Oct 28th 2013

Diabetes: Diagnosis, Treatment, and Opportunities (Coursera)

This multidisciplinary course will emphasize the diagnosis and treatment of diabetes. Topics will include patient self-management, appropriate use of technologies, nutrition, behavior modification and pharmacotherapy in the management of this disease. The course will conclude by summarizing new basic science research regarding the pathophysiology and treatment of diabetes.

Over a dozen faculty from UC San Francisco's Schools of Pharmacy, Medicine, Nursing, and Dentistry will present on topics including the epidemiology, diagnosis, nutritional strategies for self-management, the role of insulin in managing diabetes, effects of diabetes on oral/dental health, and current research in the field.

Course Syllabus:

Week 1: Introduction, Diagnosis, and Treatment Plans

- Review the epidemiology and pathogenesis of diabetes

- Outline the different types of diabetes

- State the diagnostic criteria for diabetes and the tests to distinguish type 1 diabetes and type 2 diabetes

- Review the relationship of glycemic control and outcomes, including the prevention or delay of long-term complications

- Provide a general treatment algorithm for type 2 diabetes, including glycemic targets and individualization

- Describe the general treatment approach to type 1 diabetes

Week 2: Self-Management, Nutrition, Technologies, Behavior Modifications

- Review the importance of self-management principles as applied to diabetes care, including problem-solving and SMART goal setting as examples

- Review the role of blood glucose monitoring in the self-management of diabetes

- Review the role of continuous glucose monitoring (CGM) in the management of diabetes

- Recognize the National Standards for Diabetes Self-Management Education (DSME) toward planning a diabetes education program

- Discuss meal planning tips for people with diabetes

- Discuss nutrition basics for people with diabetes

Week 3: Pharmacotherapy

- Describe the different types of insulins and their time action profiles.

- Review insulin therapy modalities used in type 1 diabetes

- Describe the role in therapy of the classes of medications used to treat type 2 diabetes (including sulfonyurea, meglitinides, biguanides , thiazolidinediones, alpha glucosidase inhibitors, DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT-2 inhibitors

- Propose initial drug therapy in type 2 diabetes, logical advancement to dual and triple therapy, and transitions to insulin

- Review key side effects of diabetes medications, including hypoglycemia, and appropriate management strategies

Week 4: Diabetes and Oral/Dental Health

- State the risk for periodontal disease, root caries, tooth loss and impaired wound healing in diabetic patients

- Characterize the benefit of non-surgical periodontal therapy toward improved glycemic control

- State the effectiveness of adjunctive antibiotic therapy in non-surgical periodontal treatment in diabetic patients

- For non-dental health care providers: recognize root caries lesions, describe options toward prevention of root caries, and criteria for referral of patients with root caries

- Describe options for assessment and management in patients with extremely poor glycemic control and need for extraction of abscessed teeth

- Describe the impact of periodontal infection on adverse pregnancy outcomes and the safety of non-surgical periodontal treatment for women with gestational diabetes

Week 5: Frontiers/New Horizons

- Describe the role of T regulatory cells in modulating immune response in diabetes

- Define the role of induction of beta cell proliferation both during child development and in adults

- Describe the current state of stem cell differentiation for beta cells

- Describe future anti-inflammatory options, including those associated with macrophages and lipid metabolism, in type 2 diabetes

- Highlight the distinction between brown, beige, and white fat in humans in the pathophysiology and potential treatment of diabetes

More info: