABETES

22. Indirect costs  Increased absenteeism - $5 billion  Reduced productivity while at work - 20.8 billion American Diabetes Association. The Cost of Diabetes. www.diabetes.org/advocacy C OST OF D IABETES

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

24. 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 2014. Vol37, Number 9 C OST OF D IABETES

25. 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

26. 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). www.eeoc.gov/laws D IABETES IN THE W ORKPLACE

27. 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). www.eeoc.gov/laws D IABETES IN THE WORKPLACE

28. Ways to keep employees healthy D IABETES IN THE WORKPLACE

29. St. Vincent Charity Medical Center Diabetes Education Program 216-363-2732 D IABETES