Know Your NumbersJenna Rainis, RN BSNDenise Stumpf, RN, BSN, CDESarah Tierney, RN BSN, CDE

www.SpringfieldClinic.comwww.SpringfieldClinic.com

Let’s look at the Numbers

25,800,000 people in the US have diabetes

That’s 8.3% of the population!But only………

18,800,000 have been diagnosed 7,000,000 undiagnosed!!!!

In 2010, 1.9 million new diagnosis of DM for adults > 20 years of age

Let’s Start from the beginning….

American Diabetes Association

Link for Lou sufyan

How is this diagnosed?

American Diabetes Association• Fasting blood glucose >126 mg/dl• 2 hour post glucose load >200mg/dl• Symptoms of diabetes, PLUS casual

plasma glucose >200mg/dl• A1C > 6.5%

The Bad Stuff…………….Long Term Uncontrolled Diabetes is the

leading cause of ….• Blindness for those 20-74 years of age• Kidney failure • Amputations accounts for 60% of non

traumatic • Neuropathy affects 60-70% of those with

diabetes• Heart Disease 2-4x increased risk then

those without diabetes• Stroke 2-4x increased risk then those

without diabetes

SO…..WHAT ARE YOUR TARGETS?

Before Meal 2 hours After Meal

Diabetes 70-130mg/dl <180mg/dl

No Diabetes 70-120mg/dl 70-120mg/dl

What About This?Shaky Dizziness Hunger

Sweaty Headache Weakness

Irritability Anxiety Rapid Heartbeat

Impaired/blurry vision HYPOGLYCEMIA

<70mg/dl

RULE OF 15

1. If possible, test2. Drink/eat 15-20 grams of Carbohydrates*3. Wait 15 minutes4. Re-test, if still low, repeat # 2,35. Eat a meal within the next hour

*if blood sugar 50mg/dl or below,

drink/eat 30 grams of carbohydrates

What About This?Thirsty Frequent urination

Weakness* Impaired/Blurred vision*

Irritability* Nausea or vomiting

Weight loss despite extreme hunger Hyperglycemia

Treatment of Hyperglycemia

ExerciseWater

Sensible Meal ChoicesMedication as instructed by your

providerCall office if blood sugar >400mg/dl

TELENURSE available after hours, weekends & Holidays

Diabetes Learning Center

GOALS FOR MANAGEMENT OF DIABETES MELLITUS

American Diabetes Association Clinical Practice Recommendations 2012

Lipid Targets

Blood Pressure Targets

Goal: < 130/80

Nephropathy

Keys to prevention include:Meet blood pressure goalMeet blood glucose goals

Annual labs to check:Creatinine, BUN and Microalbumin

Oral Health Care• People with diabetes are at an

increased risk of cavities, gingivitis, and tooth loss

• See your Dentist at least yearly

RetinopathyVery small blood vessels grow from the surface of the retina. These growing blood vessels are very delicate and bleed easily.

•See an ophthalmologist at least once a year for a diabetes dilated eye exam

Peripheral NeuropathyOvertime, diabetes can cause:

skin breakdownloss of feeling

poor circulation

See your doctor for a annual foot exam using a monofiliment

Benefits and/or Goals

• Prevent long term complications of diabetes

• Improve blood glucose– 70-130 before meals

<180 after meals• Maintain healthy weight• Weight loss – 5-7% current body weight

Body Mass Index

• Goal of LESS THAN 25

• Remember, focus on loss of 5-7% of current weight for reduction in insulin resistance

Aerobic Activity

Start with:

1.10 minutes of activity 2.Increase session time3.Increase frequency

Goal: At least 3 times a weekFor at least 30 minutes each time

Carbohydrates

• Single most important nutrient that affects blood sugar

• MINIMUM of 30 grams per meal

Come Learn MORE……

The Diabetes Learning Center

WHAT? You Can Do It….Successful Diabetes Management

WHEN? Tuesday evenings and Thursday Afternoons

HOW? Talk with your Primary Care Physician, Endocrinologist or call the Diabetes Learning Center