Managing Diabetes

1. Managing Diabetes • What Is Diabetes? • and • Diabetes ABCs

2. Types of Diabetes • Type 1 diabetes • Usually diagnosed in children and young adults • Type 2 diabetes • Most common form • Most often diagnosed in adults • Gestational diabetes • Can appear during pregnancy • High risk for type 2 diabetes later in life

3. Managing Your Diabetes • Most of diabetes day-to-day care is up to YOU • Choosing what you eat • Including physical activity in your routine • Taking your medications • Keeping track of your blood glucose, blood pressure and cholesterol numbers • Learning all you can about diabetes

4. A1C • A = A1C(pronounced A-one-C) • Provides average blood sugar for the past 2-3 months • Recommended level of below 7 for most people with diabetes • Measure at least two times each year

5. Blood Pressure • B = Blood Pressure • Measures the force of blood inside your blood vessels • High blood pressure can lead to heart attack, stroke, eye problems and kidney disease • Blood pressure of below 130/80 recommended

6. Cholesterol • C = Cholesterol • Fat in your blood - 3 important numbers: • HDL- “good” cholesterol Protects your heart • LDL- “bad” cholesterol Clogs blood vessels • Triglycerides – fat that increases risk for heart attack and stroke

7. Managing Diabetes • Getting the Best Care for Your Diabetes

8. Every Visit • Every Visit • Check/Review Blood Glucose Results • Check Blood Pressure • Review Meal Plan • Review Activity Level • Check Weight • Ask About Smoking Status

9. Every 3-6 Months • At Least Every 3-6 Months • Check A1C • Provides average blood sugar for the past 2-3 months • Recommended level of below 7 for most people with diabetes

10. At Least Once a Year • At Least Once a Year Check: • Cholesterol • Microalbumin • Feet • Eyes • Flu Shot • Pneumonia Vaccine Status

11. Managing Diabetes • All About Blood Glucose

12. Blood Glucose • Keeping your Blood Glucose in the recommended target range can prevent or delay the long-term health problems caused by diabetes

13. Blood Glucose • What are the blood glucose targets for people with diabetes?

14. Blood Glucose • What makes blood glucose rise? • More food or more carbs than usual • Inactivity • Not enough diabetes medications • Side effects of other medications • Infection or illness such as a cold or flu • Stress • Changes in hormone levels

15. Blood Glucose • What makes blood glucose fall? • Less food and less carbs than usual • Missing a meal or snack • Drinking alcoholic beverages, especially on an empty stomach • Extra activity • Too much diabetes medications • Side effects of other medications

16. High Blood Glucose • If your blood glucose is too high? • Make notes in your record book (what time? what did you eat? how active were you? etc.) • Talk to your health care team about adjustments to your meal plan, physical activity or medications

17. Low Blood Glucose • If your blood glucose is too low? • Called hypoglycemia • When blood glucose drops below 70

18. Low Blood Glucose • Treating low blood glucose • Check your blood glucose level; if below 70 eat one of following: • 2 to 5 glucose tablets • ½ cup (4 ounces) of fruit juice • ½ cup (4 ounces) of regular soft drink • 6 to 8 ounces milk • 5 to 7 pieces hard candy • 2 teaspoons of sugar or honey

19. Managing Diabetes • Medications

20. Medications • Most people with diabetes need medications to reach their target blood glucose, blood pressure and cholesterol (ABC) targets.

21. Medications: Blood Glucose • Medication option plans for type 2 diabetes: • One type of diabetes pill • Two types of diabetes pills • Diabetes pill(s) plusinsulin

22. Medications: Blood Glucose • Diabetes pills work best when used together with meal planning and exercise. The combination of all three work together to lower your blood glucose levels.

23. Your Medications • You may need multiple medicines to manage your ABCs. • The more medications you take the harder it is to keep track of them.

24. Managing Diabetes • An Ounce of Prevention – Avoiding Complications

25. Topics • How to prevent or delay: • Heart Disease • Eye Disease • Kidney Disease • Nerve Disease • Skin Problems • Dental Problems

26. Warning Signs • 2 out of 3 people with diabetes die from heart disease or stroke • Know the warning signs of a heart attack and stroke • If you have warning signs, call 911 right away

27. Managing Diabetes • Losing Weight

28. Why Lose? • Losing weight can help you improve blood glucose, blood pressure and cholesterol levels (the ABCs). • A loss of only 10 to 15 pounds can be beneficial.

29. Cutting Calories • Reduce serving sizes • Take less than usual • Use smaller plates and bowls • In restaurants • Order the smallest portion • Split entrees and desserts with others • Take some home for later

30. Cutting Calories • Select lower-calorie items • Include a fruit or vegetable with each meal or snack • Drink water or calorie-free drinks instead of regular soft drinks and juice

31. Planning Healthy Meals • Rate Your Plate Goal: • ¼ is carbohydrate • ¼ is meat or meat substitute • ½ is vegetables • May also add another carbohydrate such as a glass or milk or a slice of bread

32. Rate Your Plate

33. Keeping a Record • Records helps keep you on target • Write down • Everything you eat and drink including serving sizes • Your physical activity – what kind and how long • Your weekly weight

34. Managing Diabetes • All About Physical Activity

35. What Can Physical Activity Do? • Lower blood glucose, blood pressure, and cholesterol (the ABCs) • Lower your risk for heart disease and stroke • Relieve stress • Help insulin work better • Strengthen your heart, muscles, and bones • Improve your blood circulation and tone your muscles • Keep your body and joints flexible

36. What Activities Are Best? • Best to include four kinds of activities: • Being active throughout the day • Aerobic activity, such as brisk walking, swimming or dancing • Strength training, such as lifting light weights • Flexibility exercises, such as stretching

37. Getting Started • Have a medical checkup and find out which activities are safe for you. • Review the symptoms of low blood glucose and know how to treat. • Plan how to have water and snacks handy during activity. • Wear medical identification. • Wear well-fitting shoes.

38. Managing Diabetes • Foot • Care

39. Foot Care • Diabetes increases your risk for foot problems: • Nerve damage • from high blood glucose levels • called diabetic neuropathy • causes pain, tingling or numbness • Peripheral arterial disease (PAD) • blood vessels in feet and legs narrowed or blocked by fatty deposits

40. Foot Care • Keep your feet safe by • Keeping your blood glucose levels on target • Taking care of your feet every day – use your Foot Care Checklist

41. Foot Exams • At least once a year have: • a complete foot exam to check skin, muscles, bones and blood circulation • a monofilament test to check the nerves in your feet

42. Managing Diabetes • Learning How to Change Habits

43. Ready to Change • Make a Plan that is • Realistic • Achievable • As specific as possible • Ask your health care team for help

44. Helpful Hints • Remember: • it takes time to make new habits, but your patience and persistence will pay off in the long run.