TeachME Professional Development

Diabetes Prevention and Lifelong Management

Introduction-The Problem

1. Diabetes is a chronic, expensive disease that affects 8.3 percent of the U.S. population.

A. True B. False

2. Diabetes disproportionately affects all of the following EXCEPT:

A. African Americans B. Hispanic Americans C. American Indians D. Italian Americans E. Asian and Pacific Islanders

Type 1 and Type 2 Diabetes

3. Type 2 diabetes usually strikes children and young adults, although disease onset can occur at any age.

A. True B. False

4. AIC is the standardized blood test that indicates the average blood glucose over the previous 12 to 16 weeks.

A. True B. False

Chronic Disease and the Health Care Delivery System-Medical Home Model

5. The Medical Home Model emphasizes prevention, ___________, coordination of care, and shared decision making among patients and their health care team.

A. Health information technology B. Self-management support C. Community involvement D. Communication and leadership E. None of the above

What Makes a Successful Team?-Possible Diabetes Team Care Outcomes

6. Studies of diabetes team care in various settings have shown marked improvement in the following area(s):

A. Glycemic, lipid and blood pressure control B. Patients' satisfaction C. Risk for diabetes complications D. Quality of life E. All of the above

Develop a System for Coordinated, Continuous, High-Quality Care

7. Widely accepted standards of practice support continuity of care through regular team meetings, ongoing documentation and communication of information among team members, ideally via a computerized information system.

A. True B. False

Five Steps to Maintain a Successful Team

8. Which of the following is NOT one of the important elements for successful team care?

A. Promoting patient satisfaction, quality of life and self-management B. Promoting a community support network C. Maintaining team coordination and communication D. Stream-lined billing procedures E. Encouraging mutual respect between team members and the patient

Maintain Team Coordination and Communication

9. A multidisciplinary planning and documentation tool for the medical record could include:

A. Patient's Medicare eligibility B. Treatment and personal patient goals C. Disease management including medications, medical nutrition therapy, self- D. B and C only E. A and B only

Non-traditional Team Care Approaches-Telehealth

10. Telehealth (or telemedicine) is the use of secure high-speed Internet connections for real-time video conferencing for medical, diagnostic, monitoring, and therapeutic purposes when distance and/or time separates the participants.

A. True B. False

11. Telehealth applications that expand the reach of the diabetes team include:

A. Primary care digital retinal imaging for diabetes eye screening to augment or enhance regular comprehensive vision and eye health exams B. Video conferencing for provider education C. Video conferencing for group diabetes education and individual counseling D. Remote monitoring of self tests for blood glucose and blood pressure E. All of the above

Case Study 1

12. In order to improve diabetes management for its patients, The Native Hawaiian Health System developed a remote monitoring program.

A. True B. False

Case Study 2

13. The focus of the Florida Initiative in Telehealth and Education for Children with Diabetes was to provide supplemental care for those who had adequate access to care and average diabetes management.

A. True B. False

Case Study 3

14. A family physician in San Antonio found that group visits had no improvement in patient understanding, diet, or medication taking behaviors.

A. True B. False

Payment and Cost-Effectiveness Data for Diabetes Education and Services-Self-Management Diabetes Education Program Services

15. Which of the following has/have the authority to accredit, or recognize, diabetes education programs?

A. American Dietetic Association (ADA) B. American Diabetes Association (ADA) C. American Association of Diabetes Educators (AADE) D. B and C only E. A and B only

Billing Practices

16. To maximize insurance coverage of team member contributions to the patients' care, it is important to know the billing practices in a local area and allowable fees and to use the correct CPT codes.

A. True B. False

Cost-Effectiveness Evidence for Diabetes Education

17. One study of 18,404 patients with diabetes concluded that each visit to a nutritionist was associated with 4.7 fewer hospitalizations per 100 person-years and _____less in hospital charges per person. .

A. $7,865 B. $6,503 C. $5,788 D. $5,212 E. $4,926

Collaborative Care In Practice-Diabetes Management

18. Peer support can take many forms: phone calls, text messaging, group meetings, home visits, and shared activities, and peers can provide emotional, social, and practical assistance to help others manage their diabetes and stay healthy.

A. True B. False

19. According to the authors, peers can help others with diabetes to cope with _________ or emotional barriers.

A. Physical B. Environmental C. Social D. Cultural E. All of the above

Case study 4

20. After using a data registry to identify patients lost to routine follow-up, Holyoke Health Center (HHC) in Holyoke, Massachusetts found the average A1C was reduced from 8.4 percent to ___ percent, and the proportion of patients with an A1C >10 percent decreased from 18.2 percent to ___ percent.

A. 7.7; 9.9 B. 7.5; 10.8 C. 7.1; 11.3 D. 6.6; 11.9

Case Study 6

21. A key role of the dietitian at the Clinica Family Health Services community health center was to train CNA's and LVN's in addition to counseling patients with diabetes.

A. True B. False

Case study 7

22. The key goal of the Healthy People 2010 diabetes focus area is to increase the proportion of people with diabetes who receive formal diabetes education.

A. True B. False

23. The University of Pittsburg Institute provided "__________" to increase availability for services.

A. Diabetes days B. Dietitian days C. Healthy living days D. Nutrition education days

Registered Dietitians

24. A one-year randomized controlled trial compared usual medical care to usual care-plus-lifestyle case management provided by a registered dietitian. The case-managed group showed :

A. Increased A1C values B. Substantially greater weight loss C. Increased prescription use D. A and B only E. B and C only

Appendix 1: Identify Patients at Risk for Type 2 Diabetes

25. Risk factors for type 2 diabetes include each of the following EXCEPT:

A. Family history: has a first-degree relative with diabetes B. History of vascular disease: diagnosed by physical exam and testing C. Inactive lifestyle: is physically active less than three times a week D. Hypertension: blood pressure greater than 135/85 E. Signs of insulin resistance: such as acanthosis nigricans

26. History of gestational diabetes or giving birth to a baby weighing > 9 lbs is a risk for diabetes.

A. True B. False

Identify Patients at Risk for Diabetes Complications

27. Which of the following is NOT included in clinical information to assess patients at risk for diabetes complications?

A. A1C values B. Blood pressure control C. Oral exam status D. Reduced literacy E. Poverty

28. Depression and other psychosocial illness may be risk factors for diabetes complications.

A. True B. False

Identify Patients at "Break Points"

29. "Break points" in the course of diabetes include:

A. New onset of type 1 or type 2 diabetes B. New onset of significant complications C. A1C consistently above 6 percent D. A and B only E. All of the above

30. The level of diabetes control can be affected by several factors including limited provider availability and service payment and outdated or ineffective management protocols.

A. True B. False

Appendix 2

31. Diabetes educators apply in-depth knowledge and skills in the biological and social sciences, communication, ____________ and education to provide self-management education and training.

A. Nutrition B. Health and well being C. Counseling D. Both A and B E. None of the above

32. Certified Diabetes Educators (CDE) receive certification from the National Certification Board for Dietetic Educators by taking a voluntary examination that indicates distinct and specialized knowledge in diabetes patient self-management education, thereby promoting high-quality care for people with diabetes.

A. True B. False

33. Certification of diabetes educators are awarded to those who meet eligibility requirements from the following disciplines EXCEPT:

A. Social worker B. Registered dietitian C. University faculty member in a related field D. Physical therapist E. Physician

Appendix 4

34. Medicare is health insurance for people age 62 or older, under age 62 with certain disabilities, and any age with end-stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant).

A. True B. False

35. Which is NOT one of the costs covered by Medicare:

A. "Welcome to Medicare" physical examination B. A1C testing C. Geriatric vitamins D. Diabetes self-management training E. Therapeutic shoes and inserts if medically necessary


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