This week I learned that the Preventative Cardiovascular Nurses Association (PCNA) has partnered with NovoNordisk to bring diabetes into the preventative cardiovascular nursing space. The Making the Connection program increases awareness of the link between cardiovascular risk and type 2 diabetes in the nursing community through five education modules. The modules that focus on type 2 diabetes discuss the prevalence, health disparities, pathophysiology, and the ADA Standards of Care for the management of the person with diabetes and cardiovascular disease, including shared-decision making and healthcare teams, which of course includes a diabetes care and education specialist (DCES).
The union for the DCES and cardiovascular health harkens back to 2019, when ADCES announced a new vision for the specialty that positioned DCESs as experts in the full range of cardiometabolic conditions. Cardiometabolic and cardiovascular health are areas that I have long believed a DCES has worked in without perhaps defining it as such. When we work with the person we take into account all co-conditions and potential complications. This is what we talk about when practicing secondary prevention. Diabetes isn’t siloed in the body and the DCES does not treat diabetes in isolation.
How many times have you worked with someone with diabetes, hypertension, and/or dyslipidemia and mentioned when talking about the plate method for meal planning that their protein source should be low fat and low salt? Or how exercise can not only help reduce glucose values but also lower blood pressure and increase HDL? And when discussing risk factor modification, why do we look at all three of these conditions together in the prevention of atherosclerotic cardiovascular disease (ASCVD)? Because it is the leading cause of death in people with type 2 diabetes.
How far do you take those conversations? Do you discuss lowered glucose variability and improved time in range as ways to help lower the risk of developing cardiovascular complications? Do you [...] discuss the numerical risk of a cardiac event in the next 10 years?
Cardiovascular-specific knowledge can genuinely help the DCES treat the whole person. We know that having diabetes is a risk factor for ASCVD, microvascular and microvascular complications, heart failure and stroke, to name a few. We are talking to people with diabetes about these risks and helping them reduce these risks/complications through the ADCES7 Self-Care Behaviors™. But how far do you take those conversations? Do you discuss lowered glucose variability and improved time in range as ways to help lower the risk of developing cardiovascular complications? Do you run the person’s information through an ASCVD risk calculator and discuss the numerical risk of a cardiac event in the next 10 years?
Fortunately, ADCES is there to help you increase your expertise in cardiovascular health. ADCES22 has incorporated a cardiometabolic metabolic track for education sessions and will be hosting a Cardiometabolic Summit to assess the state of cardiometabolic care and education and the needs of DCES and other members of the diabetes care team. There are also online educational certificate programs to further our expertise in cardiometabolic areas, starting with obesity care. Resources to address cardiovascular health are also available at DiabetesEducator.org/CVD.
Managing cardiovascular risk in the people with work with is an ongoing practice. Today I was talking with my Lilly Medical Science Liaison about the newly approved tirzepatide and the potential cardiovascular benefits they hope to see in their SURPASS-CVOT trials. I asked about cardiovascular implications because this is such an important part of diabetes care and education. The people we work with want to know and need to be informed in all aspects of their care and you as the DCES are the perfect person to help them put this all together.
ADCES Perspectives on Diabetes Care
The Association of Diabetes Care & Education Specialists Perspectives on Diabetes Care covers diabetes, prediabetes and other cardiometabolic conditions. Not all views expressed reflect the official position of the Association of Diabetes Care & Education Specialists.
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