1. Taking Steps to Prevent Type 2 Diabetes
Type 2 diabetes is serious, common, costly, and controllable. But we know from research that it can be delayed or prevented. This workshop is designed to teach you how to prevent or reduce your risks of developing type 2 diabetes.
Among individuals at high risk for developing type 2 diabetes, structured programs such as this one emphasizing lifestyle changes including moderate weight loss (7% body weight) and regular physical activity (150 minutes per week) with dietary strategies including reduced calories and reduced intake of dietary fat, can reduce the risk for developing diabetes and are therefore recommended.

2. What is Type 2 Diabetes?
The body may make insulin but it doesn’t work effectively
Sugar builds up in the blood, causing diabetes
Uncontrolled diabetes over a long period of time can lead to serious health problems
Type 2 can be treated with healthy eating and increased physical activity and sometimes medications
Checking blood sugars helps the person manage diabetes.

3. Signs & Symptoms of Type 2 Diabetes
Thirst
Hunger
Unexplained tiredness
More urination than usual
Blurred vision
Sores that won’t heal
Dry itchy skin
Many people have no symptoms
Some people have some of the symptoms, some may have none and some will try to explain away their symptoms.

4. Why is Type 2 Diabetes on the Increase?
Inactivity
Overweight
Poor eating habits
Living longer
Increase in ethnic diversity
Larger portion sizes

5. Who Is At Risk? Age 45 or older Overweight Inactive
Ethnic or minority population
Family history of diabetes
Excess abdominal fat
High blood pressure
Pre-diabetes
High blood fats
Darkening of the skin
Polycystic ovary syndrome
History of Gestational Diabetes or large baby
Excess fat in the abdomen is an independent risk factor for disease.
Women over 35 inches are at risk.
Men over 40 inches are at risk.
Darkening of the skin, back of the neck and skin folds is called acanthosis nigricans, it appears as dirty spots and can not be washed off.
PCOS is a hormonal imbalance which may cause hyperinsulinemia, facial hair, overweight, infertility
Giving birth to a baby that weighs more than nine pounds.

6. Could You be at Risk for Diabetes?
Where do you start?
ADA Risk Test (paper or online)
Distribute a paper risk test of your choice and allow each participant to complete.
Call DIABETES ( )

7. What Was Your Score? Low Risk – 3 to 9 points Maintain healthy weight
Regular exercise
Keep up the good work
High Risk – 10+ points
High risk for diabetes
Go see your doctor
Take steps to improve your score
Review the ADA paper test and direct people to the bottom of the page where the score is located.
Reference: Could You Have Diabetes Take the Test. Know the Score -014B

8. Pre-Diabetes
Higher than normal blood sugars, but not high enough to diagnose.
Some people may think that pre-diabetes is borderline diabetes but there is no such diagnosis as a touch of sugar or borderline diabetes.
Distribute the KDN pre-diabetes care tool.

9. Diagnosis of Diabetes Normal, Fasting Pre-Diabetes, Fasting Diabetes,
Below 100 mg/dl
Between mg/dl
Higher than 126 mg/dl at 2 different times

10. The Good News . . .
Research shows that lifestyle changes can be very effective in preventing or delaying type 2 diabetes.
NEWS
Lifestyle changes may reduce risk by 58%.
A 5-10% weight loss.
Exercising 30 minutes a day, 5 days a week for a total of 150 minutes per week.

11. How Can You Reduce Your Risk?
Get physically active
Healthy eating
Weight management
Adopt healthy habits
Regular check-ups
Manage stress
Refer to an effective ongoing support program for weight loss of 5-10% of body weight, and increase physical activity to at least 150 minutes per week of moderate activity such as walking.
Individuals who have prediabetes or diabetes should receive individualized medical nutritional therapy (MNT) as needed to achieve treatment goals, preferably provided by a registered dietitian familiar with the components of diabetes MNT.
In overweight and obese insulin resistant individuals, modest weight loss has been shown to reduce insulin resistance. Thus, weight loss is recommended for all overweight or obese individuals who have or are at risk for diabetes.

12. Getting Physically Active
Aim for 150 minutes per week of moderate physical activity (example 30 minutes of exercise five days a week = 150 minutes)
Walking
Swimming
Dancing
Running
Biking
Jogging
Physical activity may be in increments of a minimum of 10 minutes, 3 times daily.
It is important to include flexibility, strengthening and aerobic activity.
Suggested Teaching Aids:
Fat and muscle models

13. Moving Safely
Check with your doctor before you start an exercise program
Always warm up and cool down to prevent injury
Start out slowly
Investing five minutes to warm up your muscles and an additional five minutes to cool down your muscles is important to prevent muscle injury.

14. Make Exercise Count
Talking and walking should be your rule– but no singing!
Stop right away if you are dizzy, short of breath, sick to your stomach or in pain, seek medical help
When people exercise they should be able to talk with their walking partner comfortably but if they are able to sing they are not exercising hard enough to get the full benefit from their physical activity.

15. Hints For Helping You Stick to Your Exercise Plan
Choose an exercise you enjoy
Find an exercise buddy
Set goals you can reach
Keep the cost low
Exercise won’t just happen
You have to plan for it!

16. Healthy Eating Choose a variety of healthy foods
Select smaller serving sizes
Eat 3 meals a day at regular times
Make each meal about the same size
It is important to space meals 4-5 hours apart.
Resources:
MyPyramid.gov
KDPCP-Nutrition Basics
Serving Size Handout
Suggested Teaching Aids:
Food Models
Example of healthy plate

17. Healthier Eating Habits
Eat more whole grains
More Matters® - choose more vegetables & fruits
Choose low fat foods
Choose low fat dairy and yogurt
Drink more water and sugar-free beverages
Fruits and Veggies - More Matters- try to eat 5-9 servings of vegetables and fruits each day.
A low fat food is defined as one that has 3 grams of fat or less per 100 calories.

18. Changing Eating Habits
Use herbs and spices to limit sodium
Choose healthier dessert
Low fat yogurt, fruits
Change recipes to reduce sugar and fat
Handout- “How to Adapt Your Recipes”

19. Weight Management
If overweight, losing 5-10% of body weight can reduce risks for Type 2 diabetes
Safely lose weight with:
Healthy eating
Physical activity
Among individuals at high risk for developing type 2 diabetes structured programs that emphasize lifestyle changes that include moderate weight loss (7% body weight) and regular physical activity (150 minutes per week) with dietary strategies including reduce calories, reduce intake of dietary fat can reduce the risk for developing diabetes.
Slowly losing weight leads to sustainable weight loss.

20. Adopt Healthy Habits No tobacco Get plenty of sleep
Wear your seatbelts/helmets
Keep up to date on immunizations
Limit alcohol intake
Key immunizations for people with diabetes include an annual flu shot and a pneumonia vaccine.

21. Regular Check-ups
See your doctor at least once a year for a complete check-up.
Recommended age/gender appropriate screenings
Regular dental and eye exams
Resource: Gender Specific Screenings per PHPR guidelines
For example: Women: Stay Healthy at Any Age and Men: Stay Healthy at Any Age from the Dept of Health and Human Services/

22. Manage Stress Take time to relax Pace yourself and your activities
Get enough sleep
Make time for fun
Regular physical activity
Everyone has good stress and bad stress- it is when stress is out of balance that people have problems. People who get regular physical activity are more resilient to stress.
Research shows that not getting enough sleep (about 7-8 hours for most people) can lead to chronic health problems.

23. Get Support Make it goal to adopt healthier habits
Include family and friends
Know and use your community resources
Give a list of community resources.

24. Setting Personal Goals
Choose small goals
Be specific, realistic and patient
Choose goals you can control
Use non-food rewards
Build on your successes

25. Examples of Personal Goals
Example of weight management goal:
I will lose 5 pounds, in five weeks by cutting out 500 calories every day.
Example of physical activity goal:
I will begin walking for minutes per day, at least 5 days a week.
Example of healthy habits goal:
I will make an appointment for my regular check up by the end of this week.
Give participants a chance to write their own personal goal.
Goals should be written in positive language.
They should be specific and measurable.

26. Preventing type 2 diabetes
If there was a vaccine to prevent diabetes would you take it?
There is no vaccine to take to prevent diabetes but as research has shown Type Two diabetes can be prevented by investing in a healthy diet, daily physical activity, and stress management. Another way to prevent type two diabetes -- if you are overweight lose 5-10% of your current body weight.

27. You Can Reduce Your Risk
Get physically active
Healthy eating
Weight management
Adopt healthy habits
Regular check-ups
Manage stress 27

28. What Can You Do to Prevent
Type 2 Diabetes REVIEW!
Get Physically Active
Healthy Eating
Weight Management
Adopt Healthy Habits
Lets play diabetes feud!
Ask the audience to list the major ways they can reduce their risk for type 2 diabetes.
This game is played similarly to Family Feud – So you may say something like “the survey says”--- click on the color bar to reveal the answer.
What Can You Do to Prevent Type 2 Diabetes REVIEW!
Get Physically Active
Healthy Eating
Weight Management
Adopt Healthy Habits
Get Regular Checkups
Manage Stress
Regular Check-ups
Manage Stress