Lions District 24-A & American Diabetes Association Diabetes Education and Eye Screening Training

July 14, 2012 8 am to 4 pm Fairfax Government Center

Suzanne Tolson, BS, MSEd, CC-NREMT-P

To learn how we can

help our fellowman

Why are we here???Why are we here???

To become more active as Lions Club MembersTo learn more about

Diabetes

To learn more about

screening for vision

problems

To learn more about screening for the potential for diabetes

Patient Assessment Patient Assessment QuestionsQuestions

Imagine this: You are going on a medical mission to underserved area in the USA or maybe even abroad.

And you are asked to gather baseline data on each of the individuals who comes to the ADA/Lions Club clinic.

What data would you

choose to collect?

Patient Assessment QuestionsPatient Assessment Questions

Let’s look at an example.

(Insert Patient Data Collection Sheet here.)

• What is Body Mass Index?

Body Mass IndexBody Mass Index

http://www.nhlbisupport.com/bmi/bmicalc.htm

What is yourWhat is yourBody Mass Index ?Body Mass Index ?

• What does BMI have to do with diabetes?If your BMI is above the normal range then you are at greater risk for developing type 2 diabetes.

Body Mass IndexBody Mass Index

Blood Pressure ScreeningBlood Pressure Screening

• What is blood pressure?Systolic ?Diastolic ?

Blood Pressure ScreeningBlood Pressure Screening

What is a “normal” blood pressure?

Normal Blood Pressure Ranges for ADULTS perThe American Heart Association:

Blood Pressure ScreeningBlood Pressure Screening

Category systolic, mmHg diastolic, mmHg

Hypotension < 90 < 60

Desired 90–119 60–79

Prehypertension 120–139 or 80–89

Stage 1 Hypertension 140–159 or 90–99

Stage 2 Hypertension 160–179 or 100–109

Hypertensive Crisis ≥ 180 or ≥ 110

What about children???

Systolic Diastolic Infants 1 to 12 months 75–100 50–70Toddlers 1 to 4 years 80–110 50–80Preschoolers 3 to 5 years 80–110 50–80School age 6 to 13 years 85–120 50–80Adolescents 13 to 18 years 95–140 60–90

Blood Pressure ScreeningBlood Pressure Screening

The Mayo Clinic says:• Using a blood pressure cuff that's too large or too

small can give you inaccurate blood pressure readings. You should have several sizes of cuffs to ensure an accurate blood pressure reading.

• The inflatable part of the blood pressure cuff should cover about 80 percent of the circumference of your upper arm. The cuff should cover two-thirds of the distance from your elbow to your shoulder.

TIME TO VOLUNTEER

Random blood sugar test: This test can be conducted throughout the day, irrespective of the meal times. The blood sugar levels should be between 70 and 125 mg/dL to be declared 'normal' in case of random testing method.

Blood Sugar Levels

Fasting blood sugar:This test is commonly conducted to check the rise or fall in the glucose levels after a prescribed eight-hour fast. The levels are required to fall and get recorded between 70 and 99 mg/dL to be declared as normal blood glucose levels.

Blood Sugar Levels

VOLUNTEERS ???

• Glaucoma is a complicated disease in which damage to the optic nerve results in vision loss. There are 2 types.

• In open-angle glaucoma, the angle in your eye where the iris meets the cornea is as wide and open as it should be, but the eye’s drainage canals become clogged over time, causing an increase in internal eye pressure and subsequent damage to the optic nerve. It is the most common type of glaucoma, affecting about four million Americans, many of whom do not know they have the disease.

GLAUCOMA

GLAUCOMA

Angle-closure glaucoma is caused by blocked drainage canals in the eye, resulting in a sudden rise in intraocular pressure. This is a much more rare form of glaucoma, which develops very quickly and demands immediate medical attention. In contrast with open-angle glaucoma, symptoms of acute angle-closure glaucoma are very noticeable and damage occurs quickly.

GLAUCOMA

• What is normal intraocular pressure?– Current consensus among ophthalmologists and

optometrists define normal intraocular pressure as that between 10 mmHg and 20 mmHg.

– Intraocular pressure >20 mmHg (ocular hypertension) is the primary indicator for glaucoma diagnosis.

GLAUCOMA

PASCAL Dynamic Contour Tonometer

Diaton Transpalpebral Tonometer

Testing for Glaucoma

What is it???

Audience Response, Questions and Recommendations