Diabetes: Diagnosis, Treatment, and Opportunities

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.

Week 1: Introduction, Diagnosis, and Treatment Plans

• Review the epidemiology and pathogenesis of diabetes
• Describe the different types of diabetes
• Review 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.
• Describe the general treatment approaches for insulin therapy in type 1 and type 2 diabetes
  
• Describe the use of insulin pumps 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
• Review initial drug therapy in type 2 diabetes, how to advance 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