Taking Control of Your Diabetes

1. Taking Control of Your Diabetes Sara Schwager Patricia Eusterbrock

2. Agenda • 4 Steps to Control Your Diabetes • Frequently Asked Questions About Diabetes

3. 4 Steps to Control Your Diabetes • Step 1: Learn about diabetes • Step 2: Know your diabetes ABCs • Step 3: Manage your diabetes • Step 4: Get routine care to avoid problems

4. Step 1: Learn about diabetes • What is diabetes? • Diabetes is when your blood has too much sugar in it • Normally your body breaks down your food into sugar and sends it into your bloodstream

5. Step 1: Learn about diabetes • What is diabetes? • Your pancreas makes a hormone called insulin which helps to get the sugar from the blood into the cells to be used for energy • People with type 2 diabetes don’t make enough insulin or it doesn’t work well

6. Step 1: Learn about diabetes http://www.soylabs.com/img/diabetes_type2.jpg

7. Step 1: Learn about diabetes • There are two main types of diabetes: • Type I • The body does not make insulin • People with Type I diabetes need to take insulin every day • Type II • The body does not make or use insulin well • Most common form of diabetes • People with Type II diabetes often need to take pills or insulin

8. Step 1: Learn about diabetes • Taking good care of yourself and your diabetes can help you feel better. It may help you avoid health problems caused by diabetes such as: • heart disease and stroke • eye problems that can lead to trouble seeing or going blind • nerve damage that can cause your hands and feet to feel numb. Some people may even lose a foot or a leg • kidney problems that can cause your kidneys to stop working • gum disease and loss of teeth

9. Step 1: Learn about diabetes • When your blood glucose is close to normal you are likely to: • have more energy • be less tired and thirsty and urinate less often • heal better and have fewer skin, or bladder infections • have fewer problems with your eyesight, feet, and gums

10. Step 2: Know your diabetes ABCs • A for the A1C test • B for Blood pressure • C for Cholesterol

11. Step 2: Know your diabetes ABCs A for the A1C test • It shows you what your blood glucose has been over the last three months. The A1C goal for most people is below 7. High blood glucose levels can harm your heart and blood vessels, kidneys, feet, and eyes.

12. Step 2: Know your diabetes ABCs B for Blood pressure • The goal for most people is 130/80 • High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease

13. Step 2: Know your diabetes ABCs C for Cholesterol • The LDL goal for most people is less than 100. • The HDL goal for most people is above 40. • LDL or "bad" cholesterol can build up and clog your blood vessels. It can cause a heart attack or a stroke. HDL or "good" cholesterol helps remove cholesterol from your blood vessels.

14. Step 3: Manage your diabetes • Maintain a healthy diet • Eat healthy foods such as fruits and vegetables, fish, lean meats, chicken or turkey without the skin, dry peas or beans, whole grains, and low-fat or skim milk and cheese. • Keep fish and lean meat and poultry portion to about 3 ounces(or the size of a deck of cards). Bake, broil, or grill it. • Eat foods that have less fat and salt. • Eat foods with more fiber such as whole grains cereals, breads, crackers, rice, or pasta.

15. Step 3: Manage your diabetes • Exercise, exercise, exercise! • Get 30 to 60 minutes of physical activity on most days of the week. • Increase your daily activities around the house by doing things such as laundry, gardening, or walking around the house while on the phone.

16. Step 3: Manage your diabetes • Keep a positive attitude • Ask for help if you feel down. A mental health counselor, support group, member of the clergy, friend, or family member who will listen to your concerns may help you feel better. • Learn to cope with stress. Stress can raise your blood glucose. While it is hard to remove stress from your life, you can learn to handle it.

17. Step 3: Manage your diabetes • Take care of your body • Check your feet every day for cuts, blisters, red spots, and swelling. Call your health care team right away about any sores that do not go away. • Brush your teeth and floss every day to avoid problems with your mouth, teeth, or gums • Report any changesin your eyesight to your doctor.

18. Step 3: Manage your diabetes • Other ways to improve your health • Stop smoking. Ask for help to quit. • Take medicines even when you feel good. Ask your doctor if you need aspirin to prevent a heart attack or stroke. Tell your doctor if you cannot afford your medicines or if you have any side effects. • Stay at a healthy weight by using your meal plan and moving more.

19. Step 3: Manage your diabetes • Know Hypoglycemia • Hypoglycemia is having low blood sugar (<70) • Be aware of the signs and symptoms

20. Step 3: Manage your diabetes • Treating hypoglycemia • If you have symptoms, test your blood sugar • For blood sugars less than 70, you should eat or drink 15 grams of carbohydrates quickly • ½ cup fruit juice or regular soda (NOT diet) • 1-2 tsp of sugar or honey • 5-6 pieces of hard candy (NOT sugar free) • 1 cup of milk • Glucose gel or tablets • Test blood sugar again in 15 minutes. If still below 70, eat another 15 grams of carbohydrates.

21. Step 3: Manage your diabetes • Know hyperglycemia • Hyperglycemia is having high blood sugar • Be aware of the signs and symptoms • Can lead to coma

22. Step 4: Get routine care • Check your own blood glucose • Using a glucose monitor, you should check your blood glucose at least once a day. Ask your doctor what times would be good for you to check it.

23. Step 4: Get routine care • See your health care team at least twice a year to find and treat any problems early. Ask what steps you can take to reach your goal • At each visit be sure you have a: • blood pressure check • foot check • weight check • review of your self-care plan shown in Step 3

24. Step 4: Get routine care • Two times each year get: • A1C test - it may be checked more often if it is over 7 • Once each year be sure you have a: • cholesterol test • triglyceride test - a type of blood fat • complete foot exam • dental exam to check teeth and gums - tell your dentist you have diabetes • dilated eye exam to check for eye problems • flu shot • urine and a blood test to check for kidney problems

25. Frequently Asked Questions

26. #1 Can I get diabetes from being around someone who has diabetes? No. Diabetes is not contagious and cannot be caught from someone else. Although we do not know the exact cause of diabetes, it appears that some genetic (passed down from your parents) and lifestyle factors can help lead to diabetes.

27. #2 Does having diabetes mean that I can't eat sweet foods such as candy or desserts? No. People with diabetes can eat sweets as long as they are following a healthy lifestyle including diet and exercise. Of course, this means limiting the amounts one eats to that of a well-balanced diet, which should be followed by all people, NOT just those with diabetes.

28. #3 Can I develop diabetes if I eat too much sugar? No. Diabetes is caused by a number of genetic (passed down from your parents) and lifestyle factors. Being overweight, however, does increase your risk of developing Type 2 Diabetes. For that reason, it is recommended that people with a family history of diabetes exercise regularly, eat foods that are low in fact and also reduce the number of calories one eats to help to lose weight.

29. #4 Should I be on a special diabetic diet? There is no one "diabetic" diet. It is important, however, that you do follow a healthy meal plan. This means eating foods that are low in fat (especially saturated and trans fat), moderate in salt and sugar, that have a variety of whole grain foods, vegetables and fruits. There is no advantage to eating foods that are labeled as "diabetic" or "dietetic" versions and they may be more expensive or cause changes in bowel habits.

30. #5 Do I need to limit the amount of foods that I eat that are high in starch such as bread, pasta and potatoes? Starches are one of the main food groups and are needed in any well-balanced diet. The important thing to remember is portions. Most healthy diets recommend 6-11 portions of whole grain breads, cereals, pasta, rice and starchy vegetables like potatoes, yams, peas and corn every day.

31. Myth #6 Am I more likely to get a cold or other illness than someone without diabetes? No. Having diabetes does not make you more likely to get colds or become ill. Having a cold can, however, prevent you from eating properly which can lead to changes in your blood glucose levels. Diabetes can also make your immune system more vulnerable to severe cases of the flu and, therefore, people with diabetes are encourage to get a yearly flu shot.

32. #7 Why is it important for me to exercise with diabetes? Moderate intensity physical activity such as walking briskly, mowing the lawn, swimming, or bicycling can help lower your blood glucose, weight and blood pressure as well as raise your "good" cholesterol (HDL) and lower your "bad" cholesterol (LDL). It may also reduce the risk of heart disease and nerve damage which often occur with diabetes. People with diabetes should perform moderate intensity physical activity for 30 minutes per day at least 5 times a week.

33. Summary • Step 1: Learn about diabetes • Ask your health care team what type of diabetes you have. • Learn why diabetes is serious. • Learn how caring for your diabetes helps you feel better today and in the future.

34. Summary • Step 2: Know your diabetes ABCs • Ask your health care team: • What your A1C, blood pressure, and Cholesterol numbers are • What should your ABC numbers should be • What you can do to reach your targets  • Write down all your numbers on a record card

35. Summary • Step 3: Manage your diabetes • Talk with your health care team about your blood glucose targets. Ask how and when to test your blood glucose and how to use the results to manage your diabetes. • Use this plan as a guide to your self-care. • Discuss how your self-care plan is working for you each time you visit your health care team.

36. Summary • Step 4: Get routine care • Ask your health care team about these and other tests you may need. Ask what the results mean. • Write down the date and time of your next visit. • Keep a record of your diabetes care.

37. Sources • American Diabetes Association[www.diabetes.org] • National Diabetes Education Program[http://www.ndep.nih.gov/]