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Learn More About Diabetes Management
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Keywords: Managing diabetes is more than testing
Medline makes it easy
Improving Diabetes Management in Long-Term Care
Diabetes is a devastating disease that greatly impacts long-term care. Twenty-six percent of nursing home residents have diabetes. The
estimated cost of caring for these residents, and the complications arising from diabetes, exceeds $6 billion dollars annually. In the United
Sates, approximately $132 billion dollars goes towards the cost of diabetes and its complications.
Considering that heart disease, stroke, high blood pressure, blindness, kidney disease, dental disease, nervous system disease, and even
amputations are all complications of diabetes, it’s easy to see why healthcare providers want to do everything they can for their residents.
Diabetes is the 6th leading cause of death and 82,000 lower limb amputations are performed annually. Additionally, knowing that CMS is
looking at Pay for Performance measures and considering avoidable hospital admissions, like those due to complications from diabetes, it
is vital for nursing home staff to understand current standards of practice.
Managing diabetes is more than glucose testing. Recognizing this, Medline has assembled a tool to help healthcare providers provide
better care for residents with diabetes. We compiled and organized data acquired during the course of working with healthcare
professionals for more than 40 years. Our Compass Diabetes Program includes a main binder for the Director of Nursing and
supplemental educational packets to be placed on carts for daily reference. Compass will help staff care for residents with diabetes and
provide education and training materials for staff and family members.
ADA Standards of Care
The American Diabetes Association (ADA) is the nation’s leading voluntary health organization supporting diabetes research, information
and advocacy. Their mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. Special tests and
exams are critical to diabetes care. The ADA guidelines are as follows:
Test or Exam Frequency
Routine physical exam Once a year
Blood pressure At every routine exam
Lipid (cholesterol) test Yearly, if low risk, every 2 years
Comprehensive foot exam Yearly, including sensory (nerve) test
Eye exam • Yearly, by an eye physician (ophthalmologist)
• For Type 1 diabetes, start the yearly exams
within 3-5 years of diagnosis
• For type 2 diabetes, start now
Microalbumin (protein) urine test • Yearly, For Type 1 diabetes, start testing 5
years after diagnosis
• For Type 2 diabetes, start now
Hemoglobin A1C (HbA1c) Every 3 to 6 months
What’s in the Compass Diabetes box?
• One Director of Nursing (DON) Instruction Manual—
A teacher’s guide to the program, which includes 4 CE contact hours.
• Three additional Glucose MonitoringTraining resource books—
Put them on treatment carts or in nurses’ stations for easy access.
• Five additional Family Education books—Give them to residents’ families.
• Two Educational Compact Discs (CDs)—
To educate staff on using the Optium™ Glucose Monitoring System.
1
Nutrition
Healthy nutritional habits help control diabetes and reduce
risk factors for other complications such as heart disease,
kidney disease, and vision-related issues. To get the correct
amount of vitamins and minerals and remain energetic, it is
best to eat a variety of foods. The Compass Diabetes
Program lists food sources where these vitamins and
minerals can be found.
While adequate oral intake through meals and snacks is
always desired, there are times when supplements are
necessary. Nutritional supplements help add important
nutrients to a resident’s diet, and can be helpful in situations
where residents are unable to eat enough food to
meet their individual nutritional requirements.
The following four key elements should be focused
upon to provide the best possible care for residents
with diabetes.
STAYING HEALTHY
Glucose Monitoring
Residents diagnosed with diabetes need to have their blood
sugar levels tested daily or as ordered by their physician.
Regardless of the monitor chosen, it is imperative that it be
used correctly because appropriate care can only be provided
based on accurate test results. There are many variables that
can affect glucose readings. Results can be affected by
medications, sample size, and how the test strips are packaged.
Our Compass Diabetes Program provides valuable
information about glucose testing.
Medline’s Optium monitor,manufactured by Abbott Diabetes
Care, takes these factors into account by utilizing its patented
True MeasureTechnology. Optium's test results are not
affected by commonly taken medications, which permits the
health care professional to apply an additional sample onto the
same test strip. The individually wrapped foil test strips ensure
that the test strip was not compromised by humidity, dust, dirt,
consideration and produces a glucose-specific result.
To compliment daily glucose testing,ADA guidelines indicate that a Hemoglobin A1C test should be
performed every 90 days. A1C testing measures the average glucose levels for a 2 to 3 month span of time.
This result allows the physician to gauge if the resident is on an appropriate combination of medication to control
glucose. An elevated result indicates poor glucose control. If glucose levels remain elevated, the risk of developing
complications is increased.
2
Exercise
Exercise is an effective way to improve physical health.
While fitness is promoted primarily to the young, research
indicates that the elderly can also benefit from an exercise
program. Many nursing facilities have developed creative
health and fitness programs to improve their resident’s
physical and emotional health, and they are especially
effective to help manage diabetes. Our Compass
Diabetes Program details sample exercises that can be
done by residents even if they are wheelchair-bound.
Medication
Different medications are regularly used to treat diabetes. Type 1 diabetes is usually treated with insulin administered by injection or
through a pump. Individuals withType 2 diabetes, depending on their physician’s orders, generally control their diabetes through a
combination of dietary modification, exercise, oral antidiabetic medication, or some form of replacement insulin. Our Compass Diabetes
Program provides education on medication and its role in treating diabetes.
3
Pathogens are infectious materials that cause disease in humans.
Many pathogens are blood borne. Universal precautions
should be followed to help protect from spreading infectious
disease. There are more than 20 infections that can be
transmitted through needlesticks, including: hepatitis C, HIV,
hepatitis B, tuberculosis, syphilis,malaria and herpes.
The Needlestick Safety and Prevention Act passed by Congress
became effective April 18, 2001. In response,OSHA revised
the Bloodborne Pathogens Standard. The revised standard
clarifies the need for employers to select safer needle devices
and to involve employees in identifying and choosing these
devices. The updated standard also requires employers to
maintain a log of injuries from contaminated sharps. All
medical facilities must evaluate, select and implement safer
sharps safety devices including needles, syringes and devices
designed to eliminate or minimize occupational exposure.
Safety devices help reduce the likelihood of needlestick injuries
before, during and after use through built-in safety features. No
single device will work equally well in every circumstance.
Employers must develop programs to select the most
appropriate devices. Ultimately, the device must be clinically
effective, acceptable to users, and it must reduce needlesticks.
Sample page of Safety Self-Assessment
LetMedline be part of
your survey-preparedness
team. YourMedline
representative can provide
you a copy of the Safety
Self-Assessment, or you
can contact us through
www.medline.com.
The second section of the
booklet consists of
Medline product solutions
that can help you comply
with various safety
requirements. Choosing
the right product for your
specific situation can
increase the safety of your
employees and residents.
ADDRESSING SAFETY COMPLIANCE
4
Medline Optium™ Glucose Monitoring System
Medline Optium test strips are designed to prevent inaccurate tests and test
strip wastage caused by interferences from many common substances and/or
application of an inadequate sample volume. Application of inadequate blood
samples in some blood glucose monitoring systems can potentially lead to
erroneous results or error messages, which mean wasted test strips. A unique
fill trigger prevents the test from starting until an adequate blood sample is
applied. Simply add more sample and the Medline Optium meter produces a
result, without compromising accuracy. With a 450 result memory,
downloading feature and large, easy-to-read display, the Optium system can
handle all your blood glucose testing needs.
Item No. Description Quantity
MIS70517Z Optium Blood Glucose Meter 1 ea
MIS99134 Optium Glucose Test Strips 12 bx/cs
50 ea/bx
MIS99134Z Optium Glucose Test Strips 50 ea/bx
MIS99135 Optium Glucose Test Strips 6 bx/cs
100 ea/bx
MIS99135Z Optium Glucose Test Strips 100 ea/bx
MIS70550 Precision Control Solution 6 bx/cs
1 vial high, 1 vial low per box
MIS70550Z Precision Control Solution 1 set/bx
1 vial high, 1 vial low per box
Monofilament
This monofilament can be used as a routine test to assess a resident’s
foot sensitivity.
Item No. Description Quantity
MSC0002 Foot Monofilament, Diabetic
Neuropathy Test 25/bx
A1C Test
The A1CNow® InView System offers incredibly fast, quantitative A1C
results (in just 5 minutes) utilizing micro-optical technology that is
integrated into a proprietary reusable monitor with single use cartridges
that is lab accurate at 99%.
Item No. Description Quantity
DIB0310510 A1cNow InView Monitor 10/kit
Medline Preferred Safety Lancets (available July, 2007)
Medline Preferred safety lancets are simple and safe for both the healthcare
professional and the patient. The needle retracts automatically and locks out
for extra safety, protecting patients and healthcare professionals from
needlestick injuries and preventing cross-contamination.
Item No. Description Quantity
MPHSAFETY21 Lancet, Normal Flow,
21 Gauge 1.8mm 200/bx
MPHSAFETY28 Lancet, Micro Flow,
28 Gauge 1.6mm 200/bx
MIS70517Z
MSC0002
DIB0310510
MPHSAFETY28
5
Safety Lancets
Offers maximum comfort for your residents. The Unistik® needlepoint is
hidden before use and automatically retracts after use to avoid needle stick
injuries and cross contamination.
Item No. Description Quantity
OMMAT0747Z Unistik 2 - Comfort
28 Gauge 1.8mm depth penetration 200/bx
OMMAT0704Z Unistik 2 - 21 Gauge
2.4mm depth penetration 200/bx
OMMAT0714Z Unistik 2 - 21 Gauge
3.0mm depth penetration 200/bx
Safety Insulin Syringes
These safety syringes have a secure safety shield that covers the entire
needle length.
Item No. Description Quantity
SWD511110Z 1 mL syringe, 29 gauge x
1/2” needle 100/bx
SWD511136Z 1/2 mL syringe, 29 gauge x
1/2” needle 100/bx
SWD511144Z 3/10 mL syringe, 29 gauge x
1/2” needle 100/bx
SWD511310 1 mL syringe, 30 gauge x
5/16” needle 500/cs
SWD511336 1/2 mL syringe, 30 gauge x
5/16” needle 500/cs
SWD511344 3/10 mL syringe, 30 gauge x
5/16” needle 500/cs
Woven Gauze Sponges
Ideal for wound dressing, our gauze sponges have folded edges to prevent
unraveling and are debris-free when packaged. Sterile 2’s are packed in coated
paper envelopes to further reduce fiber debris. Easy-open packages.
Item No. Description Quantity
NON21420 2" x 2", 8-ply, sterile 50 pk/bx
30 bx/cs
1,500 pk/cs
Alcohol Prep Pads
Before injections, alcohol prep pads are used as a topical antiseptic. The soft,
absorbent, non-woven pads are saturated with 70 percent isopropyl alcohol, USP.
Item No. Description Quantity
MDS090730 11⁄4" x 21⁄2", medium 200/bx
3000/cs
SWD511110Z
OMMAT07 series
MDS090730
NON21420
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Oral Supplements
Item No. Description Quantity
DOY349100 Resource® Diabetishield®, 27 tetra
8oz Orange Burst brik/cs
DOY349300 Resource Diabetishield, 27 tetra
8ozWild Berry brik/cs
DOY360100 Boost® Diabetic, 27 tetra
8oz Vanilla brik/cs
DOY360200 BoostDiabetic, 27 tetra
8oz Chocolate brik/cs
DOY360300 Boost Diabetic, 27 tetra
8oz Strawberry brik/cs
Tube Feeding Formulas
Item No. Description Quantity
DOY355001 Resource® Diabetic TF, 1000mL 6 btls/cs
DOY355020 Resource Diabetic TF, 1500mL 6 btls/cs
DOY365000 Diabetisource® AC, 250mL 24 cans/cs
DOY365001 Diabetisource AC, 1000mL 6 btls/cs
DOY365020 Diabetisource AC, 1500mL 6 btls/cs
Medline Active Protein
Item No. Description Quantity
Medline Active Protein is a flavor-free way to add a high-quality whey protein
isolate. We offer a highly dispersible supplement for residents who need more
protein in their diet. It can be added to all types of foods or beverages. Active
Protein contains 6g of protein per serving and is a high-quality, lactose-free
source of concentrated protein with a well-balanced amino acid profile.
ENT32108 Medline Active Protein, 8 oz Can 6/cs
Resource Arginaid®
Item No. Description Quantity
Resource Arginaid drink mix is an arginine-intensive drink formulated for
patients recovering from burns, surgery, or chronic wounds. This drink
contains nutrients that may help to promote healing. This product is
intended for pressure ulcers, diabetic ulcers, venuous ulcers and burn injury.
DOY359830 9.2g (0.3 oz) Packets Orange 56/cs
DOY359840 9.2g (0.3 oz) Packets Cherry 56/cs
DOY359850 9.2g (0.3 oz) Packets lemon 56/cs
(4 inner cartons, 14 packets each)
DOY365000, DOY365020,
DOY365001
DOY355020, DOY355001
ENT32108
DOY360100
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DOY349100, DOY349300
Over the Counter Drugs
Item No. Description Quantity
OTC25233 Glucoburst™, Glucose Gel,
15 g/Pack. Caffeine Free
& Paraben Free 3 packs/bx
OTC9L75504 Tussin DM, 4 oz. Bottle, Sugar
Free, Alcohol Free, Dye Free 1 btl
OTC83101 Vitamin C 250Mg Tablets 100/btl
OTCS0783C2 Vitamin C Chewable 250Mg 100/btl
OTC84101 Vitamin C 500Mg Tablets 100/btl
OTC027760 Vitamin E 1000IU Soft Gels 100/btl
OTC0047982 Vitamin E 200IU Soft Gels 100/btl
OTCS0813C2 Vitamin E 400IU Soft Gels 100/btl
OTC0047996 Vitamin E 400IU Soft Gels 1000/btl
Lotions
Item No. Description Quantity
A risk factor of Diabetes is dry skin and bacterial infections of the skin. Since
the skin is an actively metabolizing system and relies on the cardiovascular and
nervous system, diabetes affects the skin indirectly. The importance of a skin
care regiment is essential. Medline has a variety of lotions to aid to this process
OTC060001 Hydrocerin Cream 16 oz Jar,
compare to Eucerin 56/cs
OTC062008 Hydrocerin Lotion 8 oz Btl,
compare to Eucerin 56/cs
OTC81008 Lubriskin Lotion 8 oz Btl,
compare to Lubriderm 56/cs
Patient Room Sharps Containers
System of sharps disposal containers designed for use in patient rooms and
high traffic areas.
• Tortuous lid design limits access to container contents.
• Lid design facilitates one-handed operation.
• Horizontal drop design for maximum capacity to fill line.
• Translucent lid provides easy-to-see fill levels.
• Containers easily lock for final disposal and safe transport.
• Large openings accommodate larger syringes.
• Nestable design saves money in shipping costs and storage space.
• Multiple bracketing options.
Item No. Size Feature Quantity
MDS705125 2.5 Quart Wall Mount 30 ea.
MDS705152 5 Quart Wall Mount 30 ea.
The most popular patient room product.
MDS705151 5 Quart Wall Mount/Freestand 14 ea.
MDS705203 3 gallon Wall Mount/Freestand 12 ea.
OTC9L75504
OTC25233
OTC84101
MDS705203
MDS705151
MDS705152
8
Multipurpose Sharps Containers
Every area has its own unique sharps disposal needs. These containers are
designed for use in restricted access areas.
• Non-tortuous lid design accommodates a variety of sizes of sharps.
• Translucent lid for quick ID of fill level.
• Containers lock for final disposal.
• Nestable containers save space and reduce shipping costs.
• Horizontal drop maximizes use of container volume.
• Brackets available.
Item No. Size Quantity
MDS705201 1 gallon 32 ea.
MDS705202 2 gallon 20 ea.
The most popular multipurpose product.
Phlebotomy Sharps Containers
Portable sharps containers are designed to fit into blood drawing trays, also
provides point-of-use disposal and features a square base for added stability.
• Translucent top allows easy ID of contents.
• Choice of single or dual openings accommodates a variety of sharps.
• Containers lock for final disposal and safe transport.
• Available holders and brackets.
1 Quart Containers
Item No. Size Quantity
MDS705110 1 Quart 100 ea.
The most popular phlebotomy product.
1.5 Quart Containers
• Funneled opening with snap-type closure.
• Designed to fit Artrocarts.
Item No. Size Quantity
MDS705115 1.5 Quart 20 ea.
Mail-Back Sharps Containers
Each Kit includes all components required for collection and transportation of
sharps and regulated medical waste.
• Compact design that uses a minimum of counter space.
• Lids that provide temporary and final locking closure.
• The most available sizes in the industry.
• Step-by-step instructions.
•Waste shipping containters.
• Easy to use and close outer shipping box.
• Pre-paid, pre-addressed shipping labels and Pre-paid disposal.
• Tracking documents.
Item No. Size Quantity
SCC1QV2 1 quart 1 ea.
MDS705000 1 gallon 1 ea.
SCC2GV2 2 gallon 1 ea.
SCC3GV2 3 gallon 1 ea.
SCC5GV2 5 gallon 1 ea.
MDS705202
MDS705201
MDS705115
Sharps Container -
MDS705110 plastic Holder - MDS707910 sold separately
9
Brackets and Cabinets for Sharps Containers
Mounted wall cabinets secure sharps containers, free up counter space and help
prevent access in high-traffic areas. Economical wall mounting brackets provide
an unobtrusive method for mounting containers. Easy to clean and suitable for
a variety of decors.
• Containers secured in locked enclosure.
• Cabinets feature a tinted viewing window that allows contents
to be viewed by hospital personnel, but not by others.
Item No. Description Quantity
MDS707054 Wire bracket, locking, for
MDS705151 & MDS705203 10 ea.
MDS707062 Wire bracket for MDS705151
and MDS705203 10 ea.
MDS707963 Wire bracket, locking, for MDS705201,
MDS705202 & MDS706202 5 ea.
MDS707975 Wire bracket for MDS705201,
MDS705202 &MDS706202 5 ea.
MDS707912 Wire bracket for MDS705110 5 ea.
KDL8518X Wire bracket, locking, for
SWD85121 and SWD85131 5 ea.
KDL8519C Wire bracket for
SWD85121 and SWD85131 5 ea.
MDS707960 Plastic bracket for MDS705125 and
MDS705152 (includes 5 keys) 20 ea.
KDL31139747 Replacement Key for MDS707960 10 ea.
MDS707549 Wall cabinet with key for
MDS705125 & MDS707152 10 ea.
MDS707553 Wall cabinet with key for MDS705151 1 ea.
MDS707005 Wall cabinet with key for MDS705203 1 ea.
KDL85165H Wall cabinet with key for
SWD85121 and SWD85131 5 ea.
Locking Cabinet Refills
Sharps container fits into some Sage and Kendall locking cabinets.
Item No. Size Quantity
SWD85121 Clear, 5 qt. 20 ea.
SWD85131 Red, 5 qt. 20 ea.
MDS707960
Sources
1. Nursing Homes Long Term Care Management. www.nursinghomesmagazine.com. Accessed April 11, 2007.
2. American Diabetes Association. Available at www.diabetes.org. Accessed April 30, 2007.
3. American Diabetes Association. Available at www.diabetes.org. Accessed April 30, 2007.
A1cNow is a registered trademark of Metrika, Inc.
Boost Diabetic, Diabetisource AC, Resource Arginaid, Resource Diabetic TF, and Resource Diabetishield are either registered trademarks or trademarks of
Novartis AG Corporation, Switzerland
GlucoBurst Glucose Gel is a trademark of PBM Products, LLC.
Optium is a trademark of Abbott Laboratories, Inc.
Unistik is a registered trademark of Owen Mumford, Inc.
MDS707912
MDS707553
(Container shown, sold separately)
MDS707549
MDS707005
(Container shown, sold separately)
SWD85131
(Cabinet not included)
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Not all products are currently available for sale in Canada. Please
contact your Account Representative for additional information.
For your convenience we have included a CD that includes diabetes related product brochures as
well as educational information for you and your staff. We hope that you find its contents helpful
in developing a care plan for your residents with diabetes.
MKT207053/LIT196R/10M/4xxx |
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