First Choice Medical SupplySpeaker – Jay Buinicky

“Diabetes”What you need to

know...

Who is First Choice MedicalDiabetes “What you need to know”Diabetic FootwearCommunity ResourcesProducts & ServicesQuestions

Who is First Choice Who is First Choice Medical?Medical?

Home Medical Equipment Company Committed to providing the highest quality and most

reliable medical equipment products & services Specialize in helping people with their comfort &

mobility needs Accredited Medicare & Medicaid Provider Over 20 years of industry experience

Our Mission StatementOur Mission StatementFirst Choice Medical is committed to being

a leading provider of high quality and reliable medical equipment products with a

professional and courteous approach to customer service.

We gladly offer the following We gladly offer the following servicesservices

Direct Billing to Medicare & Medicaid (Provide latest info.) Prepare Proper Documentation (We work with your doctor) FREE Delivery & FREE Setup of Equipment (Same or next day) Provide Product and Safety Education (On-site education) Service & Repair Everything We Provide (Yearly maintenance) Rental Equipment Available Service Mecklenburg, Union, Cabarrus, Gaston, Catawba, Lincoln, Iredell, Lancaster, and York county

Direct Billing to Medicare & Medicaid (Provide latest info.) Prepare Proper Documentation (We work with your doctor) FREE Delivery & FREE Setup of Equipment (Same or next day) Provide Product and Safety Education (On-site education) Service & Repair Everything We Provide (Yearly maintenance) Rental Equipment Available Service Mecklenburg, Union, Cabarrus, Gaston, Catawba, Lincoln, Iredell, Lancaster, and York county

DIABETESDIABETES““What you need to know”What you need to know”

What is DIABETES?What is DIABETES?

What is diabetes? What is diabetes?

Diabetes is a serious disease that can develop from the Diabetes is a serious disease that can develop from the lack of insulin production in the body or due to the lack of insulin production in the body or due to the inability of the body’s insulin to perform its normal inability of the body’s insulin to perform its normal everyday function.everyday function.

Insulin is a substance produced by the pancreas gland Insulin is a substance produced by the pancreas gland that helps process the food we eat and turn it into that helps process the food we eat and turn it into sugar (energy).sugar (energy).

Diabetes is classified into 2 different types: Type 1 and Diabetes is classified into 2 different types: Type 1 and Type 2. Type 1 is usually associated with juvenile Type 2. Type 1 is usually associated with juvenile diabetes and is often hereditary. Type 2 is commonly diabetes and is often hereditary. Type 2 is commonly referred to as adult onset diabetes and is usually referred to as adult onset diabetes and is usually caused by elevated blood sugar.caused by elevated blood sugar.

WHAT ARE THE DIFFERENT WHAT ARE THE DIFFERENT TYPES OF DIABETES? TYPES OF DIABETES?

Type 1 DiabetesType 1 Diabetes

Type 1 diabetes (formerly called juvenile diabetes) results Type 1 diabetes (formerly called juvenile diabetes) results when the body’s immune system attacks and destroys its when the body’s immune system attacks and destroys its own insulin-producing beta cells in the pancreas. People own insulin-producing beta cells in the pancreas. People with type 1 diabetes usually has insulin delivered by with type 1 diabetes usually has insulin delivered by injection or a pump. injection or a pump.

Symptoms of type 1 diabetes – increased thirst and Symptoms of type 1 diabetes – increased thirst and urination, constant hunger, weight loss, blurred vision, urination, constant hunger, weight loss, blurred vision, and extreme fatigue – usually develop over a short and extreme fatigue – usually develop over a short period of time. period of time.

Type 1 diabetes accounts for 5 to 10 percent of all diagnosed Type 1 diabetes accounts for 5 to 10 percent of all diagnosed cases of diabetes.cases of diabetes.

Type 2 DiabetesType 2 Diabetes

Type 2 diabetes (formerly called adult-onset diabetes) occurs Type 2 diabetes (formerly called adult-onset diabetes) occurs when the body does not make enough insulin or cannot use when the body does not make enough insulin or cannot use the insulin it makes effectively. This form of diabetes usually the insulin it makes effectively. This form of diabetes usually develops in adults over the age of 40 but is becoming more develops in adults over the age of 40 but is becoming more prevalent in younger age groups – including children and prevalent in younger age groups – including children and adolescents. adolescents.

The symptoms of type 2 diabetes – feeling tired or ill, unusual The symptoms of type 2 diabetes – feeling tired or ill, unusual thirst, frequent urination (especially at night), weight loss, thirst, frequent urination (especially at night), weight loss, blurred vision, frequent infections, and slow-healing wounds blurred vision, frequent infections, and slow-healing wounds – may develop gradually and may not be as noticeable as in – may develop gradually and may not be as noticeable as in type 1 diabetes. Some people have no symptoms.type 1 diabetes. Some people have no symptoms.

Type 2 diabetes accounts for about 90 to 95 percent of all diagnosed Type 2 diabetes accounts for about 90 to 95 percent of all diagnosed cases of diabetes. cases of diabetes.

are 45 years old or older are 45 years old or older have a family history of diabetes have a family history of diabetes are African American, Hispanic/Latino, are African American, Hispanic/Latino,

American Indian, Alaska Native, Asian American Indian, Alaska Native, Asian American, or Pacific Islander American, or Pacific Islander

are overweight or obese are overweight or obese had diabetes while pregnant (gestational had diabetes while pregnant (gestational

diabetes) diabetes) have high blood pressure have high blood pressure have abnormal cholesterol levels have abnormal cholesterol levels have dark, thick and velvety patches of have dark, thick and velvety patches of

skin around the neck and armpitsskin around the neck and armpits are not getting enough physical activity are not getting enough physical activity have blood vessel problems affecting the have blood vessel problems affecting the

heart, brain or legs heart, brain or legs

A person is more likely to develop type 2 diabetes if they:

Treating Type 2 DiabetesTreating Type 2 Diabetes

Because Type 2 diabetes is often brought Because Type 2 diabetes is often brought on by being overweight, it can normally on by being overweight, it can normally be controlled by a combination of good be controlled by a combination of good nutrition, exercise, blood glucose nutrition, exercise, blood glucose monitoring and oral medications.monitoring and oral medications.

FACTS ABOUT DIABETESFACTS ABOUT DIABETES

How many Americans have diabetes and How many Americans have diabetes and pre-diabetes? pre-diabetes?

Total:Total: 25.8 million children and adults in the 25.8 million children and adults in the United States—8.3% of the population have United States—8.3% of the population have diabetes.diabetes.

Diagnosed:Diagnosed: 18.8 million people 18.8 million people Undiagnosed:Undiagnosed: 7.0 million people 7.0 million people Prediabetes:Prediabetes: 79 million people 79 million people New Cases:New Cases: 1.9 million new cases of 1.9 million new cases of

diabetes are diagnosed in people aged 20 diabetes are diagnosed in people aged 20 years and older in 2010.years and older in 2010.

Under 20 years of age - Under 20 years of age - 215,000, or 0.26% of all 215,000, or 0.26% of all people in this age group have diabetes. About 1 in people in this age group have diabetes. About 1 in every 400 children and adolescents has diabetesevery 400 children and adolescents has diabetes

Age 20 years or older - Age 20 years or older - 25.6 million, or 11.3% of 25.6 million, or 11.3% of all people in this age group have diabetesall people in this age group have diabetes

Age 65 years or older - Age 65 years or older - 10.9 million, or 26.9% of 10.9 million, or 26.9% of all people in this age group have diabetesall people in this age group have diabetes

Men - Men - 13.0 million, or 11.8% of all men aged 20 13.0 million, or 11.8% of all men aged 20 years or older have diabetesyears or older have diabetes

Women - Women - 12.6 million, or 10.8% of all women aged 12.6 million, or 10.8% of all women aged 20 years or older have diabetes20 years or older have diabetes

FACTS ABOUT DIABETESFACTS ABOUT DIABETES

Every 24 Hours….Every 24 Hours….

4,384 new cases of diabetes are diagnosed4,384 new cases of diabetes are diagnosed 195 non-traumatic lower limb amputations 195 non-traumatic lower limb amputations

are performedare performed 128 people begin treatment for end-stage 128 people begin treatment for end-stage

renal diseaserenal disease 50 people develop blindness50 people develop blindness 839 people die of diabetes or diabetes is a 839 people die of diabetes or diabetes is a

contribution cause of deathcontribution cause of death

Other Facts contributed to Other Facts contributed to diabetesdiabetes

BlindnessBlindness Diabetes is the leading cause of new cases of Diabetes is the leading cause of new cases of

blindness among adults aged 20–74 years.blindness among adults aged 20–74 years.

Kidney diseaseKidney disease Diabetes is the leading cause of kidney failure, Diabetes is the leading cause of kidney failure,

accounting for 44% of new cases in 2008.accounting for 44% of new cases in 2008.

Nervous system disease (Neuropathy)Nervous system disease (Neuropathy) About 60% to 70% of people with diabetes have About 60% to 70% of people with diabetes have

mild to severe forms of nervous system damage.mild to severe forms of nervous system damage.

AmputationAmputation More than 60% of nontraumatic lower-limb More than 60% of nontraumatic lower-limb

amputations occur in people with diabetes.amputations occur in people with diabetes.

CARDIOVASCULAR DISEASE CARDIOVASCULAR DISEASE AND DIABETESAND DIABETES

Cardiovascular disease is the leading cause of death Cardiovascular disease is the leading cause of death for people with diabetes – about 68 percent die of for people with diabetes – about 68 percent die of heart disease or stroke. heart disease or stroke.

Adults with diabetes have heart disease death rates Adults with diabetes have heart disease death rates about two to four times higher than adults without about two to four times higher than adults without diabetes. diabetes.

The risk for a stoke is two to four times higher The risk for a stoke is two to four times higher among people with diabetes. among people with diabetes.

About 75 percent of adults with diabetes also have About 75 percent of adults with diabetes also have high blood pressure. high blood pressure.

Smoking doubles the risk for heart disease in Smoking doubles the risk for heart disease in people with diabetes. people with diabetes.

What You Need to Know What You Need to Know About Medicare & DiabetesAbout Medicare & Diabetes

Medicare & DiabetesMedicare & Diabetes

Benefits for People with Diabetes Benefits for People with Diabetes People with diabetes can tap into several Medicare benefits to People with diabetes can tap into several Medicare benefits to help manage their diabetes. These benefits will help with day-to-help manage their diabetes. These benefits will help with day-to-day care of diabetes. Everyone who has Medicare insurance has day care of diabetes. Everyone who has Medicare insurance has access to Medicare Part B-covered benefits for which they pay a access to Medicare Part B-covered benefits for which they pay a monthly premium. If a person with diabetes has a prescription monthly premium. If a person with diabetes has a prescription from their doctor, Medicare Part B will cover part of the cost for:from their doctor, Medicare Part B will cover part of the cost for:

diabetes self-management training to learn how to manage diabetes self-management training to learn how to manage diabetes – provided through an accredited diabetes self-diabetes – provided through an accredited diabetes self-management education program for a total of 10 hours of initial management education program for a total of 10 hours of initial training within a 12-month period and up to two hours of follow-training within a 12-month period and up to two hours of follow-up training in each subsequent year up training in each subsequent year

medical nutrition therapy services provided by a registered medical nutrition therapy services provided by a registered dietitian or nutritional professional dietitian or nutritional professional

therapeutic shoes to protect feet from injury therapeutic shoes to protect feet from injury diabetes self-testing equipment and suppliesdiabetes self-testing equipment and supplies insulin pumps and the insulin used in the pumps insulin pumps and the insulin used in the pumps

Other Part B benefits for people with diabetes that Other Part B benefits for people with diabetes that do do not need a prescription include: not need a prescription include:

a “Welcome to Medicare” physical exam provided a “Welcome to Medicare” physical exam provided during the first 12 months after enrollment in during the first 12 months after enrollment in Part B Part B

a foot exam every six months by a podiatrist or a foot exam every six months by a podiatrist or other foot care specialist – if nerve damage is other foot care specialist – if nerve damage is present in either footpresent in either foot

a dilated eye exam – every yeara dilated eye exam – every year glaucoma screening– every yearglaucoma screening– every year cholesterol testingcholesterol testing all flu and pneumonia shotsall flu and pneumonia shots

Medicare & DiabetesMedicare & Diabetes

WHERE CAN I GO FOR MORE WHERE CAN I GO FOR MORE INFORMATION INFORMATION

About Medicare & Diabetes?About Medicare & Diabetes?

For details, contact the Centers for Medicare & Medicaid Services For details, contact the Centers for Medicare & Medicaid Services at www.medicare.gov or 1-800-MEDICARE (1-800-633-4227)at www.medicare.gov or 1-800-MEDICARE (1-800-633-4227)

For more information about preventing and controlling diabetes, For more information about preventing and controlling diabetes, call 1-888-693-NDEP (6337) or visit the National Diabetes call 1-888-693-NDEP (6337) or visit the National Diabetes Education Program website at www.YourDiabetesInfo.org. Education Program website at www.YourDiabetesInfo.org.

Diabetes & Your FeetDiabetes & Your FeetDiligence in caring for your feet is critical in preventing ulcers Diligence in caring for your feet is critical in preventing ulcers and other problems that may lead to difficulty in walking or and other problems that may lead to difficulty in walking or more serious complications. Almost 2 million diabetes patients, more serious complications. Almost 2 million diabetes patients, will develop a serious foot ulcer during their lifetime. will develop a serious foot ulcer during their lifetime.

Proper foot care is especially critical for diabetics because they Proper foot care is especially critical for diabetics because they are prone to foot problems such as:are prone to foot problems such as:

* Loss of feeling in their feet * Loss of feeling in their feet * Changes in the shape of their feet * Changes in the shape of their feet * Foot ulcers or sores that do not heal * Foot ulcers or sores that do not heal

Simple daily foot care can prevent serious problems. According Simple daily foot care can prevent serious problems. According to the National Institute of Health, the following simple to the National Institute of Health, the following simple everyday steps will help prevent serious complications from everyday steps will help prevent serious complications from diabetes:diabetes:

Be sweet to your feet by following these Be sweet to your feet by following these foot care tips:foot care tips:

Check your feet every day (evening is best) for cuts, blisters, red Check your feet every day (evening is best) for cuts, blisters, red spots, swelling, and sore toenails. If you have trouble bending spots, swelling, and sore toenails. If you have trouble bending over to see your feet, use a plastic mirror or ask a family member over to see your feet, use a plastic mirror or ask a family member or caregiver to help. or caregiver to help. Wash your feet every day in warm water, and be sure to dry well Wash your feet every day in warm water, and be sure to dry well between the toes. between the toes. Rub a thin coat of skin lotion on the tops and bottoms of your Rub a thin coat of skin lotion on the tops and bottoms of your feet, but not between your toes. feet, but not between your toes. Trim your toenails carefully and straight across when needed. Trim your toenails carefully and straight across when needed. See podiatrist if you need help. See podiatrist if you need help. Keep the blood flowing to your feet by wiggling your toes and Keep the blood flowing to your feet by wiggling your toes and moving your ankles up and down for 5 minutes, two or three moving your ankles up and down for 5 minutes, two or three times a day. times a day. Plan a physical activity program with your health care team. Plan a physical activity program with your health care team. Take your shoes and socks off at every check up and have your Take your shoes and socks off at every check up and have your doctor look at your feet. Tell your health care team right away doctor look at your feet. Tell your health care team right away about any foot problems. about any foot problems. Let your doctor know right away if you have loss of feeling in Let your doctor know right away if you have loss of feeling in your feet, changes in the shape of your foot or foot ulcers or sores your feet, changes in the shape of your foot or foot ulcers or sores that do not heal. that do not heal. Never walk barefoot, and wear comfortable shoes that fit well Never walk barefoot, and wear comfortable shoes that fit well and protect your feet. Look and feel inside your shoes before and protect your feet. Look and feel inside your shoes before putting them on. putting them on.

Diabetic Footwear ProgramDiabetic Footwear Program Medicare “Therapeutic Shoe Medicare “Therapeutic Shoe

Bill” for DiabeticsBill” for Diabetics May 1, 1993 Medicare past the Therapeutic Shoe Bill May 1, 1993 Medicare past the Therapeutic Shoe Bill Shoes help prevent foot problems among Diabetic Shoes help prevent foot problems among Diabetic

patientspatients Therapeutic footwear and protective insoles provide Therapeutic footwear and protective insoles provide

protection that helps reduce callusing which can lead protection that helps reduce callusing which can lead to ulcerations to ulcerations

Protective footwear can help in the fight to prevent Protective footwear can help in the fight to prevent the 54,000 diabetic amputations that occur each year the 54,000 diabetic amputations that occur each year

Under their Therapeutic Shoe Bill benefits, the Under their Therapeutic Shoe Bill benefits, the patient receives one pair of Diabetic Shoes and three patient receives one pair of Diabetic Shoes and three pair of Protective Inserts once every calendar year pair of Protective Inserts once every calendar year

In order for Medicare to pay for therapeutic In order for Medicare to pay for therapeutic shoes, the doctor treating the patient for diabetes shoes, the doctor treating the patient for diabetes

must certify that the patient meets all of the must certify that the patient meets all of the following 3 conditions:following 3 conditions:

1. Patient must have diabetes.1. Patient must have diabetes.2. Patient must have at least 1 of the following 2. Patient must have at least 1 of the following conditions in one or both feet:conditions in one or both feet:

•Partial or complete foot amputation•Partial or complete foot amputation•Past foot ulcers•Past foot ulcers•Calluses that could lead to foot ulcers•Calluses that could lead to foot ulcers•Nerve damage because of diabetes •Nerve damage because of diabetes

(neuropathy)(neuropathy)•Poor circulation•Poor circulation•Deformed foot•Deformed foot

3. Patient is being treated under a comprehensive 3. Patient is being treated under a comprehensive diabetes care plan and need therapeutic shoes diabetes care plan and need therapeutic shoes and/or inserts because of diabetes.and/or inserts because of diabetes.

1993

Shoes have Shoes have come along come along

way!way!

2013

SummarizeSummarizeDiabetes is a self-managed disease. People with diabetes must Diabetes is a self-managed disease. People with diabetes must take responsibility for their day-to-day care. The chances of take responsibility for their day-to-day care. The chances of having diabetes complications can be reduced or delayed having diabetes complications can be reduced or delayed significantly by keeping blood glucose (blood sugar), blood significantly by keeping blood glucose (blood sugar), blood pressure, and cholesterol levels in the target range. pressure, and cholesterol levels in the target range.

Thanks to new technology, information and education, diabetes Thanks to new technology, information and education, diabetes is no longer the disease it used to be. Today, it is possible for is no longer the disease it used to be. Today, it is possible for people with diabetes to live a normal life. They can keep better people with diabetes to live a normal life. They can keep better control of their illness, eat better, and with the help of control of their illness, eat better, and with the help of therapeutic shoes ... walk more comfortably than ever!therapeutic shoes ... walk more comfortably than ever!

Mobility Aids:Mobility Aids: Canes / 4 Prong

Canes Standard Walkers Rollator Walkers Manual Wheelchairs Transport

Wheelchairs Motorized

Wheelchairs Scooters / POV’s

Home Care Products:Home Care Products: Hospital Beds / Bed Rails Gel/Air Mattresses Patient Lifts / Transfer Aids Trapeze Bars / Assist Rails Lift Chairs / Up-Lift Seats Diabetic Shoes / Supplies Bariatric Equipment Wheelchair Cushions /

Accessories Lifts / Carriers / Ramps Personal Emergency Alert

Systems And Much More!

Bath SafetyBath Safety

Raised Toilet Seats Bedside Commodes Bath/Shower Chairs Transfer Benches Grab Bars Tub Rails Hand Held Shower

Heads

Pain ManagementPain Management Arthritic Pain Relief Back Braces Knee Braces Ankle Braces Wrist Braces Elbow Braces T.E.N.S Units (Electro

Therapy)

Wide-range of applications:

Arthritis Herniated Discs Lower Back Pain Knee Pain Edema (Swelling) Muscle Pain or

Cramps Chronic and Acute

Strains Post-Surgical

Recovery & Stabilization

Bulging Discs Degenerative Disc

Disease Functional Mobility

Back Brace / Lumbar Back Brace / Lumbar SupportsSupports

Every back brace incorporates key features Every back brace incorporates key features

to promote comfort and convenience, to promote comfort and convenience, including:including:

Dynamic force technology to keep the Dynamic force technology to keep the brace in constant contact with your bodybrace in constant contact with your body

Moisture-wicking materials on all facing Moisture-wicking materials on all facing surfacessurfaces

A unique spinal cutout to reduce spinal A unique spinal cutout to reduce spinal pressure an increase airflowpressure an increase airflow

A lightweight, ergonomic design that A lightweight, ergonomic design that keeps the braces from riding upkeeps the braces from riding up

Medicare Approved!Medicare Approved!

Wide-range of Wide-range of applications:applications:

• ArthritisArthritis• Herniated DiscsHerniated Discs• Lower Back PainLower Back Pain• Post-Surgical Post-Surgical

Recovery & Recovery & StabilizationStabilization

• Bulging DiscsBulging Discs• Degenerative Disc Degenerative Disc

DiseaseDisease• Chronic and Acute Chronic and Acute

StrainsStrains

Personal Emergency Response Personal Emergency Response SystemSystem

Personal Assistant Link (PAL) Handset

Alert Sentry

Benefits & Benefits & Features:Features:

24 Hour Monitoring (Up to 400 Feet Range)

Speaker Phone (2-Way Communication)

Battery Back Up (32 Hours of Standby Power

Waterproof Help Button FREE Shipping & Activation

(Simply Install) No Contracts (Cancel Anytime) Must Have Home Phone Line

Benefits & Benefits & Features:Features:

Works Anywhere In The Country Uses Cell phone/GPS Technology Fall Detection GPS Location (Identification &

Direction) Roadside Assistance Part Cell phone with 150

minutes 4 Preset Phone Numbers FREE Activation (No Install

Required) No Contracts (Cancel Anytime) No Home Phone Required

RememberRemember

We are here to help… “First” company you

think of… Consultants, not a sales

people… Just a phone call away…

If you have a need, we have a source.If you have a need, we have a source.

Community ResourcesCommunity Resources

Home Health Care Diabetic Education Nutritional Counseling Podiatry Long Term Health Insurance Supplemental Insurance Elder Law & Estate Planning

Physical Therapy Pharmacy VA Benefits Meal Delivery Adult Day Care Transportation Hearing Aids

www.CharlotteSeniorResources.com

Showroom hours from 8 a.m. - 5 p.m., Monday through Saturday by appointment.

Contact UsContact Us

First Choice MedicalFirst Choice Medical251 N. Trade St.251 N. Trade St.

Matthews, NC 28105Matthews, NC 28105

(704) 821-7777 Fax (704) 821-1012(704) 821-7777 Fax (704) 821-1012

Jay Buinicky, Healthcare ConsultantJay Buinicky, Healthcare Consultantjay@firstchoicemedical.comjay@firstchoicemedical.com

www.FirstChoiceMedical.comwww.FirstChoiceMedical.com

Thank You For Your Thank You For Your Time!Time!