Presentation on theme: "How to help yourself and your family"— Presentation transcript:
1How to help yourself and your family Managing Diabetes:How to help yourself and your familyThis presentation will take about 45 min to 1 hour
2Objectives State a difference in Type 1 vs. Type 2 diabetes State 3 ways to prevent diabetesUnderstand the purpose of blood sugar monitoring
3National Diabetes Fact Sheet 23.6 Million people (8% of the U.S. population) have diabetes57 Million people have pre-diabetesRisk of death is 2 x that of people similar age without diabetesHeart 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 amputationDiabetes is a BIG DEAL. It needs to be addressed, not ignored. If managed, we can prevent complications.
4Obesity will make today's kids die younger Life expectancy is decreasing1 out of 3 children born after 2000 will get diabetesWhat will you do to change the course?Researchers predict that life expectancy of Americans may begin a sustained decline, reversing the gains from the last 100 years. By the middle of this century, the increased risk of diabetes, heart disease, and cancer that kids will face could lessen the average life expectancy by 2 to 5 years.
5The Perfect Storm Hit Hard! Toxic food environment of :Cheap, fatty foodHighly caloric drinks (soda, juices, gatorade, energy drinks)Gigantic portionsProcessed, “boxed” foodsPervasive food advertisingSedentary lifestyles$10+ billion spent on advertising unwholesome junk and fast food.Modern society makes everyday chores continually easier, successfully eliminating activity from daily living. (Drive thrus, shopping online, etc.)Kids stopped playing outside or walking to school.TV and video games replaced physical activity .Portion sizes that grew slowly enough for us to lose sight of normal portion sizes.
7Risk Factors for Diabetes HeredityAge (>45)Race and Ethnicity(Alaska native, Hispanic-American, Pacific Islander,African-American)Gestational diabetes or delivering a baby >9 poundsBeing overweightSedentary lifestyleWaist CircumferenceAcanthosis Nigricans – darkening of the skin (at folds)Try measuring your waist. If you are a woman and your waist circumference is 35 inches or larger you are at high risk for disease. If you are a man and your waist circumference is or larger 40 inches you are at high risk for disease.
8Acanthosis 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 diabetesHave you seen this on anyone before?It looks like they have a dirty neck but can’t wash it off. It’ also slightly rough and thickened skin.Do you know of anyone who has acanthosis nigricans?Does this person know they are at high risk of developing diabetes or they have diabetes?neckarmpit
9How Does Family History Affect Your Risk of Diabetes? Type 1Type 2Relative w/ diabetesYour estimated riskMotherFatherBoth parentsSiblingIdentical twin1% - 5%5% - 15%10% - 25%5% - 10%25% – 50%5% - 20%25% - 50%60% - 75%Who in your family has diabetes? Are you at risk?
10Signs and Symptoms Frequent Urination Excessive Thirst Dry, Itchy Skin Weight Loss/GainBlurred VisionFatigueTingling/Numbness in fingers/toesFrequent Infections or sores that don’t healWhen diabetes starts to develop, most people don’t notice signs and symptoms. Many people walk around with diabetes for 7-9 years before they are diagnosed, because they don’t “feel” it. Once you have these signs and symptoms, your diabetes has been around for a while and your blood sugars are usually very high. Typically your blood sugars have to be high consistently to feel these symptoms. People often ignore these symptoms or “write them off” as something else. We live in AK, it’s dry here in the winter so my skin is itchy and I get thirsty more. I am so busy in my life so I always feel tired. My vision is getting worse as I get older, I must need new glasses….
11Type 1 Autoimmune Disease Typically develops in people <30 years oldCan be triggered by virus or traumaBody does not produce insulin, insulin shots are required.Type 1 is not caused by eating too much sugar.
12Type 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.
14Pathophysiology of Type 2 Diabetes 1. You eat food and some turns to glucose (sugar)2. The sugar goes to the blood vesselGlucose3. The pancreas makes insulin to get the glucose into your cells.Cells in the Pancreas get “tired” and have trouble making insulinYou eat food, it goes into the stomach and some of the food gets broken down into “sugar” or glucose.The glucose/sugar leaves the stomach and goes into the blood vessel.In order for our bodies to use the glucose/sugar for energy it has to get into the cells in the body.Insulin is the hormone that helps the sugar get into our cells.5. Over time the pancreas can get worn out and starts to make LESS insulin.If we are making less insulin, what do you think happens to the sugar? Answer: it starts to build up in the blood causing high blood sugar.The other problem is sometimes the cells in our body are RESISTANT to the insulin and so it’s harder for the sugar to get into the cells.Again, this can lead to the build up of sugar in the blood causing high blood sugar.Sometimes the cells in the body are resistant to insulinDinneen SF. Diabet Med. 1997; 14 (Suppl 3): S19-24.14
15How 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 sugarEat smaller amounts of foods that turn to sugar. If you eat less, it’s 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.Carbohydrates are foods that turn into sugar. These foods are healthy for you, but they need to be eaten in smaller portions. What are some examples of carbohydrate foods? Answer: breads, rice, pasta, grains, beans, fruits, yogurt, milk, potatoes, corn, peas
16Hemoglobin A1CA weighted mean (average) of your last days of blood glucoseMeasures how much sugar has attached to the red blood cells and is reported in % formACE guidelines - <6.5% goal for diabetesADA guidelines - <7% goal for diabetesNormal is ~4-6%This is a lab test that your doctor will do. It is ONE way to see how well your blood sugar is being controlled and tell us if you are at high or low risk of developing complications.
17Blood Glucose Monitoring When to checkACEADAFasting or pre-meal<110mg/dl<130mg/dl2 hours post- meal<140mg/dl<180mg/dlA1C<6.5%<7%
18Blood Sugar Monitoring A way for YOU to see if your blood sugar is under controlCheck before a meal, 2 hours after a meal, before bed, or when you wake up.If your blood sugars are high, check more often.
19Short Term Complications HypoglycemiaToo much medsMore exercise than normalToo little food to match medsHyperglycemiaForgot medsStressIllnessToo much food, not enough exercise
20Long Term Complications Retionopathy – eye diseaseNephropathy – kidney diseaseHeart attacks and StrokeNeuropathy – nerve damageSexual ProblemsPain in hands, feet, legsgastroparesisRetinopathy can lead to blindness.Nephropathy can lead to the lead for dialysis.Gastroparesis is partial paralysis of the stomach, which can lead to problems of nausea, vomiting, and abdominal fullness
21What can people do to live a healthy life with diabetes? Check blood sugar regularlyExercise regularlyHealthy food choicesTake medications as prescribedSee doctors regularly and get labs checkedEye, heart, diabetes, internal med, therapistAttend a diabetes education class or individual sessions with a CDEA person with the credentials of “CDE” is a certified diabetes educator. They have receive special training on diabetes and the management of diabetes.
22I, Jane Doe, will never eat dessert for the rest of my life!!! This is NOT how we manage diabetes. How many of you would be willing to sign this contract? Eating healthy for diabetes is misunderstood. It doesn’t mean cutting out everything that tastes good, it means enjoying sweets less often and in moderation. Eating more fruits, vegetables, whole grains, and lean protein.Patient Signature:Jane Doe
23Timing Eat SOMETHING within one hour of getting up Eat about every 4 hoursSmaller, more frequent meals is the keyWhen skipping meals or going a long time without eating:Blood sugar can increaseMetabolism can slow downCan lead to eating tons at one meal!
24Smaller portions of food, spread out = smaller rise in blood sugar Has anyone tried eating smaller more frequent meals?What did you feel like when you skipped breakfast or some other meal? How much did you eat when you finally had time to eat something?How do you feel, how have your blood sugars been, and how have you felt on medications since you started eating smaller more frequent meals? (How does this compare to when you were skipping meals or eating 2-3 big meals a day?)Time
25Balancing Your Plate (No effect blood sugar) Non-starchy Vegetables TOFULots of veggies. They don’t have to be fresh. Canned and frozen vegetables are great. A traditional Alaska Native diet is a great way to prevent diabetes.Grains, Beans & StarchyVegetables(100% effect on blood sugar)Lean Protein(No effect on Blood Sugar)
26Label Reading Serving Size? Grams of Total Carbohydrate? Number of carbohydrate servings?Use overhead to explain carbohydrates (CHO) on the labelLabel ActivityClass to work through label stations in groupsYogurtsCerealsBreadsSoda, Juice(show sugar in soda and juice)Sugar Free foodsDessertsCome back as a group and examine
27EXAMPLE meal plan 1400 kcal per day Breakfast: 40 g carbs Lunch: 40 g carbsDinner: 45 g carbsSnack: 15 g carbsTOTAL: 140g carbsRemember overall portion control of ALL foods isimportant for weight loss, not just controllingcarbohydratesIf you know how to count the grams of carbs by reading labels or estimating portions, this is an example of how to spread and balance your carbs throughout the day for better control! Everyone’s body is different so depending on your energy needs, you may need more or less carbs and calories in a day.
28Medications Understand proper times to take them Understand side effectsUnderstand the same meds will not work for a lifetimeAbout half of patients with diabetes type 2 will need insulin at some pointTell your doctor about any natural herbs, plants, or supplements you use for your health.
29Depression 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?Sometimes people feel “down” when they are diagnosed with a disease. People can feel scared, angry, helpless. Talk to your health care professional about these feelings. It’s important to address your feelings. You deserve to feel happy and have a good quality of life.