Four Corners Safety Network

1. Four Corners Safety Network General Session Meeting November 5th, 2015 COFFEE SERVICE 7:30 – 8:00 AM MEETING BEGINS AT 8:00 AM

2. WELCOME Call to Order, Tory N. Larsen, Special thank you to our Sponsor Industrial Ecosystems Inc.

3. WELCOME ROOM INSTRUCTIONS

4. Safety Moment Diabetes is a Silent Killer. When I spoke with our Employees about Diabetes none had a primary care physician and one said Tory “the last time I had a physical was when you hired me five years ago” today we have an awareness level presentation on recognition and how to take care of yourself so you aren’t dealing with the Silent Killer Diabetes.

5. Four Corners Safety Network “Diabetes a Silent Killer” San Juan College Nov 5, 2015 Maria Cassidy Begay Ruby Johnson IHS/NAV

6. What are the “ABCDE’s” of Diabetes Control? • How can you take control of your diabetes healthcare?

7. Insulin and Digestion

9. Poorly Controlled Diabetes Can Cause Problems • Eye disease • Kidney disease • Nerve damage • Heart attacks • Strokes • Amputations • Sexual problems Eye Kidney Heart Blood vessel

10. Taking Care of Your Diabetes • What you can do? • Plan healthy, balanced meals • Know your blood sugars • Exercise • Be aware of symptoms • Take your meds as directed (if needed) • Be proactive about education! Adapted from “The top 5 ways to manage diabetes”, Dr. Gerald Bernstein, http://livewellnewyork.com

11. Focus on the of Diabetes Control • HbA1c control • HbA1c: < 7% • Blood pressure control • < 140/80 mm/Hg • Cholesterol control • Total cholesterol < 200 • Diet • Exercise

12. HbA1c: Glycosylated Hemoglobin • HbA1c is a test (measurement) of your blood sugar over the last three months

13. AverageHbA1cBlood Glucose 5%-----------------90 mg/dl 6%----------------120 mg/dl GOAL: 7%----------------150 mg/dl Less than 7% 8%----------------180 mg/dl 9%----------------210 mg/dl 10%---------------240 mg/dl 11%---------------270 mg/dl 12%---------------300 mg/dl Please note: discuss individual goals with your doctor, they may be different depending on other risk factors such as age.

14. Blood Glucose Goals for People with Diabetes • Before meals 70 - 130 mg/dl Targets are individualized, speak with your doctor!

15. Checking Blood Sugars at Home • Using a glucose meter can be valuable in managing diabetes. • How often you test your blood depends on your level of blood sugar control and medications. • Please discuss how often and when to test with your diabetes health care provider.

16. Understanding Blood Pressure • ADA Target is less than 140/80 • Recent research has shown that a blood pressure that is too low can also be unhealthy. • BP can be measured at home.

17. Understanding Blood Pressure • Systolic—top, or higher, number • Measures the pressure in the arteries when the heart beats (when the heart muscle contracts). American Heart Association www.heart .org

18. Understanding Blood Pressure • Diastolic—bottom, or lower, number • Measures the pressure in the arteries between heartbeats (when the heart muscle is resting between beats and refilling with blood). American Heart Association www.heart .org

19. Understanding Cholesterol • A complete fasting lipoprotein profile will show the following four results. • Total Blood (Serum) Cholesterol • HDL (Good/Happy) Cholesterol Level • LDL (Bad/Low) Cholesterol Level • Triglyceride Level American Heart Association www.heart .org

20. American Diabetes Association Goals • Cholesterol: less than 200 mg/dl • LDL cholesterol: less than 100 mg/dl (less than 70 if there is a prior heart attack or stroke) • HDL cholesterol: greater than 40 in men greater than 50 in women • Triglycerides: less than 200 mg/dl

21. Understanding Cholesterol

22. Understanding Cholesterol • Cholesterol comes from two sources: your body and food. • 75% comes from your liver and other cells • 25% comes from what you eat • Cholesterol is only found in animal products. American Heart Association www.heart .org

23. Understanding Cholesterol: LDL • LDL cholesterol is the "bad" cholesterol. • Too much clogs arteries, increasing risk of heart attack and stroke. • LDL cholesterol is produced naturally by the body, but is also influenced by inherited factors. • Diet also affects LDL. American Heart Association www.heart .org

24. How do you decrease LDL? • Decrease saturated fats (butter, fat on meat, cheese) • Decrease trans fats (vegetable shortening, some margarine, crackers, candies, baked goods, cookies and many packaged and processed foods) American Heart Association www.heart .org

25. How do you decrease LDL? • Decrease dietary cholesterol (foods from animal sources, especially egg yolks, meat, poultry, fish, seafood and whole-milk dairy products) • Medication

26. Understanding Cholesterol: HDL • HDL is the "good/happy" cholesterol • HDL helps prevent LDL from attaching to artery walls • Low levels of HDL have been shown to increase the risk of heart disease. • Exercise can help increase HDL.   American Heart Association www.heart .org

27. Diet and Exercise • Can help manage the ABCs of diabetes control (A1c, blood pressure and cholesterol) • Losing weight and increasing activity can: • Help control/reduce A1c, BP and cholesterol • Reduce medication needs

28. Eating Well with Diabetes • Eat lots of fruit and vegetables • Choose non-starchy veggies as side dishes • Stick with whole grains Adapted from “The top 5 ways to manage diabetes”, Dr. Gerald Bernstein, http://livewellnewyork.com and www.diabetes.org

29. Eating Well with Diabetes • Choose non-fat dairy products • Eat lean meats • Eat fish 2-3 times per week • Eat lots of dried beans (lentils, pintos, etc.) Adapted from “The top 5 ways to manage diabetes”, Dr. Gerald Bernstein, http://livewellnewyork.com and www.diabetes.org

30. Eating Well with Diabetes • Avoid sugary beverages • Avoid high calorie/high fat snacks • Avoid or limit alcohol (one drink per day for adult women and 2 drinks per day for men) Adapted from “The top 5 ways to manage diabetes”, Dr. Gerald Bernstein, http://livewellnewyork.com and www.diabetes.org

31. Eating Well with Diabetes • Eat variety of nutrient dense foods in appropriate portion sizes. • Achieve and maintain body weight goals. • Delay or prevent complications of diabetes.

32. Benefits of Exercise • Decreases blood sugar • Decreases blood pressure • Decreases weight • Increases blood flow • Decreases stress • Improves self-esteem and energy

33. Exercise and You • Safety first! • ALWAYS check with your healthcare provider before starting a new exercise regimen! • Your provider can give you more personalized exercise advice given your age, health, etc.

34. Getting Ready for Exercise: Checklist • Carry a simple sugar-containing food. • Wear comfortable clothing and shoes. • Exercise with someone. • Carry ID.

35. What toMonitorDuring Physical Activity MONITOR: • low blood sugar • foot pain or numbness • muscle soreness • joint pain or swelling • chest pain • dizziness

36. When to STOP Physical Activity • STOPexercise for: • signs of low blood sugar • chest pain, chest tightness • extreme tiredness • excessive shortness of breath

37. Low Blood Sugar Treatment(Choose One) 1/2 cup Regular Soda or Pop 1/2 cup Orange Juice 1 cup Milk Hard Candy Glucose Tablets

38. Symptoms of Low Blood Sugar(Hypoglycemia) Pounding heart Shaky, headache, confused, dizzy Sweaty Weak, tired, sleepy

39. Warning Signs and Signals of Heart AttacksDon’t wait , call 911 • Uncomfortable pressure in the chest • Pain that spreads to the shoulders, neck or arms • Chest discomfort with • Lightheadedness • Fainting • Sweating • Nausea • Short of breath

40. Foot Care • Look at your feet every day: • between your toes • on the bottom of your feet • report redness, tenderness, swelling, blisters or cuts to your doctor • Wash and dry your feet every day. • Don’t apply heat to your feet.

41. Foot Care • If you have neuropathy, never go barefoot ! • Wear sturdy, comfortable shoes • See a podiatrist if you have any concerns or notice any changes. • Medicare has a shoe benefit covered under Part B.

42. If You Are Sick • Check blood sugar more frequently. • Drink plenty of liquids, get rest. • Check your temperature.

43. If You Are Sick • Report to your doctor: • fever, diarrhea, vomiting, cough • blood sugars higher than 350 mg/dl • If you are unable to eat, call your doctor about taking your diabetes medicine.

44. Safety First

45. How to Get the Most Out of Your Healthcare Visits!

46. Take Control of Your Healthcare: Manage your meds • Make sure you always carry an updated list of your medications • NEVER stop taking your medications without asking your healthcare provider • If you are having side effects or medication problems talk with your healthcare provider.

47. Take Control of Your Healthcare: New Medications When you are prescribed a new medication always ask the following: • 1. What does it do? • 2. What are the side effects? • 3. How do I reduce the side effects? • 4. Is it ok with my other medications? • 5. What is the cost/will my insurance cover it?

48. Take Control of Your Healthcare: New Diabetes Medications • When you are prescribed a new DIABETES medication ask the following • Will this medication increase my risk for low blood sugars? • Will this medication cause weight gain? • What to do if these things happen? • When should I call you?

49. Preparing for Visits with your Provider • Bring: • A list of your medications (or bring them in a bag) • Your meter • A list of questions/concerns • A list of necessary refills • Face to face time is more effective than a phone call, so be prepared!

50. Take Control of Your Healthcare • Bring your calendar to your visit and ALWAYS schedule a follow-up appointment before you leave. • Your healthcare provider is your partner in care and if you work together your health will be better!