Vol 13, No. 04                                                           April 17, 2008

The April meeting was held at Guisseppe’s in Kingsport, TN. Matt Kilgore with NovoNordisk sponsored the meeting, and our speaker was Becky Roberts, RN, CDE.  She specializes in a program called "Teachable Moments" and provided tips on nutrition, carb counting, and effecting behavioral change patients with Diabetes

Presentation Highlights

(The overall presentation was very basic and therefore I included key points most of us forget or didn’t know re: DM management. I did not include the basic patho and signs/sx hypo/hyperglycemia)

• DM management becoming more complex
• 6 classes of diabetes drugs
• Type 1 DM has no insulin production at diagnosis and 50% of insulin production is lost in Type 2 at time of diagnosis
• Analog insulins provide more predictable blood sugar control; can take immediately at meal times and expect a 90-120 minute peak time
• Basal insulins (Lantus and Levimir) taken once daily and provide 24 hour control
• Insulin pens are covered by TN Care; come as box of 5 for 1500 units total; sample comes with 7 free needles, but otherwise you need to write a separate Rx for needles (100/box)
• Diet changes are difficult for patients to make; focus on simple changes like substituting starch vegetables like corn/potatoes with non-starch vegetables
• Sugar-free labels do not = carb free
• If glucose monitoring strips too expensive, and patients sugars are well controlled, suggest checking glucose before breakfast and after dinner every other day.
• 50% of lower limb amputations in diabetics are from wounds in feet that started because they stepped on something in their own house without shoes on….WEAR SHOES!!
• Remember the emotional/psychological side effects of new diagnosis of DM, like with any other chronic disease diagnosis
• Byetta is not indicated for use with insulin, therefore choose Symalin with insulin if needed
• ACE guidelines for blood glucose control:
• <110 fasting
• <140 post prandial
• HgB A1C < 6.5% (check q 3 mo if poor control and q 6 mo for well controlled)

Business Meeting

The regular meeting of the Northeast Tennessee Nurse Practitioners Association was called to order at 7:30 PM on April 17, 2008, at Guisseppe’s in Kingsport, by President Vickie Lewis.

Approval of Minutes

• The minutes of the previous meeting were unanimously approved as distributed

Old business

• The budget proposal for 2008 was sent via email with the April minutes. Members’ suggestions and comments on the budget are welcome
• Dues are DUE!! Please give your $35 to Paula Countiss ASAP!

New Business

• Kay Bone asked for member input regarding upcoming meeting topics. She has several reps requesting sponsorship covering topics already covered. Previously, membership against repetition. Census would like variety, but understand if sponsorship needed repetition OK. May meeting to cover headaches; June: hepatologist; July and August: OPEN; September: Singulair and allergies. Email Kay with meeting interests and sponsorship interests @ kayandpatbone@aol.com


• Wendy Vogel updated us on the DNP issue. She was recently quoted in the Wall Street Journal in an article that ran on April 2, 2008 titled "Making Room for 'Dr. Nurse'.  On Friday April 4, 2008 AANP submitted a response to The Wall Street Journal expressing our concern about much of the information presented. Please click here to view The Wall Street Journal article and here to view AANP's response. The article was highly inaccurate and one-sided. We encourage you to send your individual thoughts on this article to wsj.ltrs@wsj.com or fax (212) 416-2255. As a result, there is also a blog about the article that can be reviewed at http://blogs.wsj.com/health/2008/04/02/say-hello-to-dr-nurse/?mod=WSJBlog


• Anna Northrop is requesting some missing issues of Advance: Jan-June 05; Sept-Dec 05; Jan 06 & Jun-July 06. Please contact her at abnorthrop@yahoo.com if you would like to donate these.

Job availability:

• ETSU is looking for a temporary NP for the college clinic
• Washington County Health Department in Johnson City still needs NP
• Part-time or full-time NP needed for Centerpointe Medical Clinic in Kingsport.  Contact April Barrett at 423-247-7030
• Telemental Health @ VA looking for NP
• Pulmonary NP wanted at Blue Ridge Medical Specialists, PC
• Dr. Grunstra's group is looking for a NP-- will take a new graduate (located in Bristol)
• Dr. Weddington is looking for a NP
• Med Trim Rx looking for part-time NP. Call Deb Stahl at 878-5100 for more info.
• Dr. Gonce with HMG in Long-term Care is looking for NPs. He previously had three, one who has left and the other two are looking to leave. Contact him by email for more information: goncejd@yahoo.com

Education opportunities:

• APN Conference in Nashville 4/25/08 (Note: this conference has now been canceled)
• Integrative Medicine Conference at Bristol Regional Medical Center on 4/25; all day conference with FREE CEUs. Call 423-224-5380 for info
• Providers at the Grove Park Inn in Asheville, NC. Approved for 7.5 ACCME/AMA CME credits.  (If you would like to attend this conference and stay at the Grove Park-please contact us so that a room can be secured at the conference rate.) 
• For more information or to register please visit the website: http://com.etsu.edu/cme and click on special conferences or call the ETSU Office of CME 423-439-8027.  The conference brochures with agendas are available on the website

Announcements:

• Sandra Hickman and Susan Hossler are the winners of the attendance award for Nov 2007 thru Jan 2008. Paula to mail checks.
• Kay Bone announced that senate in TN has passed legislature approving Nurses/NPs to own their own businesses (PLLC).

Next Meeting: