Overview

Diabetes Education Services

Although serious, diabetes is a manageable disease. Overlake’s Diabetes Education Services team teaches you how to manage your diabetes to help you lead a healthy life and reduce the risk of complications.

Your Diabetes Education Team

Your Diabetes Education Team

Overlake Medical Center's Diabetes Education Services has been recognized by the American Diabetes Association for Quality Self-Management Education.* Our team approach to care is designed to help adults, their friends, support persons and family members learn and practice the skills needed to manage and control their diabetes.

Our team consists of registered nurses and dietitians that are Certified Diabetes Educators (CDEs). In addition, other healthcare providers, such as pharmacists, are available to provide additional education specific to diabetes self-management. The diabetes education team provides comprehensive information to help you manage your diabetes.

Topics include:

  • Diabetes and its complications
  • How to monitor glucose levels
  • What to eat
  • Exercise
  • Medication management
  • Eye and foot care
  • Goal-setting and stress management
  • Sick-day management
  • Community resources
  • Medicare coverage for glucose supplies

Education

One-On-One Education

You and your physician may decide to begin with individual consultations with a diabetes nurse educator and registered dietitian. You will learn to monitor your glucose levels, set goals for managing your diabetes and work to develop a meal plan that fits your taste and lifestyle.

For appointments call 425.688.5700.

Diabetes Education Classes

Classes are led by certified diabetes educators and are offered several times each month in the morning or afternoon. They are kept small to help individualize the information as much as possible. Some insurance policies (such as Medicare Part B) require that most diabetes education take place in a class setting. Prerequisite: attend a one-on-one diabetes education session.

Call 425.688.5700.

Diabetes Community Education + Lectures

Overlake's Community Education Department also offers free classes on a variety of diabetes-related topics to help you and your family. These are general overview sessions and are not meant to replace individual and group diabetes training. 

You can register for classes online or by phone at 425.688.5259

Medicare Coverage for Blood Glucose Supplies

Medicare Coverage for Blood Glucose Supplies

Medicare covers blood-glucose supplies including test strips, meters and lancets whether you are using diet, medication or insulin to control your diabetes. This includes people who are enrolled in Medicare part B or Medicare managed care. Deductibles and co-pays may apply to this benefit.

Eligibility

Eligibility

To be eligible for coverage you must:

  • Be treated by a physician for diabetes, being seen at least every six months
  • Have your physician provide a written prescription that includes the specific number of strips and lancets needed, whether or not you use insulin and how often you will be testing
  • Have received training to do blood glucose monitoring or are scheduled to be trained.
  • Be capable of using the test results to help you obtain blood-glucose control

Quantity Guidelines

Quantity Guidelines

The quantity of test strips and lancets provided depends on your medical needs. The general guidelines provide:

  • For diabetes controlled by diet and exercise or by oral medications you can receive 100 test strips every three months and 100 lancets every three months.
  • For diabetes controlled by insulin you may receive 100 test strips and 100 lancets every month.

To receive more than 100 test strips every three months you must have:

  • Your physician request in writing the need for additional strips
  • Been seen by the treating physician within six months for an evaluation of your diabetes control
  • Your treating physician maintain documentation in your medical record of your blood-glucose results and any changes in your diabetes medication regime
  • Documentation of your need for more test strips that should accompany the Medicare claim form submitted by the pharmacist. Your pharmacist may ask to copy your testing logbook to send in to Medicare with the claim form.

Prescription drugs, insulin and syringes are still not covered under Medicare. If you have any questions, you can call the Medicare toll-free hotline at 1-800-638-6833. For general information, you can also visit the at American Diabetes Association.

Diabetes Education Services

Nutrition for Diabetics

Healthy eating is the first step in taking care of your diabetes. These are some general guidelines for healthy eating, but meeting with a dietitian is still important, as meal plans should be individualized.

General Pointers for Healthy Eating

  • You do not need special or diet foods.
  • You can, and should, eat a wide variety of foods every day.
  • Do not skip meals. This is especially important if you are on medication for diabetes.
  • Use less added salt and sugar.
  • Eat less fat, especially saturated fat.
  • Include high-fiber foods, such as beans, whole grains, fruits and vegetables.
  • Eat about the same amount of food every day.
  • Eat snacks and meals at regularly-scheduled times every day.
  • Limit sweets.
  • If you want to lose weight, cut down on your portion sizes.
  • Remember the food that is good for you is also good for your whole family.
  • Watch your carbohydrate intake (in starchy foods, fruits, milk and sweets) which most directly affects blood sugar levels.
  • Spread carbohydrate intake throughout the day.
  • See a dietitian for a meal plan that is best for you.

Starch

Cereals, grains, pasta, bread, beans, starchy vegetables

Guideline: six or more servings a day

A serving can be:

  • 1/4 bagel
  • 1 small tortilla or waffle
  • 1/2 English muffin, pita bread, 1/2 hamburger bun
  • 4 to 6 crackers
  • 3/4 oz. pretzels
  • 1 small potato - about the size of a tennis ball
  • 3/4 cup dry cereal
  • 1/2 cup cooked cereal or bulghur
  • 1/3 cup cooked rice or pasta
  • 1/2 cup peas or corn

Helpful Hints:

  • Choose foods such as whole-grain bread or crackers, tortillas, bran cereal, brown rice or bulgur. They are nutritious and high in fiber.
  • Choose beans as a good source of fiber.
  • Use whole-wheat or other whole-grain flours in cooking and baking.
  • Choose low-fat breads, such as bagels, tortillas, English muffins and pita bread.
  • For snacks, try pretzels or low-fat crackers.

Non-starchy Vegetables

Guideline: three to five servings a day

A serving can be:

  • 1 cup raw vegetables (lettuce, carrots, celery, cucumbers, etc.)
  • 1/2 cup cooked vegetables
  • 1/2 cup tomato or vegetable juice

Helpful Hints:

  • Choose fresh or frozen vegetables without added sauces, fats or salt.
  • Choose more dark-green and deep-yellow vegetables, such as spinach, broccoli, romaine, carrots, chilies and peppers.

Fruits

Guideline: three to four servings a day

A serving can be:

  • 1 small fresh fruit
  • 1/2 cup canned fruit with no added sugar
  • 1/2 cup fruit juice
  • 1 cup melon or berries
  • 2 tbsp raisins

Helpful Hints:

  • Choose whole fruits often. They have more fiber than juices.
  • Choose fruits and fruit juices without added sweeteners or syrups.
  • Choose citrus fruit, such as oranges, grapefruit or tangerines.

Milk

Guideline: two to three servings a day

A serving can be:

  • 1 cup milk
  • 3/4 cup plain yogurt

Helpful Hints:

  • Choose low-fat or nonfat products, such as skim or 1% milk. Choose nonfat or lowfat yogurt.
  • Yogurt has natural sugar in it. It can also have added sugar or artificial sweeteners. Yogurt with artificial sweeteners has fewer calories and carbohydrates than yogurt with added sugar.

Protein

Guideline: two to three servings a day

A serving can be:

  • 2 to 3 oz. cooked lean meat, poultry or fish
  • 1/2 to 3/4 cup tuna or cottage cheese
  • 2 to 3 oz. cheese
  • 1 egg
  • 2 tbsp. peanut butter

Helpful Hints:

  • Choose fish and poultry more often. Remove the skin from chicken and turkey.
  • Select lean cuts of beef, veal, pork or wild game.
  • Trim all visible fat from meat.
  • Bake, roast, broil, grill or boil instead of frying or adding fat.
  • Choose cheese with no more than 5g fat per ounce
  • Limit eggs to three per week

Fats

Guideline: limit to five to eight servings a day (less for weight loss)

A serving can be:

  • 1 tsp. margarine, butter, mayonnaise, oil
  • 1 tbsp. reduced-fat margarine or reduced fat salad mayonnaise
  • 1 tbsp. cream cheese
  • 1/8 avocado
  • 10 peanuts
  • 1 tbsp. salad dressing

Helpful Hints:

  • Eat less fat, not more than thirty to thirty-five percent of total calories.
  • Eat less saturated fat. It is found in meat and animal products, such as hamburger, cheese, bacon and butter.
  • Saturated fat is usually solid at room temperature.
  • Choose fats higher in monounsaturated fat such as olive oil, canola oil and peanut oil.

Meeting National Standards

The American Diabetes Association recognizes this education service as meeting the national standards for Diabetes Self-Management Education.

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Patient Education

Patient Education

What is Diabetes?

Diabetes is a disease in which the body is unable to produce or properly use insulin, a hormone that is needed to convert sugar, starches and other food into energy necessary for daily life. This means that your body cannot properly use and store glucose (a form of sugar). The glucose builds up in your bloodstream, causing a high blood glucose level. The cause of diabetes is still being researched, although both environmental and genetic factors such as family history and obesity appear to play roles.

Long-Term Complications

Long-Term Complications

Diabetes can cause many long-term complications. The most common are:

  • Blindness -- Diabetes is the leading cause of new blindness for 20 to 74-year-olds
  • Kidney disease -- Diabetes is the leading cause of end-stage kidney disease
  • Nerve disease and amputation -- 60 to 70 percent of diabetics have mild to severe forms of diabetic nerve damage. Extreme forms can lead to lower-limb amputation
  • Heart disease and stroke -- Diabetics are two to four times more likely to have heart disease and two to four times more likely to have a stroke than non-diabetics

Type 1 Diabetes

Type 1 Diabetes

Type 1 diabetes accounts for 5 to 10 percent of diabetes cases. In type 1, the body does not produce any insulin; therefore, people with type 1 diabetes must take daily insulin injections to stay alive. This type most often occurs in children and young adults.

In type 1 diabetes an immune process destroys the cells in the pancreas that produce insulin, a hormone, usually leaving your body unable to produce insulin. Without insulin your body cannot use glucose (a form of sugar) found in food for energy, so your body cannot control sugar levels in the blood. Therefore, people with type 1 diabetes must take insulin injections daily.

Although it can occur at any age, type 1 diabetes usually occurs in children or young adults. An estimated 5 to 10 percent of Americans diagnosed with diabetes have type 1 diabetes.

Taking Insulin

Insulin cannot be taken in pill form. A pill would not have time to work before the juices in your stomach destroy the insulin. Insulin must be injected under the skin, in the fat, for it to work. Scientists are working on new ways to give insulin. But today, shots are the only reliable method.

Signs + Symptoms

Type 1 diabetes often appears suddenly. Here are some signs and symptoms to look for:

  • Frequent urination (and/or bed-wetting in children)
  • Extreme hunger
  • Extreme thirst
  • Unplanned weight loss
  • Weakness and tiredness
  • Feeling edgy and having mood changes
  • Feeling sick to your stomach and vomiting
  • High levels of sugar in the blood
  • High levels of sugar in the urine

Living with Diabetes

The key to living a healthy life with diabetes is to follow your diabetes treatment plan. The goal of this plan is to have good blood-sugar control, keeping your blood-sugar level as close to normal as possible. Your treatment plan will probably include:

  • Insulin, to lower blood sugar. Your healthcare practitioner will prescribe how much and when to take which kinds of insulin.
  • A registered dietitian, to help you design a meal plan that includes the amount, type and timing of meals. Most people have three meals and at least two snacks every day. Your meal plan can include foods you enjoy.
  • Exercise, to lower blood sugar. Along with insulin, exercise helps your body use blood sugar. Your healthcare practitioner can help you fit exercise safely into your daily routine.
  • Blood testing. Testing your blood lets you know your blood-sugar level. The tests are simple. You prick your finger to get a drop of blood. A diabetes educator can teach you how to perform this test and use the test results.

You are at a greater risk for type 1 diabetes if your siblings or parents have type 1 diabetes. This is a very active area of research, with more information being discovered all the time.

Type 2 Diabetes

Type 2 Diabetes

Type 2 diabetes accounts for 90 to 95 percent of diabetes cases and is the most common form of diabetes. In this case the body cannot make enough insulin, or is unable to use it properly. This most often occurs in adults over 40 or those who are overweight.

Type 2 diabetes used to be called non-insulin-dependent diabetes or adult-onset diabetes. With type 2 diabetes, your body does not make enough insulin or cannot properly use the insulin it makes. Without enough insulin, your body cannot move blood sugar into the cells. Sugar builds up in the bloodstream and high blood levels of sugar can cause problems.

The most common type of diabetes, type 2, affects approximately 15 million Americans. Although it can occur at any age, it usually occurs in people over age 45 and those who are overweight, among other factors.

Although the exact cause of type 2 diabetes is unknown, we do know it runs in families. A person can inherit a tendency to develop type 2 diabetes, but it usually takes another factor, such as obesity, for the disease to materialize.

Risk Factors

You are at a greater risk for type 2 diabetes if you:

  • Are over age 40.
  • Do not exercise regularly.
  • Are overweight.
  • Have a family history of diabetes.
  • Have low HDL or high triglyceride level (blood fat levels).
  • Are of a certain racial and ethnic group (e.g., African American, Hispanic American, Asian and Pacific Islander, or Native American).
  • Are a woman who has had gestational diabetes, a form of diabetes occurring in 4 percent of all pregnancies, or who has had a baby weighing nine pounds or more at birth.

Signs + Symptoms

Type 2 diabetes often develops slowly. Some signs and symptoms are:

  • Increased thirst
  • Increased need to urinate
  • Feeling edgy, tired or moody
  • Increased appetite, but losing weight
  • Having repeated or hard-to-heal infections of the skin, gums, vagina or bladder
  • Blurred vision
  • Tingling or loss of feeling in the hands or feet
  • Dry, itchy skin

These symptoms can be so mild that they go unnoticed. Older people may confuse these symptoms with signs of aging and may not go to their healthcare practitioner. Half of all Americans who have diabetes may not know it.

Often, people with type 2 diabetes have no symptoms.

Living with Diabetes

The key to living a healthy life with diabetes is to follow your diabetes treatment plan. The goal of this plan is to have good blood-sugar control, keeping your blood-sugar level as close to normal as possible.

  • Your first step is to see your healthcare practitioner. You will be prescribed a daily treatment plan. The plan should include a healthy diet and regular exercise. You can often control type 2 diabetes with diet and exercise alone.
  • Maintaining a healthy weight is important for people with type 2 diabetes.Losing weight can help some overweight people bring their blood sugars into the normal range.
  • Your healthcare practitioner may also want you to test your blood-sugar levels regularly. Testing will let you know if your diabetes is in control. Be sure to ask how to do these tests.

Gestational Diabetes

Gestational Diabetes

Gestational diabetes develops in approximately 4 percent of all pregnant women, but disappears when the pregnancy is over. This affects approximately 135,000 women in the United States each year. Women who have had gestational diabetes have an increased risk for developing type 2 diabetes.

Gestational diabetes (GDM) occurs when a pregnant woman becomes diabetic during her pregnancy. The effects of poorly controlled gestational diabetes on the baby can include a large birth weight, possible injury to the baby during delivery and possible low blood sugar for a short while after delivery. Effects on the mother include difficult delivery (often necessitating Cesarean section or use of forceps) and an increased risk of developing type 2 diabetes later in life. Maintaining good blood sugar (glucose) levels during pregnancy can eliminate these risks for the baby and reduce the risk of a difficult delivery for the mother.

Assisting the pregnant woman and her family in achieving a healthy, safe pregnancy is a team effort including primary care and specialty physicians, nurses and other health professionals. When the diagnosis of gestational diabetes is made, the team expands to include other health professionals, a certified diabetes educator and a registered dietician. The goal of the certified diabetes educator and registered dietician is to equip women with the knowledge, skills and emotional support to manage gestational diabetes and deliver a healthy, normal-sized baby.

Monitoring

It is important that women with GDM learn to monitor their own blood-glucose levels at home. With appropriate blood glucose and urine ketone testing you receive immediate feedback about your condition and can positively impact it. Guidelines for safe glucose and ketone levels are provided. Technique and timing is critical for accurate monitoring, and this is taught in the first meeting with the certified diabetes educator.

Nutrition

Counseling by a registered dietitian is provided to ensure that you know how to choose foods which will support optimal blood-glucose readings and ideal pregnancy weight gain. Follow-up sessions after delivery address the need to return to a goal weight.

Exercise

While exercise is very important in increasing insulin sensitivity during pregnancy, it must be done with care. The diabetes educator will make a careful assessment of each woman's baseline activity level and suggest safe and appropriate activities.

Emotional Support

Women with GDM are often frightened by this diagnosis. The diabetes educator can take the time to listen to her concerns and provide information. They will stay in contact with each woman until delivery to provide encouragement and support.

Insulin Therapy

Insulin therapy is implemented when the combination of diet and activity are not adequate to maintain appropriate blood-glucose levels. Diabetes educators teach the necessary skills of insulin administration and more frequent monitoring.

Cost and Access

The charge for a visit with the certified diabetes educator and the registered dietician are often reimbursed by insurance. Checking with your insurance benefits counselor is the best way to determine this. For those who are uninsured or underinsured, financial assistance is available through our financial counselors in the Patient Access Department.

Pre-Diabetes

Pre-Diabetes

A condition that occurs when blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes. It is estimated that approximately 54 million Americans have pre-diabetes. Research has shown that if action is taken to control blood glucose levels in the pre-diabetes stage development of type 2 diabetes can be delayed or prevented.

General Pointers for Healthy Eating

General Pointers for Healthy Eating

    • You do not need special or diet foods.
    • You can, and should, eat a wide variety of foods every day.
    • Do not skip meals. This is especially important if you are on medication for diabetes.
    • Use less added salt and sugar.
    • Eat less fat, especially saturated fat.
    • Include high-fiber foods, such as beans, whole grains, fruits and vegetables.
    • Eat about the same amount of food every day.
    • Eat snacks and meals at regularly-scheduled times every day.
    • Limit sweets.
    • If you want to lose weight, cut down on your portion sizes.
    • Remember the food that is good for you is also good for your whole family.
    • Watch your carbohydrate intake (in starchy foods, fruits, milk and sweets) which most directly affects blood sugar levels.
    • Spread carbohydrate intake throughout the day.
    • See a dietitian for a meal plan that is best for you.
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