1. Part 3: Preventing Complications from Diabetes

2. Preventing Complications Having pre-diabetes and diabetes puts you at a higher risk for developing other health problems HOWEVER… If you understand the risks, you can take steps now to lower your chance of diabetes related complications

3. Managing Diabetes What percentage of diabetes is managed by you vs. your healthcare provider? 20% of your diabetes control is managed by your healthcare provider 80% is managed by you

4. Preventing progression of DM Healthy eating Exercise Monitoring BG Taking medications Stop smoking

5. Heart Disease and Stroke Kidney Disease Eye Complications Nerve Damage Foot Complications Skin Complications Depression Sexual Dysfunction Gum Disease Long Term Complications of Poorly Controlled Diabetes The good news is: Better control = Less complications

6. Heart Disease and Stroke People with diabetes are 2x more likely to have heart disease or stroke than people without diabetes How can we prevent long term complications? – Cut out sugary and fattening foods – Daily exercise – Get your lipid panel done 2x/year http://www.diabetes.org/living-with-diabetes/complications/mens-health/serious-health-implications/heart-disease-and-stroke.html

7. Kidney Disease The kidneys clean our blood High blood sugar can put too much stress on the kidneys and can cause damage over time How is the long term complication prevented? – Get your kidney function tests 2x/year http://www.diabetes.org/living-with-diabetes/complications/kidney-disease-nephropathy.html

8. Eye Complications Diabetes can damage the blood vessels of the eyes, potentially leading to blindness Diabetes can also cause glaucoma or cataracts How is the long term complication prevented? – Get a comprehensive eye exam by an optometrist or ophthalmologist 1x/year http://www.diabetes.org/living-with-diabetes/complications/mens-health/serious-health-implications/blindness-or-vision-problems.html

9. Nerve Damage (Neuropathy) High sugar can harm the walls of the tiny blood vessels that connect to your nerves Described as a tingling, numbness, burning or pain in legs or fingers How is the long term complication prevented? – Get a foot exam by a physician 1x/year – Use proper foot care http://www.diabetes.org/living-with-diabetes/complications/mens-health/serious-health-implications/nerve-damage.html

10. Foot Care Check your feet every day – Look at your bare feet for red spots, cuts, swelling, and blisters Wash your feet, dry, and moisturize every day – Rub lotion over the tops and bottoms but not between your toes If you can see and reach your toenails, trim them – File the edges with a nail file Protect your feet from hot and cold – Never use hot water bottles, heating pads, or electric blankets Never walk barefoot – Wear comfortable shoes that protect your feet – Check inside your shoes before wearing them Keep the blood flowing to your feet – Don't cross your legs for long periods of time

11. Depression Studies show that people with diabetes have an increased risk of depression How is the long term complication prevented? – Exercise and see your physician at least 1x/year, or as often as the two of you feel is appropriate Don’t be afraid to reach out for help – Employee Assistance Program (EAP) 1-800-822-4847 (24 hours a day) – 5 free sessions/year

12. Gum Disease There is an increased risk for gum disease because diabetes decreases your ability to fight bacteria that invade the gums How is the long term complication prevented? – Brush and floss regularly – Have a dental exam at least 2x/year http://www.diabetes.org/living-with-diabetes/treatment-and-care/oral-health-and-hygiene/diabetes-and-oral.html

13. Reducing Risk & Sick Day Management

14. This is 1 risk factor YOU can control IT IS NEVER TOO LATE TO QUIT Smoking and diabetes have a lot of the same complications Talk to a health care professional if you are interested in quitting 1-800-Quit-Now Reduce Risk: Quit Smoking

15. Reduce Risk: Get Vaccinated Flu vaccine 1x/year – Free to all employees and dependents in Employee Health! Pneumonia vaccine 1x before 65, 1x after age 65 Hepatitis B vaccine 1 time series between age 19-59

16. Target: Less than 7% Target: Less than 140/90 Target: LDL “bad cholesterol” Less than 100 Know your ABC’s

17. A1C – your doctor will likely tell you how often to have this lab drawn For the DHP: 2x/year at Employee Health As a general rule: A1C < 7%A1C > 7% 2x/year4x/year A1C

18. Blood pressure will be checked at every doctor visit and Employee Health & Clinic visit Systolic (top number) Diastolic (bottom number) 140 or less90 or less Blood Pressure

19. Cholesterol will be drawn at least 2x/year at Employee Health & Clinic SexTotal Cholesterol HDLLDLTG Male< 200> 40< 100< 150 Female< 200> 50< 100< 150 Cholesterol

20. Helps you see how food, physical activity and medications affect your blood glucose level Goal fasting BG before meals: 80-130 mg/dL Goal 2 hours after the start of a meal: Less than 180 mg/dL Daily Monitoring

21. Discuss your sick day plan with your physician Make sure you get an annual flu vaccine www.jimchines.com Sick Day Management

22. S Is for Sugar testing more often I Is for continue to take your Insulin or oral medications C Is for Carbohydrate - keep intake as normal as possible K Is for Keep well hydrated - drink at least 8 oz of calorie free fluids every hour http://www.health.gov.sk.ca/Type-2-diabetes-on-insulin-sick-day-mgmt S.I.C.K.

23. Things To Do on a Daily Basis Eat healthy Keep active Check your sugar Reduce risky behaviors – smoking, drinking alcohol Practice proper foot care habits Wear proper footwear Brush your teeth and floss regularly Manage daily stressors Ask for help when necessary AADE7 Self Care Behaviors – Reducing Risk

24. http://diabeteshealth.com/

25. For appointments with Dietitian or Pharmacist Contact Dee Freeman at 667-5183 or Diabetes.Pharmacy@nhrmc.org For other questions related to the Diabetes Health Plan, contact the DHP Administrator at 667-5959 or wellness@nhrmc.org DHP Hotline 667-7777 Contact Information

26. American Diabetes Association http://www.diabetes.org/ http://www.diabetes.org/ Novo Nordisk http://www.cornerstones4care.com/ References

27. Other Resources http://www.health.gov.sk.ca/Type-2-diabetes- on-insulin-sick-day-mgmt http://www.diabetes.org 1 -800-QUIT NOW- for smoking cessation