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Preventing Diabetes Complications

Preventing Diabetes Complications. What is a “complication”?. Two problems at the same time A second illness caused by the first one A complication “complicates” the situation!. 5 Major Complications. Kidneys. Heart. Brain. Nerves. Eyes. Major Complications #1 &2. Heart disease

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Preventing Diabetes Complications

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  1. Preventing Diabetes Complications

  2. What is a “complication”? • Two problems at the same time • A second illness caused by the first one • A complication “complicates” the situation!

  3. 5 Major Complications Kidneys Heart Brain Nerves Eyes

  4. Major Complications #1 &2 • Heart disease • High Blood Pressure • High Cholesterol • Heart Attack • Stroke • People with diabetes 2-4 times more likely to have stroke

  5. How does it happen? • High cholesterol more common in diabetes • “Good” and “bad” cholesterol • HDL (H= healthy) • LDL (L= lousy) • TG (T= terrible) • High “bad” cholesterol (especially TG) + low “good” cholesterol= recipe for heart attack!

  6. Know your numbers! • What are the ABC’s of diabetes? • A1c • Goal is less than 7 • Check 2-4 times a year • Blood Pressure • Goal is less than 130/80 • Check at every clinic visit • Cholesterol • Goal is LDL less than 100 and TG less than 150 • HDL: women more than 50; men more than 40 • Check every 3 months until at goal

  7. Most important thing is… • Your lifestyle!!! • Low saturated fat, low salt diet • Daily physical activity (30-45 minutes daily or total 150 minutes/week) • Stop smoking • Minimize alcohol • If overweight, try to lose 7-10% of body weight • Check your blood sugar and adjust diet • Stress reduction

  8. Let’s Review! • What are the ABC’s of diabetes? • Your _________ is the most important thing you can do to prevent heart attack or stroke. • Which type of cholesterol is “good” and should be high: LDL, HDL, or TG? • What is “goal” for A1c: less than 7, 8-9, at least 10?

  9. Major Complication #3 • Kidney disease • Protein spills into urine • Kidneys cannot get rid of body waste • Kidney failure • Diabetes is leading cause of kidney disease! • Not reversible, but can be slowed • Key is prevention!

  10. How does it happen? • Diabetes damages blood vessels everywhere in body, including kidneys • Conditions that make kidney damage happen sooner: • High blood sugar • Cigarette smoking • High blood pressure • Family history of kidney disease

  11. Fight off kidney disease! • Control blood sugar (A1c less than 7) • Control blood pressure (less than 130/80) • Check for protein in urine once a year • Make sure your provider has prescribed drugs that protect your kidneys. • ACE-inhibitors (ACE) • ARB (just like ACE but fewer side effects)

  12. Major Complication #4 • Eye Disease (Retinopathy) • 20% of people with type 2 diabetes have some retinopathy when diagnosed • Leading cause of blindness in US adults aged 20-74 years • 100% of people with type 1 diabetes will have retinopathy after 20 years • Retinopathy only detected by a dilated eye exam

  13. How does it happen? • High blood sugar damages blood vessels in eye • Damaged blood vessels leak fluid that covers “seeing” part of retina • Retina cells lack oxygen and die • No symptoms until advanced disease

  14. Preventing eye disease • Control blood sugar (what is goal A1c?) • Control blood pressure (what is goal for blood pressure?) • Control cholesterol (diet and medicines) • Stop smoking • Have dilated eye exam every year

  15. Let’s Review! • What are 2 things that make kidney damage happen earlier? • Do ACE-inhibitors and ARBs protect or damage your kidneys? • True or false: People can tell when they have retinopathy. • Name 2 things that can help prevent retinopathy.

  16. Major Complication #5 • Nerve Destruction • Called “neuropathy” • 25-50% people with diabetes have it • Worsens when A1c is higher than 9% • Affects more than just feet! • Increases risk for sudden death from heart attack (can’t feel heart pain!)

  17. What does it feel like? • Sharp, stabbing • Prickling, tingling (hurts when sheets touch legs at night) • Like pain on sunburned skin when you take a hot shower • Affects bowel, bladder, stomach, sex, sleep patterns, balance

  18. How does it happen? • Starts during pre-diabetes • High blood sugar slows speed of nerve message-sending • High blood sugar makes swelling around nerves • Pain often worse at night • Pain can be everywhere- not just feet

  19. Preventing nerve destruction • Things you can change to prevent it: • Control blood sugar • Control blood pressure • Lower cholesterol • Keep A1c less than 7% • Stop smoking • Things that make it worse but can’t be changed: • Getting older • Having diabetes longer

  20. Foot Care • Check your feet every day • Wash daily with mild soap, warm water • Do not soak feet • Dry carefully between toes • Use lotion, not between toes! • Wear thick, soft socks without seams • Wear good-fitting shoes

  21. Foot Care • NEVER go barefoot (no, never!!) • Cut toenails straight across • Don’t sit with crossed legs • Wear socks to bed if feet are cold • Call your provider for sores on feet

  22. And now for a demonstration!

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