1. DEVELOPED IN PART BY THE COMMUNITY WELLNESS TEAM Diabetes GETTING STARTED

2. Chronic disease Chronic illness  a disease that persists for a long time - usually over 3 months  may worsen over time  they are not cured, but managed  ie asthma, arthritis, heart disease, cancer, kidney disease, diabetes Acute Illness  develops quickly  short in duration  ie cough/cold, infection, trauma, broken bone

4. What is diabetes?  In diabetes the body does not properly process food for use as energy  Diabetes occurs when the body doesn’t produce any or enough insulin or your cells do not accept the insulin (insulin resistance)  If glucose cannot get into your cells, it stays in your blood. This gives you a high blood glucose reading.

5. Three kinds of Diabetes Type 1 Diabetes  Formally known as juvenile diabetes  Destruction of the beta cells in the pancreas that produce insulin  Requires insulin to survive  Starts in people less than 25 – but not always  Typically rapid onset Type 2 Diabetes  Genetics, lifestyle, weight  Develops over time  A person may not require pills or may be on pills &/or insulin  Often a slower onset Gestational Diabetes  Elevated blood sugars when pregnant DEVELOPED BY COMMUNITY WELLNESS TEAM

6. Risk Factors For Type 2 Diabetes Family History of Diabetes Ethnic background – First Nations, Hispanic, African, Asian Had gestational diabetes 40 years of age or older Overweight - enlarged fat cells don’t respond well to insulin and require more Stress, both physical and emotional – due to elevated h0rmones Low activity lifestyle DEVELOPED BY COMMUNITY WELLNESS TEAM

7. Diagnosis of Diabetes Fasting (after no food for 8 hours) After eating or a Glucose Tolerance Test No Diabetes4.0 to 6.0Less than 8.0 Pre Diabetes6.1 to 6.98.0 to 11.0 Diabetes7.0 or more11.1 or more DEVELOPED BY COMMUNITY WELLNESS TEAM

8. Diagnosis of Diabetes A1C (%) A1C (%) Result Pre Diabetes6.0-6.4% Diabetes> 6.5% DEVELOPED BY COMMUNITY WELLNESS TEAM

9. A1C A1C is a 3 month average of your blood sugars It gives you the big picture of how you are doing The A1c result is a percentage (%) and reflects the percentage of the hemoglobin that has glucose attached to it The higher you’re A1C the higher your risk for complications

10. Hyperglycemia can be controlled Diet Medicine Exercise Stress reduction Liver Your Goal: Find the right balance! Here are the day to day things that influence your blood sugars

11. What is the treatment ? FOOD - The KINDS of food you choose -The AMOUNT of food you eat -The SPACING of meals and snacks Exercise - Regular exercise helps your insulin work better - Keeps you healthy and strong to fight off illness - Great for helping you lose weight Medicine - Insulin -Pills Diabetes cannot be cured, but can be controlled

12. What do I need to do? People should exercise a minimum of 150 min. of moderate activity (aerobic exercise) per week. That breaks down to ½ hr per day – 5 days a week. You should also do muscle and bone strengthening (resistance activities) at least 2 times per week.

13. Aerobic Physical Activity Resistance physical activity Movement of large muscle groups for at least 10 consecutive minutes Eg: walking, cycling, running. Repetition of brief exercises with free weights, machines, elastic bands, or one’s own body weight. Lowers insulin resistance Increases strength, muscle mass, and bone density. There are 3 types of exercise

14. Flexibility Stretching, gentle reaching, bending Keeps muscles relaxed and joints mobile All types of activities are beneficial Brisk walking is considered to be moderate exercise Physical activity helps maintain a healthy weight 3 types of exercise

15. Medicine There are many types of medications used to treat diabetes Oral pills, insulin Everyone has different needs and your medications need to be tailored to you and your lifestyle

16. Slows sugar release from the liver Makes Muscle Cells More receptive to insulin Makes your pancreas produce more Insulin INSULIN Slows absorption of glucose in the gut

17. Target Blood Sugar on a glucometer For Diabetes : Blood glucose goals should be tailored to individual needs. Before eating a meal 4.0 to 7.0 mmol/L 2 hours after a meal 5.0 to 10.0 mmol/L For Pre-Diabetes or non diabetics: Before a meal 4.0 to 6.0 mmol/L 2 hours after a meal 5.0 to 8.0 mmol/L DEVELOPED BY COMMUNITY WELLNESS TEAM

18. High Blood Sugar (hyperglycemia) High Blood Sugar (hyperglycemia) You may feel: · unusual thirst · frequent urination · fatigue and weakness · blurred vision · rapid weight loss · poor healing of cuts/scrapes Your blood sugar level... Where should it be?

20. What happens when I have high blood glucose… Poor circulation Nerve damage; may get ulcers & infections, numbness and tingling in hands & feet Decrease in vision; ie: Visual loss & Cataracts Decrease in Kidney function High blood pressure, stroke & heart attack Sexual Dysfunction

21. 1. Decrease your insulin demand - be kind to your body 2. Help your body work better 3. Prevent the complications of diabetes 4. Maintain optimal blood glucose control The Goal for Diabetes Treatment

22. Remember: Diabetes complications can happen at any time Diet & exercise are “active treatments” to lower blood glucose Diabetes is a progressive disease and changes over time & with illness Diabetes cannot be cured, but can be CONTROLLED