diabetes sweet kiiler

Diabetes: A sweet killer in 21st century

Provide practical guidance on improving diabetes care Provide practical guidance on improving diabetes care through highlighting the need for:through highlighting the need for:

Increased patient understanding of type 2 diabetes and Increased patient understanding of type 2 diabetes and the importance of reaching glycemic goals the importance of reaching glycemic goals

A multidisciplinary team approach to treating type 2 A multidisciplinary team approach to treating type 2 diabetes diabetes

AIM:

Diabetes

Patients of diabetes are present all across the world. Not only you, but in India one in every 30 people is affected by this disease. There is no cure for diabetes, you can only keep it under control.

Now sit back & go through this information carefully. Do not forget to discuss it with your doctor. This will help you manage

your disease better.

BUT WHAT

IS

DIABETES?

ABCs for Good Health Campaign

A – A1c – 7% or less

B – Blood Pressure 130/80 or less

C – Cholesterol – 200 or less

DIABETES IS A DISEASE WHERE THE BODY DOES NOT PRODUCE

OR PROPERLY USE INSULIN.

What Does Insulin Do ?

Insulin is a hormone which is needed by the body to convert sugar, starches and other food into energy needed for daily life.

Presence of insulin maintains normal level of glucose in the blood.

Lack of insulin leads to increase in levels of glucose in the blood (HYPERGLYCEMIA)

What Does Insulin Do ?

• Family history

• Obesity/central obesity

• Hypertension

• Abnormal lipids

• Hyperglycemia during pregnancy

• Age above 30 yrs

• Stress

• Sedentary lifestyle

• Impaired glucose tolerance

Risk factors for Diabetes

GLOBAL PROJECTIONS FOR THE NUMBER OF PEOPLE

WITH DIABETES (20-79 AGE GROUP), 2007 and 2025 (MILLIONS)

Highly Dense

Diabetic Population

•This is a disease in which the body does not produce insulin.

•It develops more frequently in children, but can also occur in adults

•Such people have to take daily insulin injections to stay alive!

Type 1 Diabetes

SYMPTOMS OF DIABETES

POLYDIPSIA POLYUREA

POLYPHAGIA WEIGHT LOSS

•

•

FATIGUE

What is Type 2 Diabetes ?

This is a disorder due to the body’s inability to make enough insulin or properly use insulin.

It develops more in adults, but it is now found to occur even in adolescents

They need medicines to correct this problem.

Can diabetes be life threatening?

• Yes, if not managed properly.

• Affects quality of life

• May lead to diseases of heart, kidney,eyes.

• Impotence, amputation , paralysis.

● Can diabetes be cured?• No, but if properly managed, people with diabetes can lead a

healthy, normal life

Can diabetes (type 2) be prevented?

• Yes.

• All high risk individuals should• Aim at ideal weight• Increase physical activity• Adopt a healthy, balanced diet• Use of metformin (consult your doctor)

Management of diabetes

• Get your blood Sugar under control by :

• Lifestyle modification• Diet• Exercise

• Medications

How to control Diabetes ?

Diet

Avoid deep fried food

Avoid sweet food

Consume food that is rich in fibre

Divide your meals in 3-4 parts, take smaller meals at regular intervals

Decide your meal as per the calories advised by your doctor or dietician

GrainGroup•Make half your

grains whole

•Eat at least 84 gm of whole grains every day

– Cereal -Breads

– Rice

– Pasta

VegetableGroup• Vary your veggies

• Eat more dark green veggies like broccoli, spinach and other dark, leafy greens

• Eat more orange vegetables like carrots and sweet potatoes

Fruit Group

• Focus on fruits

• Eat a variety of fruits

• Choose fresh, frozen, canned, or dried fruit

• Go easy on fruit juices


Regular exercise

Like brisk-walking, swimming, dancing, cycling, or outdoor sports that can give exercise to your body should be done every day.

Advantages of Exercise

– Reduces & controls weight– Helps to reduce blood glucose– Keeps your heart & lungs healthy– Gives a sense of well being

Exercise

• There is no universal exercise program for all.

• 30 min. daily for minimum 5 days a week

• Drink fluids before and after exercise

• Even elderly & Arthritic can exercise : Stretching, Strengthening muscles


• Drugs

Regular intake of drugs as per the

advice of your doctor is very

important

Why to control Diabetes ?

• If not controlled Diabetes can lead to serious complications of eyes, kidneys, heart, nervous system.

• Therefore, diabetes needs to be controlled strictly.

Heart Disease - Cardiovascular Disease

•People with diabetes are about three times more likely to have significant heart disease.

Complications of Diabetes

Heart Disease - Cardiovascular Disease

•Why are they at such high risk ?

•The extra glucose leads to the clogging of the blood vessels that nourish the heart.


Heart Disease: Risk Factors

•Smoking with Diabetes is Especially bad for the Heart


Smoking

High Cholesterol

300

280

260

240

220

200

180

160

140

120

100

80

60

40

20

290

270

250

230

210

190

170

150

130

110

90

70

50

30

10

High Blood Pressure

350

200

100

Heart Disease: Symptoms•Common symptoms are :


Breathlessness

Dizziness

Pain in Chest, arms, shoulder, back

Visual Disturbances

Eye Diseases: Retinopathy


Retinopathy is an impairment of the retina. Retina : The nerve-rich, light-sensing area in the back of the eyeball, that is crucial for sight.

Diabetes destroys the small blood vessels that nourish retina.

People with diabetes are four times more likely to become blind

Each year, diabetes is the underlying cause of 12% of new blindness diagnoses.

Eye Diseases: Retinopathy


Who’s most at Risk for Retinopathy ?

People with poor blood sugar control.

Long duration of Diabetes

Kidney disease

High blood pressure.


• Kidney Disease: How can you delay the progression?

Control high blood pressure

Practice tight control of glucose

Consult your doctor for the prescription of

medicine that delays kidney failure

Diabetes and Stress• Stress can make blood sugar control difficult

• What is stress ?

• Body feels as if it is under attack like physical injury or illness and mental stress due to domestic or professional reasons

• Body responds to stress by increasing levels of many hormones causing release of stored sugar & fat

Diabetes and Stress

• People with stress :

• Drink more alcohol

• Exercise less

• Irregularity in blood sugar monitoring

• Improper plan of meals

Diabetes and Stress• Coping with stress :

• Relaxation, Meditation

• Gardening, Music

• Breathing exercises at least once a day

• Lifestyle modification

Complications of Diabetes•Oral Infections

Minimize your Risk of Infections

Brush and floss daily to keep bacteria between teeth and gums in check, and see your dentist at least twice a year.

Complications of Diabetes•Skin Infections

When to see skin specialist ?

There is redness, swelling, itching, pus or pain

Rashes, bumps or pits near Insulin injection sites

Complications of Diabetes•Constipation can be another complication

Among those who’ve had diabetes for a long time, an estimated 25% complain of constipation

Never ignore the urge to go

Get regular exercise

Drink plenty of fluids

Eat a high-fiber diet: bran cereals, whole grain items, fruits, vegetables

Consult your doctor for further medication.

Foot Care• What to look for

• Any abnormal sensation

• Severe pain

• Dry scaly or cracked skin

• Any new growth on the feet

• Soreness and redness of the feet

• Changes in the shape of the foot

• Ulcers and pus formation

• Keep feet clean and dry

• Wash feet daily with warm water

• Use a mild soap and rinse well

• Dry feet thoroughly, particularly between the toes

• Do not go barefeet

• Trim your toenails straight across

• Powder feet and shoes every day

• Wear comfortable shoes

• Wear fresh socks every day

• Avoid using sandals with toe grips

Foot Care


•It is more common among those with type 1 insulin-dependent

diabetes. It is considerably less common but still possible among

those with type 2 non-insulin-dependent diabetes.

Low Blood Glucose (Hypoglycemia)


Too much insulin or diabetes medication. Less or irregular food intake, particularly carbohydrates.

Know what Causes Low Blood Glucose

Too much exercise

Drinking alcohol Alcohol lowers blood glucose levels. Be sure you don’t drink on an empty stomach.

Pregnancy

Complications of DiabetesHypoglycemia

To minimize risk of night times

hypoglycemia, test your blood sugar

periodically around 2 a.m. to 3 a.m.

and determine how your level relates to

your food, exercise, and insulin or

medication the previous day. Adjust

accordingly.

Cholesterol

Total less than 200 mg/dl

LDL (bad)-below 130 mg/dl but below 100 is optimal, if known heart disease 70-100 (the higher the risk, the lower the LDL)

HDL (good)–over 40 mg/dl but ideally over 60mg/dl as that greatly lowers heart disease risk

1% drop in blood cholesterol translates into2% drop in risk for heart disease

Where does it come from ?

• Two sources of cholesterol: Food & made in your body

• Food sources: All foods containing animal fat and meat products

65%65%35%35%

Know Your Numbers

Triglycerides

Less than 150 mg/dl is normal

150 to 500 mg/dl is considered high

Over 500 mg/dl is very high

High Blood Pressure

High Blood Pressure (HBP) also known as hypertension is a major risk factor for heart disease, kidney disease, stroke and congestive heart failure.

HBP is often called the “silent killer” because it usually does not cause symptoms.

HBP: How High is High

CategoryCategory Systolic Systolic Diastolic Diastolic

Normal Less than 120 Less than 80

Prehypertension 120-139 80-89

Hypertension 140 or higher 90 or higher

Just monitor your blood glucose regularly

Blood Glucose Monitoring

•Check your blood glucose regularly•It is indeed very easy

Blood Glucose Testing - Basics

• No matter which type of diabetes you have-type 1 insulin dependent, type 2 non-insulin dependent or gestational the single best way to manage your condition is to monitor the amount of glucose in your blood.

• Do it carefully and frequently

Blood Glucose Monitoring : Why ?

Self-monitoring of blood glucose tells you when your blood glucose is too low or when your glucose is too high, which tells you about the need to change your dose of medication, diet & exercise.

And as your blood glucose control improves, self-testing gives you positive feedback about your progress toward the goal of diabetes self-management.

Blood Sugar Testing - BasicsHow often should you test ?

In people with type 1 diabetes you need to test four or five times a day - before each meal and before bedtime - and in the middle of the night (around 3 a.m.) once a week.

People with type 2 diabetes can also have high blood glucose levels and still feel fine so, when in doubt, test, When diet or activity levels change, or when you’re ill or under other stress, test more frequently.

The more often you test, the higher your control becomes.

How to test blood for glucose?How to test blood for glucose?

How to test blood for glucose?

Blood Glucose Testing - why?

•The amount of glucose in your blood changes throughout the

day, if your blood glucose level rise too high or falls too low,

you could develop some potentially serious complications.

Take Control

Research shows that men and women can lower their heart disease risk & Diabetes by 82 percent by leading a healthy

lifestyle.

Tight Control Really Works

• People with type 2 who aggressively reduced their blood glucose

reduced their risk of blindness and kidney failure by 25%.

• In addition, if they aggressively reduced their blood pressure, their

risk of stroke was reduced by 44% and heart failure by 56%.

Blood Glucose Testing - Basics•What to do with the results ?

Every time you take a reading. Write it down

Keeping a diabetes diary like this will help you fine-tune your glucose control and help you to figure out what’s wrong if your glucose levels go haywire.

Sometimes you might find an unexpected high or low reading. Try to figure out why.

Your reading may be surprisingly high or low for no apparent reason. Keep testing to make sense of your results.

Checklist for a Diabetic

• Blood Pressure - Whenever you visit Doctor

• Blood Sugar, Urine sugar - Daily

• Urine Ketones, proteins (Micral) - Every 6 mths.

• HbA1c - Every 3 months

• Lipids (Cholesterol, Triglycerides) - Every 3-6 mth.

• Daily Foot Examination

• Eye Examination - Every year

• Body Weight

A blood sugar range that works for someone else may not work for you. Ask

your doctor about your best range.

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