Diagnosed With Diabetes, Now What?

Diagnosed with Diabetes, Now What?

Maskwacis Health Diabetes Conference, 2012

Plan for today

Now what?

Diabetes management

Diabetes complications?


NOW WHAT?

Shock

Denial

Relief

Fear

Acceptance


Acceptance?

Management

Control blood sugarKnow your blood sugar (test / finger pokes) Lifestyle balanceMedicine if necessary

Avoid complicationsMaskwacis Health Diabetes Conference, 2012

Know your ABC & D’s

B is for blood pressure

< 130/80

C is for cholesterolLDL < or = 2.0HDL > 1.3 for women, > 1.0 for

men

D is for diet!5% weight loss

Balance

A is for A1C!

< or = 7.0%


You need a TEAM

Nurse and dietitian

Doctor

Pharmacist YOU

Family


You need to fight High Blood Sugar

Too much food

Too little insulin/medication

Stress

Illness

Not enough activity


You need to avoid LOW Blood Sugar

Too LITTLE food

Too MUCH insulin/medication

Stress

Illness

TOO MUCH activity


What is Type 2 Diabetes? How can it be managed?

Leaky LiverThe liver leaks too much sugar. Blood sugars rise

Pooped out PancreasThe pancreas is not making enough insulin. Or the insulin is too tired and not able to work properly. Blood sugars rise.

Cell ResistanceThe cells don’t allow insulin to bring the sugars into the cell. Blood sugars rise.

Lifestyle Lifestyle

Pills, mainly metformin

Lifestyle

Pills, diabeta, diamicron, gluconorm, januvia

Pills, mainly metformin

Insulin, the needle

Insulin, the needle

Insulin, the needle

Acknowledgement Aboriginal Diabetes Wellness Program

Plan for today

Now what?

Diabetes management

Diabetes complications?


AVOID Complications

High blood sugar can damage the Blood Vessels & Nerves

This damage can cause problems in many parts of the body: heart, brain, kidneys, eyes, sex organs, legs and feet

Blood Vessels Nerves


Diabetes & Blood Vessel Disease

Plaque build up decreasing circulation

Blood clot blocking circulation

High Blood Sugar can break down the blood vessel walls

Build up of plaque, cholesterol, fat


Diabetes & Cholesterol

HDL (good cholesterol)

LDL (bad cholesterol)


Diabetes & High Blood Pressure

Top number = when the heart pumps blood into the vessels

Should be lower than 130

Bottom number = when the heart is at rest

Should be lower than 80

IDEALLY: less than 130/80

Blood Pressure is the measure of force on the artery walls


Diabetes & Heart Disease

Angina / chest pain - partial blockage to the arteries in heart

Heart Attack / chest pain - total blockage to arteries in heart

Peripheral Blood Vessel Damage - blockage to the small blood vessels in the legs and arms


Diabetes & Heart Attack

Signs of Heart Attack•Shortness of breath •Cold sweat•Nausea•Light-headedness•Sensation of pressure, fullness, or pain.•Pain or discomfort in one or both arms, the back, neck, jaw, or stomach.


Diabetes and StrokeStroke: Blocked blood flow to the brain

Signs of Stroke

Weakness: Sudden loss or sudden numbness in the face, arm or leg, even temporary.

Trouble speaking: Sudden difficulty speaking or understanding or sudden confusion, even temporary.

Vision problems: Sudden trouble with vision, even temporary.

Headache: Sudden severe and unusual headache.

Dizziness: Sudden loss of balance, especially with any of the above signs.

Weakened/diseased blood vessels ruptured

Blood leaks into brain

Stroke


Diabetes Heart Disease and Stroke Prevention

Staying Active and Eating Healthy

Balanced meals with regular exercise

Blood Pressure monitoring

Below 130/80

Blood Work

Cholesterol Levels

Blood fats: LDL, HDL, triglyceride & total cholesterol

LDL cholesterol can clog the artery walls but can be treated if caught early

A1c:

Measures average blood sugar levels over 3 months

It should be measured 4 times a year


Diabetes Heart Disease and Stroke Prevention


< 130/80


men


Balance

A is for A1C!

< or = 7.0%


Diabetes Complications

Heart attacks and strokes, foot problems

Nerve damage, foot problems

Kidney damage


Diabetes and Nerve Damage

Nerves transmit information to and from the brain to all parts of the body

Nerves provide sensation such as pain, pressure, hot and cold.

Nerves regulate our organs and sweat glands

High blood sugars can damage nerves interrupting the flow of information to and from the brain



Nerve Damage can:

Disrupt the sensation of pain and pressure causing numbness

Mix up our feelings of hot/cold

Affect nerves that control the heart, regulates blood pressure & controls blood sugar levels


Diabetes and Nerve Damage Prevention

Foot Exam:•Remove your shoes & socks for a foot check at each appointment with your healthcare provider•Check your feet daily to prevent problems

Monofilament: Testing for sensation


Diabetic Foot ExamOverview


Diabetes and Nerve Damage Prevention


< 130/80


men


Balance

A is for A1C!

< or = 7.0%


Diabetes and Kidney Damage

Diabetes and Kidney Damage

Your kidneys are filters that clean your blood

High blood sugars can cause damage to the blood vessels that supply the kidneys

If they are damaged, waste and fluids build up in your blood instead of leaving your body

Protein can leak out into the urine

High blood pressure & smoking also contribute


Diabetes Kidney Disease Prevention

Urine Test: Yearly

Microalbumin:

Microalbumin measures small amounts of protein in the urine

If you catch the problems early, they can be treated

Goal < 2.0


Diabetes and Kidney Damage Treatments

Treatments: Medication

Blood Pressure medications helps reduce damage to the kidneys


Diabetes and Kidney Disease management and treatment


< 130/80


men


Balance

A is for A1C!

< or = 7.0%


Diabetes and Kidney Damage Treatment

Treatments: Dialysis

Peritoneal Dialysis Hemodialysis


Diabetes and Kidney Damage Treatment

Treatments: Transplant

The transplanted kidney takes over the work of the failed kidneys and you no longer need dialysis.

Kidneys can come from live donors (family) or


Management of Complications

Honoring our 4 Bodies: Mind, Body, Spirit, Emotion

Healthy Eating, Active Living

Control blood sugar levels

Control blood pressure (check BP with every visit)

Weight loss

Regular Dr’s visits for blood and urine tests and foot examinations


Social determinants of health

Family and friends

Community leadership

Self: genetics, health beliefs, self esteem, resources

Access to quality health care

What is needed for health?

Toth 2010Maskwacis Health Diabetes Conference, 2012

Questions?


Diagnosed With Diabetes, Now What?

Health & Medicine

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