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1. State diagnostic criteria for diabetes and understand the differences between Type 1, Type 2 and pregnancy induced (gestational) diabetes.
2. Evaluate metabolic syndrome (“the deadly quartet”: diabetes, hypertension, hyperlipidemia and obesity) and pre-diabetes.
3. Recognize the symptoms of hyper- and hypoglycemia and use current research for optimal pharmacologic and nonpharmacological treatment based on ADA Standards of Care and AADE-7™ behavioral goals.
4. Discuss the basal/bolus concept of insulin administration including various insulin administration schedules to achieve optimal control.
5. Assess risk and employ prevention/treatment techniques for acute and chronic complications, including how to address weight issues.
6. Utilize current research to support the nationwide impetus for tight glycemic control for hospitalized patients, including management strategies during illness or surgery.
7. Explain what to do when a patient is wearing an insulin pump.
8. Analyze motivational techniques to assist patients to progress from knowing to doing.
9. Describe new treatment therapies and what is on the horizon.

1. Diabetes: Current Diagnostic Criteria and Prevalence
   1. Type 1/Type 2
   2. Pregnancy and diabetes
   3. Metabolic syndrome/pre-diabetes
   4. Other causes of hyperglycemia
2. Importance of Glycemic Control
   1. Outpatient:
      1. Acute Complications: Causes, Symptoms and Treatment
      2. Diabetic ketoacidosis (DKA)
      3. Hyperglycemic hyperosmolar non-ketotic syndrome (HHNK)
      4. Hypoglycemia
      5. Infection
      6. Fatigue/depression
      7. Chronic Complications: Prevention, Identification, and Treatment
      8. Cardiovascular disease
      9. Peripheral vascular disease
      10. Retinopathy
      11. Nephropathy
      12. Neuropathy
   2. Inpatient:
      1. Morbidity
      2. Mortality
      3. Length of stay
   3. Goals of Therapy:
      1. Glucose control
      2. Blood pressure control
      3. Lipid management
      4. Smoking cessation
      5. Improved "well-being"
   4. Treatment
      1. AADE-7 behavioral goals
      2. Healthy Eating (carbohydrate counting, balanced fat/protein/carb)
      3. Being active with complications of diabetes
      4. Healthy coping/stress management/depression treatment
      5. Monitoring: frequency, timing and evaluation of results
      6. Risk reduction
      7. Problem solving with case examples
      8. Medication: Indications and Contraindications
         1. Oral medications:
            1. Sulfonylureas
            2. Meglitinides
            3. Thiazolidinediones (TZD)
            4. Biguanides
            5. Alpha-glucosidase inhibitors
            6. DPP-4 inhibitors
            7. Combinations
         2. Insulin:
            1. Action times
            2. Basal/bolus dosing
            3. Benefits of insulin pump therapy
            4. Management of insulin pump in the hospital
         3. Incretin Mimetics: Byetta
         4. Amylinomimetics: Symlin
   5. New Therapies: Inhaled insulin
      1. Glucose sensors
      2. Sensor augmented insulin pumps
      3. On the Horizon: Closed loop insulin pumps
         1. Improved pancreatic transplants
         2. Many combination pills
         3. More DPP-4 inhibitors
         4. Obesity medications
         5. Stem cell research
   6. New Medications - Patient education and empowerment techniques
      1. Adult learning styles
      2. Setting "SMART" goals
      3. Motivational techniques
   7. Resources for Patients and Professionals

Laurie Klipfel, RN, MSN, ANP-BC, CDCES, WCC®, has been a Certified Diabetes Care and Education Specialist for over 20 years managing both impatient and outpatient care for patients with diabetes. She has managed several hospital ADA-recognized diabetes education programs, is a Board-Certified Adult Nurse Practitioner with specialty in endocrinology and has a certification in wound care.

Laurie is a member of the American Association of Diabetes Care and Education Specialists and past president of her local chapter. She is a certified insulin pump trainer and has published articles on use of insulin pumps for hospitalized patients. Her practical patient experiences, supported by clinical knowledge, provide a blend of information on how to treat diabetes today. Speaker Disclosures:
Financial: Laurie Klipfel has employment relationships with the VA-St. Louis and the Diabetes & Endocrinology Specialists, Inc. She receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Laurie Klipfel is a member of the St. Louis Nurses in Advanced Practice.

Save time and $10 off the price of other submission methods – purchase & take the CE test online for $9.99 USD per participant. Additional processing fees apply for other submission methods (i.e. mail, fax, etc.). Please contact our Customer Service at 1-800-844-8260 for more details.

Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self study is an acceptable form of continuing education. Please refer to your state rules and regulations.

Certificates of Successful Completion are available for email, download and/or printing from your online account immediately following the successful completion of the post-test/evaluation.

**Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners. For speaker disclosures, please see the faculty biography.

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Certified Diabetes Educators
The National Certification Board for Diabetes Educators recognizes courses sponsored by a CDR approved provider. This self-study course qualifies for 6.5 continuing education hours.

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Registered Dietitians & Dietetic Technicians

PESI, Inc., PE001, is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR) from July 1, 2019 through June 30, 2022. Registered dietitians (RDs) and dietetic technicians, registered (DTRs) will receive 6.5 continuing professional education units (CPEUs) for completion of this program/materials. Continuing Professional Education Provider Accreditation does not constitute endorsement by CDR of a provider, program, or materials. This self-study program/material is designated as LEVEL 2.

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Nurses/Nurse Practitioners/Clinical Nurse Specialists - Credit Expired: 4/7/2020
No CE available for this board.

California Nurses: PESI, Inc. is a provider approved by the California Board of Registered Nursing, Provider #:17118 for 6.5 self-study contact hours.

You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Nurses: PESI, Inc. is an approved provider by the Florida Board of Nursing. Provider #: FBN2858. These materials qualify for 6.5 self-study contact hours.

Iowa Nurses: PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 7.8 self-study contact hours.

Copies of the evaluation may be sent to the IBON. You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

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Pharmacology Nurse Practitioners
This self-study program offers 380 instructional minutes of pharmacology content which is designed to qualify for 6.0 contact hours toward your pharmacology requirement.

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Pharmacists

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Other Professions
This self-study activity qualifies for 6.5 clock hours of instructional content as required by many national, state and local licensing boards and professional organizations. Retain your certificate of completion and contact your board or organization for specific filing requirements.

Disclaimer: **Information obtained in this course should be used within your scope of practice.
**It is your ethical responsibility to report accurate hours to your licensing board.
**All self-study participants must complete and pass (80% or better) a post-test and evaluation prior to receiving a certificate of completion. If you require a copy of the test/evaluation for CE purposes, please print at the time you take the test. Or you may call our customer service department and a copy of your test/evaluation will be emailed to you. Please allow 30-45 days.

Nurses, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, Registered Dietitians & Dietetic Technicians, Pharmacists, Certified Diabetes Educators