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Managing Diabetes: How to help yourself and your family.

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Presentation on theme: "Managing Diabetes: How to help yourself and your family."— Presentation transcript:

1 Managing Diabetes: How to help yourself and your family

2 Objectives State a difference in Type 1 vs. Type 2 diabetes State 3 ways to prevent diabetes Understand the purpose of blood sugar monitoring

3 National Diabetes Fact Sheet 23.6 Million people (8% of the U.S. population) have diabetes 57 Million people have pre-diabetes Risk of death is 2 x that of people similar age without diabetes Heart disease and stroke account for 65% of those deaths #1 Cause of adult blindness (20 to 74 year old) #1 Cause of end-stage renal disease #1 Cause of non-traumatic lower limb amputation

4 Obesity will make today's kids die younger Life expectancy is decreasing 1 out of 3 children born after 2000 will get diabetes What will you do to change the course?

5 The Perfect Storm Hit Hard! Toxic food environment of : Cheap, fatty food Highly caloric drinks (soda, juices, gatorade, energy drinks) Gigantic portions Processed, boxed foods Pervasive food advertising Sedentary lifestyles


7 Risk Factors for Diabetes Heredity Age (>45) Race and Ethnicity (Alaska native, Hispanic-American, Pacific Islander, African-American) Gestational diabetes or delivering a baby >9 pounds Being overweight Sedentary lifestyle Waist Circumference Acanthosis Nigricans – darkening of the skin (at folds)

8 Acanthosis Nigricans Develops mainly from high insulin levels This means your body is having to work really hard to process your blood sugar. This is a sign that you may be at risk for diabetes armpit neck

9 How Does Family History Affect Your Risk of Diabetes? Type 1Type 2 Relative w/ diabetes Your estimated risk Relative w/ diabetes Your estimated risk Mother Father Both parents Sibling Identical twin 1% - 5% 5% - 15% 10% - 25% 5% - 10% 25% – 50% Mother Father Both parents Sibling Identical twin 5% - 20% 25% - 50% 60% - 75%

10 Signs and Symptoms Frequent Urination Excessive Thirst Dry, Itchy Skin Weight Loss/Gain Blurred Vision Fatigue Tingling/Numbness in fingers/toes Frequent Infections or sores that dont heal

11 Type 1 Autoimmune Disease Typically develops in people <30 years old Can be triggered by virus or trauma Body does not produce insulin, insulin shots are required. Type 1 is not caused by eating too much sugar.

12 Type 2 Related to body weight and lifestyle Family history Can be controlled with diet/exercise, and/or oral meds, and/or insulin. Can develop at any age, typically seen at ages of >45 years old.


14 Pathophysiology of Type 2 Diabetes Glucose Cells in the Pancreas get tired and have trouble making insulin Sometimes the cells in the body are resistant to insulin Dinneen SF. Diabet Med. 1997; 14 (Suppl 3): S19-24. 1. You eat food and some turns to glucose (sugar) 2. The sugar goes to the blood vessel 3. The pancreas makes insulin to get the glucose into your cells.

15 How do we fix it? Sometimes your doctor will give you medicines to help your pancreas make more insulin or help your cells open up to accept the sugar Eat smaller amounts of foods that turn to sugar. If you eat less, its less sugar to process at one time. Exercise is a natural medicine! It will help the sugar get out of the blood and into your cells.

16 Hemoglobin A1C A weighted mean (average) of your last 60-90 days of blood glucose Measures how much sugar has attached to the red blood cells and is reported in % form ACE guidelines - <6.5% goal for diabetes ADA guidelines - <7% goal for diabetes Normal is ~4-6%

17 Blood Glucose Monitoring When to check ACEADA Fasting or pre- meal <110mg/dl<130mg/dl 2 hours post- meal <140mg/dl<180mg/dl A1C<6.5%<7%

18 Blood Sugar Monitoring A way for YOU to see if your blood sugar is under control Check before a meal, 2 hours after a meal, before bed, or when you wake up. If your blood sugars are high, check more often.

19 Short Term Complications Hypoglycemia Too much meds More exercise than normal Too little food to match meds Hyperglycemia Forgot meds Stress Illness Too much food, not enough exercise

20 Long Term Complications Retionopathy – eye disease Nephropathy – kidney disease Heart attacks and Stroke Neuropathy – nerve damage Sexual Problems Pain in hands, feet, legs gastroparesis

21 What can people do to live a healthy life with diabetes? Check blood sugar regularly Exercise regularly Healthy food choices Take medications as prescribed See doctors regularly and get labs checked Eye, heart, diabetes, internal med, therapist Attend a diabetes education class or individual sessions with a CDE

22 Jane Doe Patient Signature:

23 Timing Eat SOMETHING within one hour of getting up Eat about every 4 hours Smaller, more frequent meals is the key

24 Portions Time Blood Sugar Smaller portions of food, spread out = smaller rise in blood sugar

25 Non-starchy Vegetables (No effect blood sugar) Grains, Beans & Starchy Vegetables (100% effect on blood sugar ) Lean Protein (No effect on Blood Sugar) TOFU

26 Serving Size? Grams of Total Carbohydrate? Number of carbohydrate servings? Label Reading

27 EXAMPLE meal plan 1400 kcal per day Breakfast: 40 g carbs Lunch: 40 g carbs Dinner: 45 g carbs Snack: 15 g carbs TOTAL: 140g carbs Remember overall portion control of ALL foods is important for weight loss, not just controlling carbohydrates

28 Medications Understand proper times to take them Understand side effects Understand the same meds will not work for a lifetime About half of patients with diabetes type 2 will need insulin at some point Tell your doctor about any natural herbs, plants, or supplements you use for your health.

29 Depression Have you lost interest in things you used to enjoy? Do you have difficulty making decisions? Have the pleasure and joy have gone out of your life? Do you feel sad, blue, and unhappy?

30 Questions???

31 Get more information from: 2010-november-diabetes-month.cfm

32 Presentation by: Angela Manderfeld, MS, RD, CDE, LD Diabetes Nutrition Consultant Alaska Native Tribal Health Consortium Phone (907) 729-1128 Fax (907) 729-1129 Mailing Address: Alaska Native Medical Center (DIA) 4315 Diplomacy Dr. Anchorage, AK 99508

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