1. Diabetes factsheet 1

2. Definition  There are 2 types of diabetes:  In general if your body doesn’t make enough insulin, or if your cells resist the insulin your body makes, the glucose can’t get into them and you have no energy. This can make you more hungry and tired than usual. The average person usually has to pee between four and seven times in 24 hours, but people with diabetes may go a lot more.

3. Symptoms of diabetes Common symptoms for type 1 and type 2  Hunger and fatique  higher-than-normal levels of glucose in your blood  Dry mouth and itchy skin  Blurred vision

4. Other symptoms Type 1 diabetes  Unplanned weight loss  Dry skin  Hunger and Fatigue  Yeast infections (Yeast feeds on glucose, so having plenty around makes it thrive. Infections can grow in any warm, moist fold of skin).  Dry mouth and itchy skin  Blurred vision  Peeing more often and being thirstier.  Nausea and Vomiting

5.  Type 2 diabetes  Weight loss: If your body can’t get energy from your food, it will start burning Muscle and fat for energy instead.  nerve damage  pain or numbness in your feet and legs  High blood sugar can affect your blood flow and cause nerve damage that makes it hard for your body to heal wounds  slow-healing sores or cuts

6. When to call your doctor  get tested if you are aged over40 years or if you have other risk factors for diabetes.  call your doctor if you have the following symptoms: feel sick to your stomach, weak, and very thirsty are peeing a lot Have severe belly ache Are breathing more deeply and faster than normal Have sweet breath that smells like nail polish remover.

7. Gestational diabetes  High blood glucose during pregnancy  Hormones from the placenta block the action of the mother’s insulin (= insulin resistance)  Hyperglycemia  Affects women in late pregnancy, after the Baby’s body is formed (busy growing)  Pancreas works overtime  Extra blood glucose goes through the placenta  Baby gets high blood glucose > makes extra insulin > extra energy is stored as fat (« fat » baby)  Damage : Shoulders during birth, very low blood glucose levels at birth, higher risk for breathing problems/obesity/type 2 diabetes.

8. Treatment of gestational diabetes  Treatment : special meal plans, scheduled physical activity, daily blood glucose, insulin injections > lower risk of a cesarean section birth, healthy pregnancy and birth, baby avoids future poor health.   Usually goes away after pregnancy, 2 in 3 chances to return in future pregnancy, mother at risk for type 2 diabetes years later  Prevention : losing a few pounds, healthy food, regular exercise.

9. Complications of diabetes  Cardiovascular disease affecting the heart and blood vessels  Kidney disease  Nerve disease  Eye disease, blindness  Pregnancy complications  Dental problems (gum disease)  Reduced blood flow in legs and feet leading to infection, ulcers and even lower limb amputation

10. Other complications for diabetes ● increased risk of early menopause and abdominal fat. ● associated with obesity, overweight, arterial hypertension, hormonal therapy, and older age. ● Obesity and hypertension do not change the risk of early menopause in younger women with type 2 diabetes unlike women older than 44.  Increased risk of breast cancer  Insulin injections increase mammographic density ( breast density : risk factor for breast cancer)

11. Prevention strategies for diabetes  Stop smoking or using other types of tabacco.  Drink alcohol with moderation and with a meal and count your calorie intake.  Brush teeth at least twice a day, floss teeth once a day, schedule dental exams at least twice a year. Beware of bleeding gums.  Monitor feet by washing daily in lukewarm water. Avoid soaking. Dry gently between toes. Moisturize with lotion or petroleum jelly. Do not put oils or cream. Check feet daily for calluses, blisters, sores, redness or swelling.  Try not to stress as it creates variation of insulin. Prioritize your tasks. Learn relaxation techniques. Get plenty of sleep. Stay positive.  Maintain a healthy weight by healthy eating or reduce fat-diet; practise physical activity regularly.  Control high cholesterol rate, high blood pressure and maintain your blood glucose levels.  To boost your immune system, get routine vaccines such as flu vaccine, pneumonia vaccine or hepatitis B vaccine.  Routine eyes exams to check retinal damage, cataracts, glaucoma.  Check signs of kidney/nerve damage, heart disease.  Follow doctor’s instructions: take prescription medication such as a low dose of aspirin every day. Schedule 2 to 3 diabetes checkups a year. => visit your diabetes care team (doctor, nurse educator, dietitian) if you have abnormals signs.

12. Risk factors for diabetes  Type 1: having a family member (parent, sibling) with type 1 diabetes increases the risk BUT researchers are still seeking what causes type 1 diabetes.

13. Risk factors for diabetes  Type 2:  Having a parent, brother or sister with diabetes  Being a member of a high-risk group  Having health complications  Having given birth to a baby that weighed more than four kilograms at birth or having had gestational diabetes  Having high blood pressure  Having high cholesterol or other fats in the blood  Being over 40 years  Overweight and obesity, especially excess fat in the abdomen  Depression, schizophrenia, bipolar disorder  Obstructive sleep apnea

14. Management of diabetes  Step 1 : Learn about diabetes  3 main types :  Type 1 diabetes : you need to take insulin every day to live  Type 2 diabetes : you may need to take pills or insulin to help control your diabetes (most common type)  Gestational diabetes : concerns pregnant women.  You are the one who manages your diabetes day by day. It’s important to talk with your doctor about how you can best care for your diabetes to stay healthy.  Diabetes is serious, but you can learn to manage it : make healthy food choices, keep/ maintain a healthy weight, move more every day, and take your medicine even when you feel good.

15. Management of diabetes  Step 2 : Know your diabetes ABCs  ABC= A1C, Blood pressure, Cholesterol. This can help lower your chances of having a heart attack, stroke, or other diabetes problems.  A 1C is a blood test. You need to know your blood sugar levels over time.  B lood pressure is the force of your blood against the wall of your blood vessels.  C holesterol : there are two kinds of cholesterol in your blood : LDL (bad cholesterol) & HDL (good) 

16. Management of diabetes  Step 3 : Learn how to live with diabetes  It is common to feel overwhelmed, sad or angry when you are living with diabetes.  Ask for help if you feel down, friends, family or doctors may help you feel better.  To be ok you need to eat well and be active.  Take your medicines for diabetes and any other health problems even when you feel good.  Ask and tell your doctor if you have any side effects, if you need healthy meal plans, ways to be more active.

17. Management of diabetes  Step 4 : Get routine care to stay healthy  See your health care team at least once a year to find and treat any problems early.  Two times each year, have an A1C test.  Once a year you need to have a cholesterol test, complete foot exam, dental exam…  At least once in your life get a pneumonia shot and hepatitis B shot.  Medicare covers some of the costs for diabetes education, supplies and medicine.  Actions you can take : ask what your results mean, use the card at the back of this booklet to keep a record of your diabetes care.

18. Managing type 1 diabetes with dogs People who suffer from Type 1 Diabetes, have low levels of blood sugar.  Symptoms of Type 1 diabetes: -nausea -stomach cramps -dizziness  Solutions: To get your blood sugar back to normal levels, you must drink fruit juice or eat hard candy, and you need an insulin injection. Type 1 diabetes is a chronic disease which affects the lifestyle of people with type 1 Diabetes.  Everyday they must be careful and control their sugar levels in the blood regularly. To help patients with type 1 diabetes special services were created: DIABETES SERVICE DOG “Diabetes service dog help alert patients with type 1 diabetes that their blood sugar is falling”.

19. Diabetes service dogs  Exemple of actions of diabetes service dog: -It recognizes symptoms and alerts patient to impending hypoglycemia -alert others if you are unresponsive and need assistance -brings objects such as juice bottles or medicine To train dogs to assist people with type 1 Diabetes, different programs exist such as Dogs for Diabetics, Can Do Canine or National Institute For Diabetic Alert Dogs. So if you have Type 1 Diabetes, if you suffer from hypoglycemia, and if you are able to financially provide for your dog, the diabetes service dog is certainly right for you. But it’s necessary to know the service dog also verifies, if your home and lifestyle are suited for the use of a personal service dog. In this way the decision to adopt a diabetes service dog is a joint decision between the patient and the service.