11/14 National Diabetes and Caregiver Months

November is National Diabetes Month and National Family Caregivers Month, and November 14, 2019 is World Diabetes Day.  The theme for both Diabetes Month and Diabetes Day this year is Family and Diabetes.  The theme for 2019 Family Caregivers Month is Caregiving Around the Clock.  To find out more, see:

10/17 DPC Webinar on Transplant

Dialysis Patient Citizens will present an October 17, 2019 webinar on Decisions You Need to Make about Your Transplant Choice.  The webinar will cover high risk donors, the transplant waitlist, and how to be a “great transplant recipient.”  RSVP at https://www.dpcedcenter.org/news-events/education-webinars/.  This is short notice, but the webinar will be recorded, and when the recording is ready you can find a link to it at the same web page, along with past webinars on topics like diabetes, employment, exercise, medications, laughter, support, and many others.  The next monthly webinar, on November 21, will be about Treatments and Modality Options for Kidney Disease.  There’s no date set yet, but the December webinar will be on Kidney Nutrition.  Find more details and RSVP for current and future webinars at https://www.dpcedcenter.org/news-events/education-webinars/signup/.

Warning: Medtronic MiniMed Insulin Pumps

The FDA has warned that certain Medtronic MiniMed Insulin Pump models are not protected from hackers, who could alter the insulin settings.  Medtronic is replacing the inadequately protected pumps.  For recommendations on protecting yourself while awaiting a replacement, a list of models and software versions involved, and more information, see https://www.fda.gov/medical-devices/safety-communications/certain-medtronic-minimed-insulin-pumps-have-potential-cybersecurity-risks-fda-safety-communication.

Diabetic Foot Care

A recent study published in the American Diabetes Association’s (ADA) journal Diabetes Care (http://care.diabetesjournals.org/content/early/2019/05/28/dc19-0296) using 2000-2015 USRDS data has shown that the rates of nontraumatic lower-extremity amputation (NLEA) among adults with ESRD and diabetes fell 44% between 2000 and 2013 from 7.5 to 4.2 NLEA per 100 person-years, while NLEA among ESRD patients without diabetes declined 31% over the same period, from 1.6 to 1.1 per 100 person-years.  Both reductions were highly statistically significant.  However, both rates flat-lined after 2013.

We want to stress the importance of improving patient and staff education on diabetes self-management and preventive foot care, in order to resume the reductions in these rates.  CDC’s recommendations on diabetic foot care can be found at https://www.cdc.gov/features/diabetesfoothealth/index.html.  The ADA’s input is at http://www.diabetes.org/living-with-diabetes/complications/foot-complications/foot-care.html in English and http://www.diabetes.org/es/vivir-con-diabetes/complicaciones/el-cuidado-de-los-pies.html in Spanish.

MAC Toolkits; Transplant, Transitions, Medications

The National Forum of ESRD Networks has introduced or updated several Medical Advisory Council (MAC) Toolkits.  Two new Kits include the Transplant Toolkit and the Medication Conversion Toolkit.  The Transitions of Care Toolkit was updated in mid-April.  Find them all at http://esrdnetworks.org/resources/toolkits/mac-toolkits-1, along with the existing Home Dialysis Toolkit, Medical Directors Toolkit, QAPI Toolkit, Medication Reconciliation Toolkit, Catheter Reduction Toolkit, Vaccination Toolkit, and Assurance of Diabetes Care Coordination Toolkit.

6/12+ Infection Control Tools

  • In mid-June 2019 a series of presentations on Infection Control, offering free CME/CE credits to physicians, nurses, and pharmacists, will expire.  CDC and Medscape produced them in 2017 with the intention that they’d be valid for two years.  The six presentations include Risk Recognition, Environmental Services, Medical Equipment, Nonsterile Gloves, Hierarchy of Controls, and Injection Safety.  Find them at https://www.cdc.gov/infectioncontrol/training/cme-info.html.

5/22 CMS/NKF Webinar on CKD Risk Reduction

CMS and NKF will present a May 22, 2019 webinar on on Population Health Strategies for Kidney Disease Risk Reduction, at noon PST.  Nephrologists, dialysis facility medical directors and renal care providers are invited and encouraged to attend. The NKF CKD Change Package will be introduced, systematic strategies for improving identification and management of CKD will be described, and a population health strategy for registry function, QI, and patient engagement for people living with CKD will be presented.  Register for the webinar at https://meetings-cms.webex.com/meetings-cms/onstage/g.php?MTID=e06e8b0a5642756b1b7a7e0998d0eeeb8.  Find the NKF CKD Change Package at https://www.kidney.org/sites/default/files/02-11-8036_JBI_CKD_ChangePackV17.pdf.