1. Dedicated to Addressing Diabetes For Patients 65 and Older
The continuing impact of diabetes on health care in this country is something I’m sure you are well aware of. We at Sanofi are dedicated to addressing diabetes with key diabetes-care stakeholders, including your organization. Today, I appreciate the opportunity to introduce our new and updated healthFORWARD resources.
Dedicated to Addressing Diabetes For Patients 65 and Older
© 2016 sanofi-aventis U.S. LLC, A SANOFI COMPANY All rights reserved Printed in the USA US.NMH

2. Today’s Presentation
Update on the impact of diabetes on patients 65 and older
How to enhance diabetes management
Introduce healthFORWARD in terms of its focus, objectives and resources
Getting started with healthFORWARD
In today’s presentation, I’d like to provide you with:
• An update on the impact of diabetes on patients 65 and older
• Ways to enhance diabetes management
• An introduction to healthFORWARD in terms of its focus, objectives and resources
• How to get started with healthFORWARD 2 2

3. The Impact of Diabetes
About 11.2 million people 65 years and older have diabetes, or almost 26% of the senior population.1
An estimated 51% of adults aged 65 and older had prediabetes in
While progression to diabetes is not inevitable, prediabetes does increase the risk of developing type 2 diabetes, heart disease, and stroke.
1 in 3 residents in nursing homes over 65 years of age have diabetes.2
The impact of diabetes on patients over 65 in assisted living facilities is among the most serious health care issues faced today:
• About 11.2 million people 65 years or older have diabetes, or almost 26% of the senior population.1
• An estimated 51% of adults aged 65 and older had prediabetes in While progression to diabetes is not inevitable, prediabetes does increase the risk of developing type 2, heart disease, and stroke.
• 1 in 3 residents in nursing homes over 65 of age have diabetes.2
References:
Centers for Disease Control and Prevention. National diabetes statistics report: estimates of diabetes and its burden in the United States, Atlanta, GA: U.S. Department of Health and Human Services; 2014.
Nettles A, Reger L. Diabetes management in long-term care facilities: A practical guide 6th edition. Accessed January 19, 2016.
Centers for Disease Control and Prevention. National diabetes statistics report: estimates of diabetes and its burden in the United States, Atlanta, GA: U.S. Department of Health and Human Services; 2014.
Nettles A, Reger L. Diabetes management in long-term care facilities: A practical guide, 6th edition. Accessed January 19, 2016., 2015 3

4. Enhancing Diabetes Management
Patients need to understand their roles and responsibilities so they can reduce the risk of developing complications.
Staff who work with patients 65 and older need to help them understand and manage their condition.
The American Geriatrics Society suggests providing education on the following to improve glycemic control1:
Medication use
Monitoring
Recognizing hypoglycemia and hyperglycemia
It’s important for patients 65 and older to understand their roles and responsibilities in managing their diabetes, so they can reduce the risk of developing complications.
It is equally important for facility staff to work with patients over 65 to help them understand and manage their condition.
The American Geriatrics Society Guidelines for Improving the Care of the Older Person with Diabetes Mellitus suggest that providing education on medication use, monitoring, and recognizing hypoglycemia and hyperglycemia can significantly improve glycemic control in older adults.1
Reference:
1. American Geriatrics Society Expert Panel on the Care of Older Adults with Diabetes Mellitus. Guidelines abstracted from the American Geriatrics Society guidelines for improving the care of older adults with diabetes mellitus: 2013 Update. J Am Ger Soc. 2013;61(11):2020–2026.
American Geriatrics Society Expert Panel on the Care of Older Adults with Diabetes Mellitus. Guidelines abstracted from the American Geriatrics Society guidelines for improving the care of older adults with diabetes mellitus: 2013 Update. J Am Ger Soc. 2013;61(11):2020–2026. 4

5. Problems and Complications1
Older Adults With Diabetes May Experience:
Accelerated atherosclerosis with vascular complication (heart attack, stroke, myocardial infarction)
Eye problems (blurred or loss of vision)
Falls
Foot problems (ulcers, deformities, gangrene)
Weight changes (gain or loss)
Frequent infections
Cognitive impairment (confusion)
Hyperosmolar hyperglycemic nonketotic syndrome (HHNS)
Decline in ability to perform daily activities
Dehydration
Impaired pain perception, neuropathy
Depression
Oral health problems (periodontal disease, tooth loss, dry mouth)
Excessive skin problems (infections, ulcers, delayed wound healing)
Urinary frequency
Facility staff should be aware of complications that may occur with their patients 65 and older. It is important to evaluate the patient with diabetes for complications and problems.
American Medial Directors Association. Diabetes management in the post-acute and long-term care setting clinical practice guideline. Columbia, MD; AMDA; 2015. 5

6. Introducing healthFORWARD Diabetes
Addressing needs
Raising awareness
Encouraging involvement
Engaging residents
Offering innovative resources
Introducing healthFORWARD Diabetes resources are provided for patients, facility staff, and providers — which makes it easy for you to match appropriate resources to your initiatives for each of these audiences.
This program can help you meet important communications needs by:
• Addressing the roles, responsibilities, and needs of patients, facility staff, and providers at appropriate communication levels
• Raising diabetes awareness among staff, patients, and families
• Encouraging involvement and interaction among interdisciplinary team members
• Engaging patients and families in diabetes recognition and management and offering you a range of innovative, unbranded diabetes resources. Remember, a wide range of healthFORWARD program resources is available:
– You can select, access, reproduce, and distribute any and all resources appropriate for your facility.
– Resources can be printed or distributed electronically via your company Web site or . 6 6

7. healthFORWARD Implementation Components Overview
Program Overview
Resource Index
Facilitator’s Handbook
Staff In-Service Program
Special Event
Quality-Improvement Forms
Let’s now take a look at healthFORWARD Diabetes by key resources. First, Program Overview Resources are for your ongoing planning and reference and include:
• A Program Overview
A summary of the current health care impact of diabetes
A Resource Index that lists all resources and their intended audiences
A description of the features and benefits of each program resource
A step-by-step plan for starting your own facility-wide program
• A Facilitator Handbook that includes:
Implementing a facility-wide systematic approach to diabetes
How a facility diabetes-intervention program can be adapted to a quality-improvement initiative
How to engage the interdisciplinary team
Patient targeting
Diabetes-management planning for the facility
Suggestions for an in-service program and a family event
• Quality-Improvement Forms for staff use 7

8. Staff In-Service Program
Staff In-Service Program includes:
Facilitator’s Handbook
Slide Presentation with Assessment Quiz
The healthFORWARD kit also provides a complete Staff In-Service Program with materials to help educate your facility staff on important issues involving diabetes management and patients. The program includes:
A facilitator’s guide
A slide presentation with speaker’s notes and assessment quiz
A certificate of participation
Topics include the role and importance of staff in diabetes management; what is diabetes; types of diabetes; blood sugar control; exercise, diet, and fall prevention for patients with diabetes; hypoglycemia and hyperglycemia; diabetes medications; and caring for patients over 65.
But that’s not all. We’ve also got these other resources for your staff… 8

9. Provider Resources “Connections in Senior Care” Fact Sheets
“Diabetes and Associated Complications” Articles
“Looking After Your Residents” Poster
“When to Contact a Physician” Tip Sheet
Discharge Instructions
Fast Fact Sheets
healthFORWARD resources for Providers include:
Connections in Senior Care Fact Sheets for the nursing staff to help them better understand the association between diet, exercise, and fall prevention in seniors with diabetes.
Diabetes and Associated Complications Handouts that give useful insights into diabetes and complications like kidney disease and weight.
Looking after Your Residents with Diabetes Poster reminds your staff to watch residents with diabetes “from head to toe.”
When to Contact a Physician (Nursing Tips) reminds nursing staff to notify attending physicians about changes in a patient’s status.
Discharge Instructions designed to ensure that appropriate documentation and instructions accompany patients transitioning to home, assisted living facilities, or the hospital.
Fast Fact Sheets on topics such as insulin, achieving glycemic control, and cultural views of diabetes. 9

10. Taking Care of Your Diabetes Special Event
Taking Care of Your Diabetes Special Family Event
Facilitator’s Handbook
Banner
Slide Presentation
Invitation/Template
Certificates
Evaluation Form
Taking Care of Your Diabetes Special Event Facility events for patients, families, and caregivers can help build awareness of diabetes and its complications. Information provided at such events can also help promote early recognition of diabetes and engage patients and their families in diabetes management.
This healthFORWARD program includes materials that enable your facility to organize and produce events of any scope:
• A Facilitator’s Guide that provides a complete introduction to the family event materials, with step-by-step instructions on conducting successful family events.
• Banner Templates to promote the event.
An informative and colorful Slide Presentation including speaker’s notes, is designed to help patients and families manage diabetes.
• Invitation/Template can be customized to announcement location, date, and time.
• A Certificate template is included so you can print certificates to help retain attendee interest and ongoing involvement.
• And an Evaluation Form can be completed by attendees and then discussed with their health care providers. 10

11. Patient Resources Blood Sugar Diary “Nutrition Know-How” Leaflets
“Be Active for a Healthier You” Handout
“Living a Healthier Life”
Self-Management Instructions
“So You Need to Take Insulin” Handout
“Blood Glucose Monitoring”
These include the following:
• Blood Sugar Diary is a helpful diary to track blood sugar.
• Nutrition Know-How helps explain the benefits of healthy eating.
• Be Active for a Healthier You helps explain the benefits of exercise and tips for being more active.
• Living a Healthier Life covers a wide range of important topics addressing concerns and provides helpful education on topics such as types of diabetes, insulin and glucose, blood sugar levels, healthy eating, exercise, and others.
• Self-Management Instructions to give to patients and their families for follow-up reminders about checking blood sugar, when to call the doctor, current medications, exams, and shots.
• The So You Need to Take Insulin helps explain important things to know about taking insulin, why diabetes pills may no longer do the trick, and the benefits and risks associated with taking insulin.
• Blood Glucose Monitoring is a review of how to test, use, and maintain blood glucose monitoring equipment.
That’s a look at all the components you’ll find in the healthFORWARD Diabetes Program. Now I’d like to tell you how easy it is to put these components to work in your facility. 11

12. Getting Started
Familiarize yourself with healthFORWARD’s program resources.
Confer with your physicians and nursing managers to select the appropriate resources to incorporate into your current program.
Update your current policies and procedures.
Schedule an in-service program for staff.
Schedule a special event for patients, families, and caregivers.
Plan to audit and review changes to your current program.
To get started, familiarize yourself with the program’s resources:
Read the Program Overview booklet for highlights of the program and its major resources.
Review the program resources for your facility.
Then:
Confer with your attending physicians and nursing managers to select appropriate resources to incorporate into your current diabetes-management program.
You may also want to update your current policies and procedures to reflect incorporation of selected resources.
Access selected resources for reproduction and distribution.
Personalize and distribute the template letters to announce your diabetes-management initiative to attending physicians and staff.
Schedule a diabetes in-service program for staff.
Schedule a diabetes family event for patients, families, and caregivers.
You may also want to plan to audit and review changes made to your diabetes-management program. 12

13. healthFORWARD Benefits
Improve awareness and recognition of diabetes among your staff and residents.
Initiate day-to-day management of diabetes.
Motivate patients to adhere to appropriate treatment regimens.
Help reduce medical costs for appropriate patients in your facility.
Increase cooperation between staff and patients 65 and older.
Enhance your ongoing quality-management process.
I hope you have a fuller understanding of the many features, resources, and benefits available to you through healthFORWARD Diabetes.
Using these resources can help your facility:
Improve awareness and recognition of diabetes among your staff and patients.
Engage staff and patients in day-to-day management of diabetes.
Motivate patients to adhere to appropriate treatment regimens.
Help reduce medical costs for appropriate patients in your facility.
Increase cooperation between your staff and patients.
Enhance your ongoing quality-management process.
This healthFORWARD program can support and enhance your existing diabetes-management initiatives. It can also help your interdisciplinary health care team work together to help patients with diabetes. 13

14. Thank you!
I hope we can work together to put healthFORWARD Diabetes to work for your organization and all your stakeholders in diabetes care.
Thank you! 14