What is Diabetes?

When you eat, your body breaks food down into glucose. Glucose is a type of sugar that is your body’s main source of energy.

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What is Diabetes?

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As blood glucose rises, the body sends a signal to the pancreas, which releases insulin.

What is Diabetes?

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Acting as a key, insulin binds to a place on the cell wall, unlocking the cell so glucose can pass into it. There, most of the glucose is used for energy right away.

What is Diabetes?

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Blood glucose goes up and down throughout the day: §  As your blood

glucose rises (after a meal), the

pancreas releases insulin.

What is Diabetes?

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Your cells don’t use insulin properly. The insulin can’t fully “unlock” the cells to allow glucose to enter (insulin resistance). Insulin is either not being made adequately or not used adequately

Your pancreas may not produce enough insulin (insulin deficiency).

TYPE I DIA

BETES

TYPE

II D

IAB

ETES

10% of Canadians

Runs in families, other risk factors unclear

Unpredictable or preventable

Diagnosis in children or teens

Insulin injection is essential

Type I

90% of Canadians

Runs in families, but there are other known risk factors*

Diagnosis often over 40

Insulin is an option but not essential. Disease also managed with diet and exercise

Type II

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Risk Factors for Type II Diabetes…

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§  Overweight (abdominal obesity) §  45 years or older §  Physically inactive §  Have a parent or sibling with type 2

diabetes. §  African or Native or Hispanic

American, or Pacific Islander §  Abnormal cholesterol levels §  Have had diabetes during pregnancy,

or given birth to a baby >9 lbs §  High blood pressure

Classic Symptoms of Diabetes Mellitus

Blurred vision

Fatigue

Hunger

Urinating in the middle of the night

Feeling of thirst

Frequent urination

Weight loss 8

Diagnosing Diabetes

Random blood sugar

•  ≥ 11.1mmol/L •  Plus classic

Symptoms

Fasting blood sugar

•  ≥ 7 mmol/L •  No calorie

intake for 8 hours

2-hours after 75g

sugar load

•  ≥ 11.1 mmol/L 9

Diagnosing Diabetes

10 Less than 5.55 mmol/L normal

5.55 to 6.99 mmol/L pre-diabetes

7 mmol/L or greater diabetes

Fasting plasma glucose test (FPG) results

Normal Pre-diabetes* Diabetes

Blood Sugar Targets for Type I and II Diabetics

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Pre-meal or fasting: 4-7 mmol/L

2 hours post-meal: 5-10mmol/L

(5-8mmol/L if A1C not met)

A1c: ≤7%

ABC’s of Diabetes Management

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A1c

Cholesterol Blood Pressure

HbA1c: the blood test with a memory

Hemoglobin is a protein that makes your red blood cells red-colored.

When hemoglobin picks up glucose from your bloodstream, it becomes ‘glycosylated’ (known as HbA1c). The HbA1c test measures % HbA1c in your blood—a number that corresponds to your average blood glucose for the previous 6 months

A1C is a measurement of your average blood glucose control for the last 2 – 3 months and approximately 50%

of the value comes from the last 30 days. 13

HbA1c and Blood Levels

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Blood Pressure •  The force of your blood against

the blood vessel walls

•  Recommended target for diabetics is ≤130/80 mm Hg

Top number = pressure when your heart contracts and pushes blood out (systolic). Bottom number= pressure when the heart relaxes between beats (diastolic).

High blood pressure means your heart is working too hard. High blood

pressure can lead to Heart Attack, Stroke, and Kidney Disease 14

•  Cholesterol: a fat substance naturally present in your blood and cells. Two main types of cholesterol: LDL and HDL.

•  Triglyceride: a form of fat that the body makes from sugar, alcohol or other food sources

Diabetes and Cholesterol

1. High triglycerides 2. Low HDL (“good”) Cholesterol 3. High LDL (“bad”) cholesterol

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Diabetics have:

LDL (low-density lipoprotein): “bad” cholesterol; increases risk of CV events HDL (high-density lipoprotein): “good” cholesterol; reduces risk of CV events

What’s the deal about SUGAR levels???????

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Diabetes Can Lead to Nerve and Small Blood Vessel Damage

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Pre-Diabetes and prevention

Pre-diabetics can delay/ prevent the development of type 2 diabetes by

making changes in diet & increasing level of physical activity.

It is currently estimated that

6 million Canadians have pre-diabetes!

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Recommendations by CDA •  Canadian Diabetes Association:

Your goal should be to complete at least 150 minutes of moderate- to vigorous- intensity aerobic exercise each week,

(e.g. 30 minutes, 5 days a week).

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Benefits of Physical Activity

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Lose Weight/ maintain body

weight

Lower Risk of Heart Disease

Reduce Risk of Cardiovascular

disease

Blood sugar control

Gain Energy

Improve Well-being

Improve Overall Health

Can’t Exercise?

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•  Pools •  Exercise balls or

exercise bands •  Stationary bikes •  Exercise videos •  Yoga •  Local Recreation

Centers or school facilities •  Walk to grocery store/work

Recommendations by CDA •  Canadian Diabetes Association:

Make positive lifestyle changes, including healthy

eating (according to Canada’s Food Guide)

REDUCE the amount of sugar, fat and sodium in your recipes by one-third to one-half ELIMINATE ingredients that add unnecessary sugar, fat or sodium

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Canadian Diabetes Association

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Managing 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

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Diabetes Self-Management

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Monitoring blood glucose

Taking medication

Following a meal plan

Getting regular exercise

Take Steps to Reduce Risk Factors for Heart Disease

26 If you smoke, quit. Call the Smoker’s Help Line toll-free

support line: 1-866-366-3667, and visit quitsmoking.shoppersdrugmart.ca to get started

Managing Blood Pressure and Cholesterol

² Vegetables and fruits (fresh or frozen without added salt)

² Low-fat (1% or skim) dairy products ² Whole grains (whole wheat breads, cereal, pasta and

brown rice, etc) ² Lean meats and poultry without added salt ² Limit processed foods and take-out ² Unsalted or ‘no added salt’ items (e.g. crackers, nuts) ² Avoid using salt at the table and in cooking

Sodium intake should be no more than 1,500 to 2,300 mg per day. One teaspoon of salt has 2,300 mg of sodium

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Managing Sugar Levels

•  Stick to small portions of sugary foods

•  Consume natural sources of sweets (i.e. fruits)

•  To keep blood sugar from spiking, avoid sweet treats à chew on sugarless gum/candy for cravings!

•  Drink lots of water (replace soda’s)

•  When you reach a healthy weight, which will be easier

to reach blood pressure, cholesterol and blood sugar goals 28

REGULAR BLOOD MONITORING!

•  Self-monitoring is essential

•  Especially important for patients treated with insulin

•  A minimum of 3 blood sugar readings per day should be performed*

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LOW BLOOD SUGAR: EMERGENCY!

Medic Alert bracelet!! Cold, sweaty skin Difficulty concentrating dizziness Blurred vision Fatigue Shakiness, Lack of coordination Irritability nervousness Fainting, unconsciousness

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Getting regular medical care as a Diabetic

Once (repeat at age 65) Pneumococcal vaccine

1 time/year Flu shot

1 time/year Urine microalbumin/ creatinine ratio

2 times/year Dental exam

At least 1 time/year Foot exam

1 time/year Dilated eye exam

At least every other year Cholesterol

At least 2 times/year Blood pressure

2-4 times/year HbA1c

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LB Cinnamon

•  Cinnamon 3000MG

•  60 capsules

•  Promotes healthy glucose levels. No sugar, gluten, lactose or preservatives.

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LB Chromium

•  Chromium - 500mcg

•  100 tablets

•  Provides support for healthy glucose metabolism. No sugar, gluten, lactose or yeast.

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LB No Calorie Sweetener with Sucralose •  100 x 1g

packets

•  Suitable for calorie reduced diets

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LB Fit Management Clearly Fibre •  Daily vitamin and dietary fibre

supplement.

•  Helps the body metabolize fats, carbohydrates and proteins.

•  No sugar added. No fillers, artificial sweeteners or colors.

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2 types of Fibre Soluble Fibre Insoluble Fibre

present in oat bran, oatmeal, legumes (dried beans and lentils) and

fruits such as apples and strawberries

Reduces cholesterol and manages sugar levels

present in wheat bran, whole grain breads and cereals, fruits and

vegetables.

Helps to prevent constipation and some cancers

controls blood glucose increases the feeling of being full manages blood pressure regulates bowel movement reduces blood cholesterol controls weight 36

LB Vitamin A

•  250 capsules

•  helps to maintain eyesight, skin, membranes and immune function.

•  No lactose, sugar, gluten or preservatives.

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LB Healthy Eyes Formula

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•  60 coated tablets

•  For adults over 50

•  Helps to maintain eyesight, skin, membranes and immune function.

•  Helps in development and maintenance of night vision.

FOR MORE INFORMATION

Online Diabetes Information Hubs:

diabetes.ca | 1-800 BANTING shoppersdrugmart.ca/diabetes

healthcanada.ca

Blood Pressure: Hypertension.ca

Smoker’s Help Line toll-free support line:

1-866-366-3667 quitsmoking.shoppersdrugmart.ca

*Health Link BC at 8-1-1 *

Calculate my Diabetes Risk Score J