1. Diabetes Edutool: Tutorial 1 Food and insulin

2. Introduction During these tutorials, the individual effects that can affect the blood glucose will first be explained separately The effects will then be combined to explain how all of them together will affect the blood glucose, as in real life

3. When we eat, our bodies break the starches in food down into a simple sugar called glucose Glucose

4. The glucose is first absorbed into our bloodstream

5. Our bloodstream moves the glucose around our bodies

6. Our bodies use the glucose for energy

7. All the glucose absorbed after a meal cannot be used at once The body must store some for later

8. Glucose Insulin To store glucose, the body produces the hormone insulin Insulin works like a key that unlocks the door of our cells to let the glucose in

9. Our pancreas makes insulin

10. In some people the pancreas is not able to make insulin This condition is called type 1 diabetes

11. Without insulin, the excess glucose in our blood cannot be stored This causes high blood glucose levels

12. High blood glucose can damage your body

13. To prevent this, people with type 1 diabetes inject insulin when they eat

14. Food, stress and exercise change our blood glucose levels We must first learn more about this, before working out how much insulin to use

15. We call one equivalent teaspoon of sugar, one = 1 1

16. Using for food makes energy calculation of food easy = 3 = 8 = 10

17. The more we eat, the higher our blood glucose rises 3108

18. When we stress, our blood glucose also rises

19. We also use to see how much energy we expend during exercise ≈ 20 Running for one hour

20. The more we exercise, the lower our blood glucose goes 10 5 15

21. BLOOD GLUCOSE We need to balance food and stress with exercise and insulin

22. To show you how, we will use Diabetes Edutool It shows you how the blood glucose of people with type 1 diabetes changes

23. The oval shape in the middle shows the blood glucose level

24. The colour of the oval means: Blood glucose normal Blood glucose too high or too low Blood glucose slightly high or slightly low Blood glucose 5 mmol/L Blood glucose 14 mmol/L Blood glucose 4 mmol/L

25. Let’s look at an example: Arnold has type 1 diabetes What happens to his blood glucose after… How much insulin will he need? + ?

26. Before we start, we must first measure Arnold’s blood glucose level It is 5 mmol/L

27. To set the starting glucose level, click on the + or – sign in the oval

28. Arnold starts off with a normal blood glucose level of 5 mmol/L

29. To add the we use the database

30. This arrow went up to show the eaten

31. The blood glucose is now high This is what Arnold’s blood glucose would be if nothing was done

32. To add the we again use the database

33. The blood glucose is now very high Again, this is what Arnold’s blood glucose would be if nothing was done

34. If Arnold had taken some insulin before the meal, it would store the excess glucose and prevent his blood glucose from rising

35. To do this, we need insulin To store the excess glucose Arnold needs to take some insulin

36. Insulin removes excess glucose from the blood by storing it elsewhere With meals, we need enough insulin to maintain blood glucose levels in a normal range

37. To add the insulin, we drag the insulin arrow to the right until the blood glucose is normal

38. Let’s recap… 1 – We increase the insulin Insulin arrow

39. 2- The insulin stores the glucose Energy stored arrow

40. 3 - The blood glucose decreases as the glucose is stored Blood glucose is lowered

41. Let’s see the insulin in action again:

42. The blood glucose is now normal again 11 units of insulin were needed to maintain Arnold’s blood glucose within a normal range

43. Question: Arnold starts off with a blood glucose level of 7 mmol/L He plans to…. for 30 minutes How much insulin will he need? + ?

44. Set the blood glucose level to 7 mmol/L

45. Use the database to add the cake and exercise

46. Drag the insulin arrow to lower his blood glucose to 5 mmol/L 7 units of insulin were needed

47. Lessons: - Starchy foods are broken down into glucose that is absorbed into the blood - The body uses glucose for energy - Insulin is needed to unlock the cells in our bodies to let the glucose in - Food and stress increase blood glucose while insulin and exercise decrease it -- End of Tutorial 1 --