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Understanding Your Sugar. Presented by: Irielle L. Banks, APRN, FNP-C Staff Endocrine Nurse Practitioner Ochsner Medical Center, Jefferson Campus Department of Endocrinology. Objectives. Define diabetes and how to diagnose List symptoms, complications, and risk factors
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Understanding Your Sugar Presented by: Irielle L. Banks, APRN, FNP-CStaff Endocrine Nurse PractitionerOchsner Medical Center, Jefferson CampusDepartment of Endocrinology
Objectives • Define diabetes and how to diagnose • List symptoms, complications, and risk factors • List ways to decrease risk of diabetes
Diabetes Statistics • 29 million children and adults with diabetes • Increase of 13% from 2011 • Undiagnosed: 8.1 million • Pre-diabetes: 86 million • Only 9.5 million are aware • 1.6 million new cases diagnosed yearly • Age >60: 12.2 million (23.1%) have diabetes
Diabetes Statistics • Costs in 2007: $174 billion • Cost in 2012: $245 billion • 41% increase over 5 years • $1 in every $10 health care dollars goes to diabetes • 1 in 3 Medicare dollars • Health expenditures on people with diabetes is 2.3 times higher
Types of Diabetes • Type 1 Diabetes • Type 2 Diabetes- **most common** • Pre-Diabetes (Glucose Intolerance) • Gestational Diabetes
Type 1 Diabetes • Previously called Juvenile Diabetes • Often diagnosed in children and young adults but can be diagnosed at any age • Autoimmune disorder- antibodies destroy the pancreas over time. • All patients MUST be treated with Insulin • No insulin is produced by the body
Type 2 Diabetes • Most common form of Diabetes • Most commonly diagnosed in adults • Increased incidence in children as obesity rates increase • Patients develop insulin resistance • Pancreas makes insulin but body does not use it efficiently • Over time insulin production decreases
Type 2 Diabetes • Often times patients have had diabetes for several years prior to being diagnosed • Causes: • Genetic • Obesity • Steroids • Endocrine disorders
Symptoms • Frequent urination • Excessive thirst • Weight loss • Fatigue and irritability • Blurred vision • Frequent skin or urinary tract infections • Slow healing wounds
Hemoglobin A1c • Average of Blood Sugars for 3 months • Goal A1c is <6.5% or <7%
Complications • Eyes- retinopathy • Increased risk of glaucoma • Increased risk of cataracts • Diabetic Neuropathy • Kidneys- Nephropathy • Hypertension • Heart and vascular disease
Complications • Stroke • Heart Attack
Prevention • Diet • Exercise • Exercise • Exercise • Helps control glucose, blood pressure, cholesterol • Improves circulation • Improves energy levels • Strengthens heart, muscles, bones • Relieves stress • Decreases risk of diabetes, pre-diabetes, heart disease, and stroke
Management • Diet • Exercise—150 minutes a week • Good Blood Pressure control • Yearly Retinal eye exam • Comprehensive foot exam by Provider • Home foot exams • Home blood sugar monitoring • Routine Dental Visits every 6 months
Management • Aspirin • Cholesterol: statin
Hi protein Good Carbs vs Bad Carbs Diabetes Myths No Carbs… Low Carbs… I have to eat snacks between each meals… My life is over…
People with Diabetes should not eat carbohydrates? • False • You should eat a healthy balanced diet. • Carbohydrates cannot be completely avoided • Found in starches, dairy, sugars, fruits, vegetables
Fruit is Healthy:You Can Eat As Much As You Want! • True and False • Fruits provide important vitamins and nutrients • People with diabetes can eat fruit but must portion and space through the day • The natural sugar in fruit increases blood sugar
Being on Insulin means you failed to take care of your diabetes? • False • Insulin is just one of many treatments used in the treatment of Type 2 diabetes • Diabetes is often progressive and occasionally insulin is required
Once treatment is started, you can eat whatever you want? • False • Treatment is often ineffective without appropriate diet
I do not need treatment because I feel fine? • False • Diabetes is often asymptomatic • Unless the glucose is low or excessively high, you most likely will have no symptoms
Why the concern with diabetes? • Chronic hyperglycemia leads to many complications • Lack of symptoms does not mean it’s not doing damage • Think of it as… termites