1. Nursing 4604L Kimberly A. Rogers, RNJune 2013 DIABETES & HEART DISEASE Risk Factors & Prevention Diabetes & Coronary Heart Disease Risk Factors & Prevention

2. 1. Diabetes Diabetes & Coronary Heart Disease Risk Factors & Prevention

3. Diabetes Disease Facts Type I Usually seen in children & young adults Accounts for approximately 5% of cases Type II Most common form in adults Commonly the aged population and certain ethnic groups 25.8 Million People Have Diabetes 27% of all people 65 and older have diabetes (American Diabetic Association, 2013) Diabetes & Coronary Heart Disease Risk Factors & Prevention

4. Diabetes Diagnosis (American Diabetic Association, 2013) Diabetes & Coronary Heart Disease Risk Factors & Prevention

5. Diabetes & Coronary Heart Disease Risk Factors & Prevention Diabetes in Pasco County and the State of Florida

6. Adults Diagnosed with Diabetes (Percent of Adult Population) (American Diabetic Association, 2013; Florida Department of Health, 2013) Diabetes & Coronary Heart Disease Risk Factors & Prevention

7. Adults Diagnosed with Diabetes – Long-Term Trend (Percent of Adult Population) (Florida Department of Health, 2013) Diabetes & Coronary Heart Disease Risk Factors & Prevention

8. Average Age at Which Diabetes was Diagnosed (Florida Department of Health, 2013) Diabetes & Coronary Heart Disease Risk Factors & Prevention

9. Diabetic Patients Who Check Blood Glucose at Least Once per Day (Florida Department of Health, 2013) Diabetes & Coronary Heart Disease Risk Factors & Prevention

10. Diabetic Patients Who Have Had Two A1C Tests in the Last Year (Florida Department of Health, 2013) Diabetes & Coronary Heart Disease Risk Factors & Prevention

11. Diabetic Patients Who Had an Annual Foot Examination in the Last Year (Florida Department of Health, 2013) Diabetes & Coronary Heart Disease Risk Factors & Prevention

12. Diabetic Patients Who Had an Annual Eye Examination in the Last Year (Florida Department of Health, 2013) Diabetes & Coronary Heart Disease Risk Factors & Prevention

13. 2. Coronary Heart Disease Diabetes & Coronary Heart Disease Risk Factors & Prevention

14. Coronary Heart Disease Facts 385,000 People In the U.S. Die Each Year from Coronary Heart Disease The Population of Pasco County is 468,000 People There are 935,000 Heart Attacks Each Year in the U.S. Coronary Heart Disease Costs the U.S. Economy Approximately $1.89 Billion Dollars Each Year (Centers for Disease Control and Prevention, 2013) Diabetes & Coronary Heart Disease Risk Factors & Prevention

15. Diabetes & Coronary Heart Disease Risk Factors & Prevention Coronary Heart Disease in Pasco County and the State of Florida

16. Percentage of People with Cardiovascular Disease (Florida Department of Health, 2013) Diabetes & Coronary Heart Disease Risk Factors & Prevention

17. Coronary Artery Disease & Anatomy (Drchandler.com, 2005) Diabetes & Coronary Heart Disease Risk Factors & Prevention

18. Coronary Artery Disease Progression (Bean et al, 2006) Diabetes & Coronary Heart Disease Risk Factors & Prevention

19. 3. Diabetes & Coronary Heart Disease Diabetes & Coronary Heart Disease Risk Factors & Prevention

20. Diabetes & Coronary Heart Disease Adults with Diabetes are 2 to 4 Times More Likely to Have Heart Disease The American Heart Association Considers Diabetes to be One of the Controllable Risk Factors for Cardiovascular Disease People with Diabetes Often Have Other Risk Factors that Increase the Chance of Developing Cardiovascular Disease (American Heart Association, 2012) Diabetes & Coronary Heart Disease Risk Factors & Prevention

21. Other Risk Factors for Coronary Heart Disease Hypertension Elevated Cholesterol & Triglyceride Levels Obesity Sedentary Lifestyle Poorly Controlled Blood Sugar Smoking (American Heart Association, 2012) Diabetes & Coronary Heart Disease Risk Factors & Prevention

22. Signs & Symptoms of Coronary Heart Disease Chest Pain (squeezing, pressure, or heaviness) Pain in Shoulders, Arms, Neck, Jaw, or Back Persistent Indigestion or Nausea Fatigue and Weakness Shortness of Breath Sweating Lightheadedness (Centers for Disease Control and Prevention, 2011) Diabetes & Coronary Heart Disease Risk Factors & Prevention

23. Signs & Symptoms of Coronary Heart Disease in Diabetics Diabetic Nerve Damage Can Interfere with Pain Signals in the Body Diabetics Can Have Some or All of the Typical Symptoms Some Diabetics May Have a Heart Attack without Symptoms When in Doubt, Always Call 9-1-1 (National Institutes of Health, 2011) Diabetes & Coronary Heart Disease Risk Factors & Prevention

24. Prevention: Controlling Modifiable Risk Factors Hypertension Comply with medications Reduce salt intake Maintain a healthy weight Limit alcohol Manage stress (American Heart Association, 2012) Diabetes & Coronary Heart Disease Risk Factors & Prevention

25. Prevention: Controlling Modifiable Risk Factors Elevated Cholesterol & Triglycerides Adopt a heart healthy diet Increase physical activity Take any cholesterol medications as directed by your doctor Obesity & Sedentary Lifestyle Exercise at least 30 minutes a day – can be broken into three 10-minute sessions Adopt a heart healthy diet (American Heart Association, 2012) Diabetes & Coronary Heart Disease Risk Factors & Prevention

26. Prevention: Controlling Modifiable Risk Factors Poorly Controlled Blood Sugar Perform blood sugar checks as recommended by doctor A1C Checks Medications: insulin or oral medications taken as directed Diet & Exercise Smoking There are many options & resources available for smoking cessation (American Heart Association, 2012) Diabetes & Coronary Heart Disease Risk Factors & Prevention

27. Resources for Success American Heart Association – www.heart.orgwww.heart.org American Diabetes Association – www.diabetes.orgwww.diabetes.org Tobacco-Free Florida – www.tobaccofreeflorida.comwww.tobaccofreeflorida.com Florida Quit Line – www.doh.state.fl.us/Tobacco/quitline.html www.doh.state.fl.us/Tobacco/quitline.html Diabetes & Coronary Heart Disease Risk Factors & Prevention

28. Quiz 1.You’re just not feeling “yourself” today. Which one of the following “sensations” should send you rushing directly to the emergency room? A.A sudden, strange desire to fill out an insurance form B.An uncomfortable, squeezing pain in the middle of your chest C.A long tone ringing in either of your ears D.A tickling sensation on the bottoms of your feet Diabetes & Coronary Heart Disease Risk Factors & Prevention (American Heart Association, 2012)

29. Quiz 1.You’re just not feeling “yourself” today. Which one of the following “sensations” should send you rushing directly to the emergency room? CORRECT ANSWER: B.An uncomfortable, squeezing pain in the middle of your chest Diabetes & Coronary Heart Disease Risk Factors & Prevention (American Heart Association, 2012)

30. Quiz 2.Just because you feel a heart attack warning sign does not mean you are actually having a heart attack. People feel these quirky sensations all the time. Save yourself some trouble. Wait until you have a few of the signs and in more rapid succession A.Good advice. B.Bad advice. Diabetes & Coronary Heart Disease Risk Factors & Prevention (American Heart Association, 2012)

31. Quiz 2.Just because you feel a heart attack warning sign does not mean you are actually having a heart attack. People feel these quirky sensations all the time. Save yourself some trouble. Wait until you have a few of the signs and in more rapid succession. CORRECT ANSWER: B.Bad advice. Diabetes & Coronary Heart Disease Risk Factors & Prevention (American Heart Association, 2012)

32. Quiz 3.There’s a reason it is called a “heart” attack. The warning signs all center on your “heart.” The idea that symptoms may occur in other parts of the upper body, such as the arms, back, neck, jaw, or stomach, is pure myth. A.True B.False Diabetes & Coronary Heart Disease Risk Factors & Prevention (American Heart Association, 2012)

33. Quiz 3.There’s a reason it is called a “heart” attack. The warning signs all center on your “heart.” The idea that symptoms may occur in other parts of the upper body, such as the arms, back, neck, jaw, or stomach, is pure myth. CORRECT ANSWER: B.False Diabetes & Coronary Heart Disease Risk Factors & Prevention (American Heart Association, 2012)

34. Quiz 4.Shortness of breath is a warning sign for a heart attack when: A.You experience a particularly beautiful wonder of nature such as the Grand Canyon. B.You walk through the “smokers’ patio” on your way into an office building from the parking lot. C.You are also feeling some discomfort or pain in your chest. D.You aren’t feeling anything strange in your chest except shortness of breath E.C and D. Diabetes & Coronary Heart Disease Risk Factors & Prevention (American Heart Association, 2012)

35. Quiz 4.Shortness of breath is a warning sign for a heart attack when: CORRECT ANSWER E.C and D. Diabetes & Coronary Heart Disease Risk Factors & Prevention (American Heart Association, 2012)

36. Quiz 5.Which of these is NOT considered a heart attack warning sign: A.Cold sweats. B.Nausea. C.Ice cream cravings. D.Lightheadedness. Diabetes & Coronary Heart Disease Risk Factors & Prevention (American Heart Association, 2012)

37. Quiz 5.Which of these is NOT considered a heart attack warning sign: CORRECT ANSWER C.Ice cream cravings. Diabetes & Coronary Heart Disease Risk Factors & Prevention (American Heart Association, 2012)

38. Quiz 6.If you are experiencing any of the common signs of a heart attack (chest pains, shortness of breath, discomfort in areas of the upper body, etc.), what is the fastest way to begin life-saving treatment: A.Call 9-1-1 immediately. B.Get someone to drive you to the emergency room now. C.Drive yourself to the emergency room now. D.Turn your “Bat Finder” to the northern sky & put out a call for Batman! Diabetes & Coronary Heart Disease Risk Factors & Prevention (American Heart Association, 2012)

39. Quiz 6.If you are experiencing any of the common signs of a heart attack (chest pains, shortness of breath, discomfort in areas of the upper body, etc.), what is the fastest way to begin life-saving treatment: CORRECT ANSWER A.Call 9-1-1 immediately. Diabetes & Coronary Heart Disease Risk Factors & Prevention (American Heart Association, 2012)

40. Questions & Answers Diabetes & Coronary Heart Disease Risk Factors & Prevention (American Heart Association, 2012)

41. References The American Diabetic Association (2013). Retrieved from www.diabetes.org.www.diabetes.org The American Heart Association (2012). Retrieved from www.heart.org.www.heart.org Bean, C.A., et al (2006). Image. ACC Atlas of Pathophysiology, 2 nd Edition. Philadelphia: Lippincott & Wilkins. Centers for Disease Control and Prevention (2013). Heart Disease Facts. Retrieved from http://www.cdc.gov/heartdisease/facts.htm.http://www.cdc.gov/heartdisease/facts.htm Diabetes & Coronary Heart Disease Risk Factors & Prevention

42. References Florida Department of Health. (2013) Retrieved from www.Floridacharts.com.www.Floridacharts.com Drchandler.com (2005). Image. Retrieved from http://drchander.com/diagnoseCAD.html. http://drchander.com/diagnoseCAD.html National Institutes of Health (2011). What Are the Signs and Symptoms of Diabetic Heart Disease? Retrieved from http://www.nhlbi.nih.gov/health/health- topics/topics/dhd/signs.html.http://www.nhlbi.nih.gov/health/health- topics/topics/dhd/signs.html Diabetes & Coronary Heart Disease Risk Factors & Prevention