diabetes sm ppt5

8/9/2019 Diabetes SM Ppt5

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DiabetesDiabetes

Making ChangesMaking Changes

forfor

SelfSelf--ManagementManagement

DebDeb BurlageBurlage,RN, CDE,RN, CDE


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ObjectivesObjectives

Participants will be able to..Participants will be able to..

Discuss Basics of DiabetesDiscuss Basics of DiabetesHow to Impact ChangeHow to Impact Change

Apply Concepts to ExerciseApply Concepts to Exercise


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EpidemicEpidemic

Approximately 17Approximately 17

million people in themillion people in theUS have diabetesUS have diabetes

Another 16 millionAnother 16 millionhave a condition nowhave a condition now

known as preknown as pre--

diabetesdiabetes


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PrevalencePrevalence

The incidence ofThe incidence of

diagnosed diabetes hasdiagnosed diabetes has

increased by 61% sinceincreased by 61% since

1990.1990.

0

2

4

6

8

10

12

1990 1998

3-DColumn 1

DX_DM

UnDx-DM


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Basic Diabetes InformationBasic Diabetes Information

DiabetesDiabetes is a disease in which the bodyis a disease in which the body

doesdoes NotNot produce or properly use insulinproduce or properly use insulin

InsulinInsulin is a hormone that is needed tois a hormone that is needed toconvert sugar, starches and other foodconvert sugar, starches and other foodinto energy needed for daily lifeinto energy needed for daily life

Cause:Cause: Genetics/EnvironmentGenetics/Environment

Sings and SymptomsSings and Symptoms


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Classification of DiabetesClassification of Diabetes

Type 1 diabetes: failure to produce insulinType 1 diabetes: failure to produce insulin

Type 2: results from insulin resistanceType 2: results from insulin resistance

PrePre--diabetes: BS in between normal anddiabetes: BS in between normal andhighhigh

Gestational Diabetes: affects 4 % ofGestational Diabetes: affects 4 % of

pregnant women per yearpregnant women per year


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FPGFPG

126 mg/dl**126 mg/dl**

Symptoms of diabetes and a casualSymptoms of diabetes and a casual

plasma glucoseplasma glucose 200 mg/dl*200 mg/dl*

Current Criteria forDiagnosis of Diabetes


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IFG: 110 mg/IFG: 110 mg/dLdL and < 126and < 126

IGTIGT

Fasting:Fasting:


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ComplicationsComplications

Heart DiseaseHeart Disease

StrokeStrokeHigh Blood PressureHigh Blood Pressure

BlindnessBlindness

Kidney DiseaseKidney Disease

Nervous SystemNervous System

AmputationsAmputations

Dental DiseaseDental Disease


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Cost $$$$$$$$$Cost $$$$$$$$$

2002: 132 Billion2002: 132 Billion

Per Person:Per Person:

IndividualsIndividuals withwithdiabetes: $13,243diabetes: $13,243per yearper year

IndividualsIndividualswithoutwithout diabetesdiabetes::$2,560 per year$2,560 per year


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ABCs of DiabetesABCs of Diabetes

Good NewsGood News

Studies have proven:Studies have proven:DCCT/UKSDCCT/UKS

You Can Make AYou Can Make A

DifferenceDifference


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Standards of CareStandards of Care

ABCsABCsA A1CA A1CB Blood PressureB Blood Pressure

C CholesterolC CholesterolD Diabetes Ed/DentalD Diabetes Ed/Dental

Exam/DietExam/Diet

E Eye Exam/ExerciseE Eye Exam/ExerciseF Foot ExamF Foot ExamG Glucose monitoringG Glucose monitoring

H Heart HealthH Heart HealthI Indications forI Indications forspecialtiesspecialties

K KidneyK Kidney


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Recommended GoalsRecommended Goals

Glycemic controlGlycemic control

A1C


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Change Is HARDChange Is HARDKISSKISS

Knowledge: get theKnowledge: get the

facts!!!facts!!!Individual: set goalsIndividual: set goalsthat arethat are

yours/understandyours/understandBenefits and BarriersBenefits and Barriers

Start with whatStart with what

motivates YOUmotivates YOUSupport: Health careSupport: Health careteam/family/friendsteam/family/friends


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ExampleExample

ExerciseExercise K:K: what do you need to know before youwhat do you need to know before youexerciseexercise

I:I: what works for you (schedules,what works for you (schedules,limitations)limitations)

S:S: start with what motivates you (family,start with what motivates you (family,

friends, hobby, travel..)friends, hobby, travel..) S:S: Find a friend or colleague that willFind a friend or colleague that will

motivate you!!!motivate you!!!


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ExerciseExercise

Exercise can control blood sugars and lower

you risk of heart disease!


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Examples of ExerciseExamples of Exercise

Examples of exercise:Examples of exercise:

Aerobic: Walking, Swimming, Bicycling,Aerobic: Walking, Swimming, Bicycling,Jogging, and SkatingJogging, and Skating

Strength: Weight/ResistanceStrength: Weight/Resistance Flexibility: Yoga, Tai ChiFlexibility: Yoga, Tai Chi


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Three Key Parts To AnyThree Key Parts To Any

Exercise ProgramExercise Program Frequency:Frequency: Exercise at least 3Exercise at least 3--5 days per5 days per

weekweek Intensity:Intensity: This means how hard you workThis means how hard you work

during exercise. You should feel like you areduring exercise. You should feel like you are

working harder than usual but still be able toworking harder than usual but still be able tocarry on a conversationcarry on a conversation

Time:Time: Exercise for at least 20Exercise for at least 20--30 minutes at a30 minutes at a

time (Start out gradual).time (Start out gradual).


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Exercise TipsExercise Tips

Type 1: do not exercise if sugars 300 or ifketonesketones are presentare presentType 2: do not exercise if sugars < 70 orType 2: do not exercise if sugars < 70 or>350>350

Exercise at peak insulin times may causeExercise at peak insulin times may causelow blood sugarslow blood sugars

Exercise can cause low blood sugarsExercise can cause low blood sugarsseveral hours after exerciseseveral hours after exercise

Schedule exercise 45Schedule exercise 45--60 minutes after60 minutes aftereatingeating


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GuidelinesGuidelines

Always check with your physician beforeAlways check with your physician before

beginning any exercise program or if youbeginning any exercise program or if youhave any complications during exercisehave any complications during exercise

Check Blood Sugars before and after exerciseCheck Blood Sugars before and after exercise

Warm up and cool downWarm up and cool down

Wear good shoes and check feet afterWear good shoes and check feet after

exercise for any blisters or signs or irritationexercise for any blisters or signs or irritation


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Further GuidelinesFurther Guidelines

Keep a daily logKeep a daily log

Wear Medical IDWear Medical IDDrink plenty of fluidsDrink plenty of fluids

Exercise with aExercise with a

partnerpartnerModify Caloric IntakeModify Caloric Intake

Carry fast actingCarry fast acting

sugarsugar

Do NOT inject intoDo NOT inject into

area where exercisearea where exerciseis involvedis involved

( )


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Knowledge (continued)Knowledge (continued)BS Type of Exercise Extra Food NeeBS Type of Exercise Extra Food Neededded

No extra foodNo extra foodNo ExerciseNo Exercise> 300 mg/dl> 300 mg/dl

No extra foodNo extra foodNo extra foodNo extra food

15 gms Carb15 gms Carb

LowLowModerateModerate

StrenuousStrenuous

171171--300 mg/dl300 mg/dl

No extra foodNo extra food

15 gms Carb15 gms Carb30 gms Carb30 gms Carb

LowLow

ModerateModerateStrenuousStrenuous

101101--170 mg/dl170 mg/dl




LowLow

ModerateModerate

StrenuousStrenuous

< 100 mg/dl< 100 mg/dl


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Individualize ExerciseIndividualize Exercise

Benefits and Barriers to ExerciseBenefits and Barriers to Exercise

Maybe You are not ready to changeMaybe You are not ready to change

Maybe you are thinking about changeMaybe you are thinking about change This is a good time to think about the benefits,This is a good time to think about the benefits,

the barriers, and becoming more physicallythe barriers, and becoming more physically

active!active!


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Individualize: ProsIndividualize: Pros--Why do youWhy do you

want to changewant to changePhysical ReasonsPhysical Reasons

Emotional ReasonsEmotional Reasons


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Individual Barriers: What isIndividual Barriers: What is

Stopping You???Stopping You???

Physical BarriersPhysical Barriers

Emotional BarriersEmotional Barriers


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Next StepNext Step

Summarize your findingsSummarize your findings

ID benefits you are most excited aboutID benefits you are most excited about ID barriers you feel strongest aboutID barriers you feel strongest about

Ask yourself if you are confident and ready toAsk yourself if you are confident and ready tocommit to changecommit to change

Ask yourself if you are satisfied with statusAsk yourself if you are satisfied with status

quoquo Are you open to learning more?Are you open to learning more?


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Start With What Motivates YouStart With What Motivates You

What is meaningful in your lifeWhat is meaningful in your life

What do you enjoy doingWhat do you enjoy doingWhat are you passionate aboutWhat are you passionate about

What have you always wanted to do?What have you always wanted to do?

So Lets Get startedSo Lets Get started


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SupportSupport

MultiMulti--disciplinary Teamdisciplinary Team

FamilyFamilyFriendsFriends


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Summary for SuccessSummary for Success

KnowledgeKnowledge

IndividualizeIndividualize

StartStart

SupportSupport


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ConclusionConclusion

Life is not simply holding a good handLife is not simply holding a good hand

Life is playing poor hand well.Life is playing poor hand well.--Danish SayingDanish Saying


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Resources/ReferencesResources/References

American Diabetes Association:American Diabetes Association:

www.diabetes.orgwww.diabetes.org

Center for Disease Control:Center for Disease Control:www.cdc.gov/diabeteswww.cdc.gov/diabetes

Clinical Diabetes:Clinical Diabetes:http://clinical.diabetesjournals.http://clinical.diabetesjournals.orgorg

Diabetes is South Dakota:Diabetes is South Dakota:www.www.sddiabetessddiabetes.net.net


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The Gift..The Gift..

diabetes sm ppt5

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