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Faculty/Steering Committee Steering Committee: Pamela Allweiss, MD, MPH Medical Officer Centers for Disease Control and Prevention Division of Diabetes Translation Atlanta, GA The findings and conclusions of this presentation are those of the presenter and do not necessarily represent views of the Centers for Disease Control and Prevention Roger P. Austin, MS, RPh, CDE Clinical Pharmacy Specialist Diabetes Henry Ford Health System Sterling Heights, MI Steering Committee and Speaking Faculty: Pamella Thomas, MD, MPH, FACPM, FACOEM Chief Medical Officer Med MatRx, LLC Consulting Medical Director E & P Business Strategy Solutions Lithonia, GA

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Pre-Symposium Survey Located in the front inside pocket of your syllabus A member of our staff will be collecting these shortly

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Faculty/Steering Committee Disclosures The steering committee/faculty reported the following relevant financial relationships that they or their spouse/partner have with commercial interests: Pamela Allweiss, MD, MPH: Nothing to disclose. Roger P. Austin, MS, RPh, CDE: Dr. Austins spouse is a faculty member at: Johnson & Johnson Diabetes Institute. Pamella Thomas, MD, MPH, FACPM, FACOEM: Nothing to disclose.

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Non-faculty/Reviewer Disclosures Non-faculty content contributors and/or reviewers reported the following relevant financial relationships that they or their spouse/partner have with commercial interests: Matthew Horn, MD; Bradley Pine; Blair St. Amand; Jay Katz, Dana Simpler, MD: Nothing to disclose.

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Educational Objectives At the conclusion of this activity, participants should be able to demonstrate the ability to: Explain the impact of inadequate control of blood glucose levels on workers overall health, work productivity, and safety Translate guideline recommendations into individualized therapeutic decisions to manage hyperglycemia, as well as reduce hypoglycemia risk, to best fit an employees needs and schedule Differentiate the mechanisms of action of diabetic medications, including agents that act on the enteroinsular axis, and explain which agents have a lower risk of hypoglycemia Build a partnership with employees by providing individualized counseling (e.g. self-management education) and resources to optimally manage blood glucose levels in the workplace and optimize adherence

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Overview The landscape of employer health The benefits and framework for worksite health and diabetes initiatives Making the business case for diabetes initiatives at the workplace How do we address the needs of the person with diabetes at the worksite? How does the worksite keep its employees productive? Case studies of employer health and diabetes initiatives Resources for practitioners Getting started worksites are a potential site for education and diabetes educators can play a role.

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Diabetes Is Hitting Hard During The Working Years Diabetes affects almost 26 million Americans (8.3%), one- quarter of whom dont know they have it Another 79 million Americans have pre-diabetes, which raises their risk of developing type 2 diabetes, heart disease, and stroke About 1.9 million new cases of diabetes were diagnosed in people age 20 years or older in 2010 One-third will have diabetes by 2050 if current trends continue Cost: $174 billion Available at: www.ndep.nih.gov or www.DiabetesAtWork.org.

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Darwin Rules Evolution of Perceptions and Diabetes Endocrine view of the world: normal glucose is the best; NEVER over 140 Previous occupational medicine view: No reactions at the workplace; Current view: Control and prevent chronic disease

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Examples: Why Are We Discussing This? Box cutter and hypoglycemia Short-term use of insulin in type 2 diabetes in an employee who drives a forklift Special occupations: Firefighters, law enforcement officers, drivers Disposal of needles: pens, ADA guidelines Shift work

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By 2050, if Current Trends Continue, 1 in 3 Americans Will Have Diabetes

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Age-adjusted Percentage of US Adults Who Were Obese or Who Had Diagnosed Diabetes Obesity (BMI 30 kg/m 2 ) Diabetes 1994 2000 No Data