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Living Well with Diabetes. Lesson 5 Living Well With Diabetes. The Bad News…. People with diabetes are at risk for a variety of problems Problems can develop years after initial diagnosis More likely to have:
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Living Well with Diabetes Lesson 5 Living Well With Diabetes
The Bad News… • People with diabetes are at risk for a variety of problems • Problems can develop years after initial diagnosis • More likely to have: • Heart attack, stroke, eye problems, kidney disease, foot or leg amputation, frequent infections, sexual problems
And The Good News… • Diabetes complications do not have to occur • People with diabetes can live long, healthful and productive lives
Three Keys To Living Well with Diabetes • Education • Early Detection • Regular Doctor/Health Care Team Visits
EDUCATION • Learn as much as you can about diabetes and its complications • How • What • Why
EARLY DETECTION • Learn earliest signs and symptoms of potential problems • Know your lab test results • Keep track of changes
REGULAR OFFICE VISITS • Make regular office visits with your diabetes care team • Set up a 3-month schedule and STICK TO IT! • Contact immediately if you are having problems • Working together = strong prevention team
Keep A Check • Every Office Visit • Blood glucose • Blood pressure • Weight • Review meal plan • Discuss concerns • At least every 3-6 months • A-1-C • At least once a year • Physical exam • Cholesterol • Triglycerides • Microalbumin • Feet exam • Dilated eye exam • Flu shot • Every 5 years • Pneumonia vaccine
Who Should Be On Your Team? • Doctor • Diabetes educator • Dietitian • Pharmacist • Nurse • Foot doctor • Eye doctor • Mental health counselor • Nurse practitioner • Dentist • Social worker • Family and friends
How Do Problems Start? • Blood glucose levels consistently exceed 140 mg/dl • Physiological changes occur and affect organs and body functions • Having high glucose levels for long term leads to complications • Nerve damage, eye damage, kidney disease, dental problems, foot problems, etc.
Take Care of Your Heart • Ask your doctor these questions: • What are my blood glucose, blood pressure and cholesterol numbers? • What should they be? • What actions should I take to reach these goals?
Take Action Now To Reduce Heart Disease • Eat the right amounts of foods for your meal plan • Eat foods prepared with less salt and less fat • Get at least 30 minutes of physical activity every day • Maintain a healthy weight
Take Action Now To Reduce Heart Disease • Stop smoking – seek help • Take medicines the way your doctor tells you to take them • Ask your family and friends to help
Seeing After Your Eyes • Have eyes checked at least once a year • Tell your eye doctor if you: • See spots • See poorly in dim light • Have eye pain • Or any other eye problem
Keeping Your Kidneys Fit • Get yearly screening for microalbumin • Keep blood glucose tightly controlled • Keep blood pressure in check • Avoid medications that can damage kidneys • Say no to nicotine • Go easy on protein • Use preventive medications when needed
Taking Care of Your Tootsies • Wear comfortable shoes and clean, properly fitting thick socks • Wash your feet daily with lukewarm soapy water and dry well, especially between toes • Keep feet soft by using lotion after a bath or shower • Inspect daily cuts, scratches, redness or swelling
Taking Care of Your Tootsies • Call health care provider if wound does not heal • Wear shoes with good support or diabetic shoes, if possible • Never go barefoot, even inside your home • Never, ever, do bathroom surgery on your own feet • See a podiatrist for foot care (surgery, trimming nails, medications)
Don’t Deny Your Dental Care • Brush and floss your teeth daily • Have your teeth cleaned every 3 to 6 months • If you notice any problems, tell your dentist
Your Sick Day Plan • When to call your physician: • Fever • Uncontrolled vomiting or diarrhea • High ketone count • Glucose levels above 240 • Do not know what to do
Things to Do… • Take your medicines for diabetes • Make sure to check blood sugar often • Try to eat and drink according to your meal plan as much as possible • 50 grams carbohydrates every 3-4 hours • Write down blood sugar levels, ketone levels, what you eat and medicines taken!!!
Gatorade Milk Soup Fruit juice Regular soft drinks Crackers Dry toast Cooked cereal Frozen yogurt, sherbet Sugar-free pudding Mashed potatoes Regular pudding Custard Peanut butter Handy Sick Day Foods
4 Basic Steps . . . • Clean • Separate • Cook • Chill
Clean • Wash hands and surfaces often
Separate • Don’t cross-contaminate
Cook • Cook to proper temperatures
Chill • Refrigerate promptly
Making Wise Food Choices • Foods most likely to contain pathogens include: • Uncooked fresh fruits and vegetables • Animal products
Tips for Safe Shopping • Check the “sell by” date. • Put raw meat, poultry or seafood in plastic bags. • Buy only pasteurized milk, cheese, dairy products and juices. • Keep it safe when buying eggs. • Don’t buy food displayed in unsafe or unclean conditions.
Transportation Issues • Pick up perishable foods last. • Follow the “2 hour rule.” • Consider a cooler.
Dining Out • Ask about uncooked ingredients. • Request a safe minimum temperature. • To minimize your risk of getting a foodborne illness it is wise to avoid restaurant buffets. • Keep the “doggy bag” safe.
Uh Oh . . . • Know the symptoms: • Nausea • Vomiting • Diarrhea • Fever
I Don’t Think We’re in Kansas Anymore . . . • Preparing for Emergencies
Before the Storm • Prepare a waterproof insulated emergency kit including standard emergency supplies plus: • At least 3 days of diabetes supplies • Carbohydrate source along with water and food • A list of emergency contacts and medications • Prescription bottles or numbers so you can replace medications at a pharmacy, if needed • Cooler with at least 4 re-freezable gel packs for storing insulin (if you’re using insulin)
Play It Safe • Consider wearing medical identification. • Identify school personnel to help with children. • Wear sturdy shoes. • Pack 2 to 3 days of extra clothing. • Keep immunizations up to date. • Keep your cell phone charged. • Have a plan.
During the Storm • Identify yourself as a person with diabetes. • Drink plenty of water. • Watch what you eat and carry a fast source of sugar with you at all times. • Stick with your testing and medication schedule. • Check your feet!
Plan Ahead • Have a medical exam • Control your ABCs • Ask for prescription and letter explaining medications, supplies and allergies • Acquire medical identification • Learn to say: “I have diabetes” and “sugar or orange juice, please” in the language of the countries if traveling abroad
Plan Ahead • Plan for time zone changes • Find out flight times, and if meals will be served, ask for special meal • Always carry enough food to cover flight time and delays
Travel Preparations • Take twice the amount of medication and supplies you need normally; pack at least half in carry-on bag • Carry-on bag • All the insulin and syringes you will need for trip • Blood and urine testing supplies • Extra batteries for glucose meter • All oral medications • Other medications or medical supplies • Your ID and medical identification • Emergency snacks
Travel Preparations • Keep insulin cool by packing in insulated bag with refrigerated gel packs. • Pack a first-aid kit. • Don’t forget a sharps container. • Notify airport security that you have diabetes. • Have all medications and delivery systems clearly marked with prescription labels intact.
You Can Be Your Own Worst Enemy . . . or Your Own Best Friend
Acceptance of Diagnosis Depression Denial Anger Bargaining Acceptance
Worst Enemies • I’m tired and this is how I relax. • These foods taste good. • I eat more when I am stressed. • I don’t want to think about whether foods are healthful or not. • I don’t want to face my diabetes. • Everyone is nagging me. • I don’t want to worry my family. • It’s too hard to make it to the doctor.
Best Friends • I want to protect my family from losing me. • I am ready to face reality and do something about my diabetes. • I am willing to try something new. • I am willing to take charge and to take action. • I am willing to ask for help. • My family is important to me, and they can help. • I should share what I am feeling with my family.
Are You Ready to Change??? • Precontemplation • Contemplation • Preparation • Action • Maintenance
How Can I Be My Best Friend? • Tell yourselfyou can do it. • Pat yourself on the back for positive changes. • Ask for help when you need it and share your fears. • Seek out positive people. • Believe that you deserve to have a healthy body. • Don’t beat up on yourself. • Don’t let yourself get away with excuses.
How Can I Help My Family Member? • Learn about diabetes. • Understand your loved one’s diabetes. • Find out what your loved one needs. • Talk about your feelings. • Offer practical help. • Try a new approach. • Get help.