1. Lions District 24-A & American Diabetes Association Diabetes Education and Eye Screening Training July 14, 2012 8 am to 4 pm Fairfax Government Center Suzanne Tolson, BS, MSEd, CC-NREMT-P

2. To learn how we can help our fellowman Why are we here??? To become more active as Lions Club Members To learn more about Diabetes To learn more about screening for vision problems To learn more about screening for the potential for diabetes

3. Patient Assessment Questions Imagine this: You are going on a medical mission to underserved area in the USA or maybe even abroad. And you are asked to gather baseline data on each of the individuals who comes to the ADA/Lions Club clinic. What data would you choose to collect?

4. Patient Assessment Questions Let’s look at an example.

5. (Insert Patient Data Collection Sheet here.)

6. What is Body Mass Index? Body Mass Index http://www.nhlbisupport.com/bmi/bmicalc.htm

7. What is your Body Mass Index ?

8. What does BMI have to do with diabetes? If your BMI is above the normal range then you are at greater risk for developing type 2 diabetes. Body Mass Index

9. Blood Pressure Screening

10. What is blood pressure? Systolic ? Diastolic ? Blood Pressure Screening What is a “normal” blood pressure?

11. Normal Blood Pressure Ranges for ADULTS per The American Heart Association: Blood Pressure Screening Categorysystolicsystolic, mmHgmmHgdiastolicdiastolic, mmHg Hypotension< 90< 60 Desired90–11960–79 Prehypertension120–139or 80–89 Stage 1 HypertensionHypertension140–159or 90–99 Stage 2 Hypertension160–179or 100–109 Hypertensive Crisis≥ 180or ≥ 110

12. What about children??? Systolic Diastolic Infants 1 to 12 months 75–10050–70 Toddlers 1 to 4 years 80–11050–80 Preschoolers 3 to 5 years 80–11050–80 School age 6 to 13 years 85–12050–80 Adolescents 13 to 18 years 95–14060–90 Blood Pressure Screening

13. The Mayo Clinic says: Using a blood pressure cuff that's too large or too small can give you inaccurate blood pressure readings. You should have several sizes of cuffs to ensure an accurate blood pressure reading. The inflatable part of the blood pressure cuff should cover about 80 percent of the circumference of your upper arm. The cuff should cover two-thirds of the distance from your elbow to your shoulder.

14. TIME TO VOLUNTEER

15. Random blood sugar test: This test can be conducted throughout the day, irrespective of the meal times. The blood sugar levels should be between 70 and 125 mg/dL to be declared 'normal' in case of random testing method. Blood Sugar Levels

16. Fasting blood sugar: This test is commonly conducted to check the rise or fall in the glucose levels after a prescribed eight- hour fast. The levels are required to fall and get recorded between 70 and 99 mg/dL to be declared as normal blood glucose levels. Blood Sugar Levels VOLUNTEERS ???

17. Glaucoma is a complicated disease in which damage to the optic nerve results in vision loss. There are 2 types. In open-angle glaucoma, the angle in your eye where the iris meets the cornea is as wide and open as it should be, but the eye’s drainage canals become clogged over time, causing an increase in internal eye pressure and subsequent damage to the optic nerve. It is the most common type of glaucoma, affecting about four million Americans, many of whom do not know they have the disease. GLAUCOMA

18. Angle-closure glaucoma is caused by blocked drainage canals in the eye, resulting in a sudden rise in intraocular pressure. This is a much more rare form of glaucoma, which develops very quickly and demands immediate medical attention. In contrast with open-angle glaucoma, symptoms of acute angle-closure glaucoma are very noticeable and damage occurs quickly.

19. GLAUCOMA

20. What is normal intraocular pressure? – Current consensus among ophthalmologists and optometrists define normal intraocular pressure as that between 10 mmHg and 20 mmHg. – Intraocular pressure >20 mmHg (ocular hypertension) is the primary indicator for glaucoma diagnosis. GLAUCOMA

21. PASCAL Dynamic Contour Tonometer Diaton Transpalpebral Tonometer Testing for Glaucoma

22. What is it???

23. Audience Response, Questions and Recommendations