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Course Author Information

Our author for this course, Gustavo Wong, MS, RD, CDE, HFS has been working as a diabetes educator since 1998. Through this work he has become intimately aware of the needs of people with diabetes, and has worked with many non-adherent patients over the years. His recent Health Fitness Specialist accreditation from the American College of Sports Medicine further solidifies his expertise in the field of diabetes.

Let's begin now by reviewing our learning objectives.

Learning Objectives
Upon completion of this course the participant will be able to:
1. List two non-adherence issues common in diabetes management.

2. Describe one method to motivate diabetes patient adherence.

3. List two examples of community service resources to improve diabetes management adherence.

Background Information
Type 2 diabetes:
Accounts for 90-95% of cases
Begins with insulin resistance
Is associated with older age, obesity, family history, history of gestational diabetes, impaired glucose metabolism, physical inactivity, race/ethnicity








Darker colors indicate higher prevalence
darkest color=>10%
lightest color=<7%

Diabetes is really a group of diseases with one thing in common: high blood glucose levels. Elevated blood glucose levels result from a problem with insulin production, a problem with insulin effectiveness, or both. Because type 2 diabetes represents the vast majority of cases of diabetes in the U.S., we will concentrate on this type of diabetes for our discussion. There is also type 1 diabetes, which involves the destruction of pancreatic beta cells that make insulin; gestational diabetes, which is a glucose intolerance that develops during pregnancy; and diabetes that can result from genetic conditions.

Type 2 diabetes typically begins with insulin resistance, the mild form of which is called “pre-diabetes”. This is very common and may be present in more than 40 million Americans. During this stage, diabetes may be preventable through lifestyle changes and weight management. It is estimated that about 23.6 million children and adults have diabetes, nearly 18 million of whom have been diagnosed, while the remaining 5.7 million undiagnosed. The Centers for Disease Control and Prevention (CDC) estimates that about 1.6 million new cases of diabetes are diagnosed each year in 20-plus year olds.

Under the age of 20, there are only 0.22% who have diabetes, but about 1 in every 6 overweight adolescents under 20 have pre-diabetes. For people who are 20 years of age or older, about 10.7% have diabetes. This is split pretty evenly between men and women with 11.2% of men and 10.2% of women over 20 years of age. Over 60 years of age, more than 23% have diabetes. People of Hispanic and non-Hispanic black heritage have higher prevalence rate than non-Hispanic whites and Asian Americans.

With trends the way they are, a study has suggested that the number of people diagnosed and undiagnosed with diabetes may nearly double by the year 2034 from 24 million to 44 million. Between 2009 and 2034 costs of healthcare for diabetes may triple, with the heaviest burden on Medicare spending.

Information on CDC’s website at: 


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