Endocrine (Diabetes) Rotation

(Also refer to the general goals and objectives for PhPr 803)

Goals

To develop a pharmacist who:

  • Can obtain the necessary information from the medical record and patient interview to determine a treatment plan for the patient.
  • Can utilize the treatment plan to manage and educate the patient and relay this information to other health care providers.
  • Is knowledgeable about the diagnosis, management, and monitoring of diabetes and common concomitant disease states such as hypertension and hyperlipidemia.
  • Has good communication and patient education skills.
  • Conducts herself/himself in a professional manner.
  • Has a commitment to lifelong learning.

 

Objectives

1. Pathophysiology of Diabetes

  • Differentiate between Type 1 and Type 2 diabetes both with respect to pathophysiology as well as signs and symptoms.
  • List the signs and symptoms of diabetes.
  • Discuss the diagnosis of diabetes.
  • Discuss the complications associated with diabetes.

2. Management of Diabetes

  • Nutrition

i. Discuss the general nutrition guidelines for a patient with diabetes.
ii. Given a specific patient, develop a nutrition plan.
iii. Discuss the use of vitamins, minerals, and nutritional supplements in patients with diabetes.

  • Drug therapy for glucose management

i. Discuss the pharmacology and therapeutic use of the drugs used in diabetes to lower glucose.
ii. Given a specific patient, design a drug therapy regimen.

  • Drug therapy for comorbid conditions

i. Given a patient with hyperlipidemia, design a drug therapy regimen and discuss the pros and cons of various agents, dosing, and monitoring.
ii. Given a patient with hypertension, design a drug therapy regimen and discuss the pros and cons of various agents, dosing, and monitoring.
iii. Discuss the use of aspirin in patients with diabetes.
iv. Discuss smoking cessation therapy.

  • Exercise

i. Discuss the benefits of exercise in patients with diabetes.
ii. Discuss the precautions to be taken when a patient with diabetes exercises.
iii. Design an exercise program for a patient with diabetes.

  • Complications

i. Discuss the causes, symptoms, and treatment of hypoglycemia.
ii. Discuss the management of diabetic ketoacidosis and hyperosmolar nonketotic coma.
iii. Discuss the use of drug therapy for common complications of diabetes including neuropathy, proteinuria/nephropathy, and gastroparesis.

3. Monitoring Diabetes

  • Discuss the American Diabetes Association Standards of Medical Care for Patients with Diabetes.
  • Physical exam

i. Perform a foot exam and know the danger signs for people with diabetes.
ii. Measure blood pressure.
iii. Discuss the appropriate monitoring for opthalmologic complications.

  • Blood glucose monitoring

i.Compare the available blood glucose monitors.
ii.Design a plan for blood glucose monitoring based on the patient's therapeutic plan, motivations, and glycemic goals.
iii.Describe errors that can occur with blood glucose monitoring.

  • Laboratory monitoring

i. Discuss the use of tests for measuring glycemic control and the target goals for these tests.
ii. Discuss the appropriate monitoring for hyperlipidemias and the target goals for lipids.
iii. Discuss available methods to detect proteinuria and the diagnostic values for these tests.

4. Patient Education

  • Assess a patient's educational needs and design an educational plan based on this assessment.
  • Discuss survival skills education.
  • Describe the various topics that on which a patient should receive education.
  • Discuss the various learning styles of patients and how best to meet these styles.

 

Originally posted: August 29, 2013
Last updated: July 1, 2016
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