Video by Dr. Dawn Elise Snipes on integrative behavioral health approaches including counseling techniques and skills for improving mental health and reducing mental illness.

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Diabetes Counseling & Case Management

~ By the time they’re diagnosed, 50% of people with type 2 diabetes already show signs of complications.
~ Diabetes (destruction or malfunction of beta cells) may begin 10 years before the diagnosis and complications may start 5 years before the diagnosis
~ Cardiovascular disease causes 52% of death and disability in people with type 2 diabetes
~ People with type 2 diabetes have a 200% increased risk of stroke
~ Kidney disease impacts 33% of people with type 2 diabetes and accounts for 11% of deaths in people with type 2 diabetes.

~ Depression is approximately 200% higher in people with diabetes than in the general population.
~ Diabetes is associated with lower dopamine levels
~ Serotonin (central and peripheral) is implicated in regulation of blood glucose. SSRIs may improve A1C in people with diabetes and depression
~ Neuropathy (nerve damage) impacts up to 50% of people with diabetes contributing to slow wound healing, lack of awareness of wounds, erectile dysfunction and chronic pain.
~ Limb amputation occurs in approximately 1:40 people with diabetes will develop a foot ulcer which results in the amputation of a foot or leg.
~ Up to 70% of people die within five years of having an amputation.
~ Life expectancy is reduced, on average, by up to 10 years in people with type 2 diabetes

Function of the Counselor-Case Manager
~ Clinicians may need to deal with diabetes in clients
~ Who have not yet been diagnosed (precontemplation / contemplation)
~ Who have been recently diagnosed and are grieving, anxious about the diagnosis
~ Who have been diagnosed for a while and are either treatment noncompliant or are having increasing difficulties managing their blood sugar and complying with treatment

~ Being active to modulate blood sugar, improve insulin resistance mood and self-esteem (150 minutes/week)
~ Blood sugar monitoring and pattern identification
~ Healthful eating
~ A1C of less than 7% to prevent microvascular disease
~ Taking Prescribed Medications
~ Aspirin (salicylate) to address CVD risk and inflammation and help with blood sugar regulation
~ Blood pressure monitoring and management
~ Problem solving (preparing for the unexpected)
~ Oral Health
~ Smoking cessation
~ Alcohol moderation or cessation
~ Sleep improvement and sleep apnea treatment
~ Illness prevention: Health education, Motivation for prevention and mindfulness & early intervention
~ Quality of life (dialectics/and)
~ Diabetes impacts people multidimensionally (PACER)
~ Counselors, social workers and case managers can assist through
~ Screening
~ Health education
~ Goal setting and planning
~ Motivational enhancement and maintenance
~ Addressing grief and anxiety issues associated with having a chronic illness

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