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Instructions & Questions

Instructions & Questions. Here you are able to raise your hand, or request the speaker to speak louder/softer. . This area allows you to comment or ask the presenter questions. . To start a private chat . If you cannot currently hear the audio, please start a private chat with Leah Kaiser.

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Instructions & Questions

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  1. Instructions & Questions Here you are able to raise your hand, or request the speaker to speak louder/softer. This area allows you to comment or ask the presenter questions. To start a private chat If you cannot currently hear the audio, please start a private chat with Leah Kaiser.

  2. Open Mic: Cara Harris NP,CDE Certified Diabetes Educator Wellness Services The OSU Health Plan March 2012

  3. Overview of Diabetes Treatments Prevention Nutrition Exercise Resources Questions Outline

  4. Diabetes Around the World The number of people with diabetes worldwide is expected to increase alarmingly in the coming decades • This increase is projected to occur as a result of: • Population ageing • Unhealthy diet • Obesity • Sedentary lifestyle • Socio-economic realities • Urbanization, and economic development

  5. 2008 1994 2000 2008 1994 2000 No Data <4.5% 4.5-5.9% 6.0-7.4% 7.5-8.9% >9.0% No Data <14.0% 14.0-17.9% 18.0-21.9% 22.0-25.9% >26.0% Obesity and Diabetes Trends in the US Obesity (BMI ≥30 kg/m2) Diabetes CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

  6. Types of Diabetes Type 1: insulin required for survival due to lack of insulin produced by the body – 10% Type 2: most common form of diabetes Occurs when the body cannot properly use the insulin that is produced - or Insulin that is produced is not enough to properly handle bodies needs -90% Gestational: Can occur in pregnant women who do not already have diabetes

  7. INSULIN The Movie http://professional.diabetes.org/UserFiles/Insulin_The%20Movie.wmv

  8. Target Blood Glucose/A1C Level American Diabetes Association 2011 American Association of Clinical Endocrinologists 2011 INDIVIDUALIZE 10

  9. Criteria for Diagnosis of Diabetes Prediabetes2 (IFG or IGT) Impaired Fasting Glucose Diabetes* Normoglycemia • FPG 126 mg/dL • 2-hr PG†200 mg/dL • Symptoms of • diabetes and casual • PG concentration 200 mg/dL • FPG <100 mg/dL • 2-hr PG†<140 mg/dL • IFG: FPG 100 and • <125 mg/dL • IGT: 2-hr PG†140 • and <200 mg/dL • HbA1c >6.5% All PG values in mg/dL= Plasma Glucose *Diagnosis of diabetes must be confirmed on subsequent day by measuring FPG, 2-hr PG, or random PG (if symptoms present). FPG test commonly used because of ease of administration, convenience, acceptability to patients, and lower cost. Fasting=no caloric intake for 8 hr †This test requires glucose load containing equivalent of 75 g anhydrous glucose dissolved in water 1ADA. Diabetes Care. 2007;30(suppl 1)/2011 suppl 34

  10. Diabetes Risk Factors Older age Being overweight Family history of diabetes Lack of physical exercise Everyone should be aware of the risk factors for Type 2 Diabetes • Prior history of gestational diabetes • Race/ethnicity • Stress

  11. Worse abdominal Waist fat

  12. Counting the Costs • The costs add up: • Direct costs to diabetics and their families • Direct costs to healthcare sector • Indirect costs to society • Psychosocial costs III.2

  13. Preventing DiabetesFocus on Risk Factors • Not modifiable • Genetic factors • Family history • Modifiable • Hyperglycemia • Hypertension • Dyslipidemia • Smoking • Obesity • Physical inactivity

  14. What can you do to prevent Diabetes • Be More Active • Watch Less TV/Video • Get up and move • 10,000 steps/day • Eat a balanced Diet • Fresh fruits and veggies • Include carbohydrates, protein and fat • Not recommended to cut out food groups

  15. HEALTHY EATINGDIET AND NUTRITION

  16. Size does make a difference!

  17. Since carbohydrates raise blood glucose the most … … that’s what we focus on most with Diabetic patients

  18. Dietary Components 6 FOOD GROUPS • Starches • Fruits • Milk • Vegetables • Meats • Fats and Sweets NUTRIENTS • Macronutrients (contain calories) • Carbohydrates • Protein • Fat • Micronutrients • Vitamins • Minerals • Alcohol

  19. Examples of Carbohydrates Starches, Cereals & Grains Breads, pasta, rice Starchy Vegetables Beans, legumes, potatoes, corn, peas Fruits & Fruit Juices Dried fruits, fresh fruits Dairy Milk, yogurt, soy milk Sweets & Snacks (smile) Ice cream, cake, cookies, crackers, chips soda, sugar drinks 6 FOOD GROUPS Starches Fruits Milk Vegetables Meats Fats and Sweets

  20. What can I eat if I have diabetes? Eat lots of vegetables and fruits. -Try picking from the rainbow of colors available to maximize variety. Eat non-starchy vegetables spinach, carrots, broccoli, green beans vs. corn, potatoes. Choose whole grain foods over processed grain products. brown rice or whole wheat spaghetti. . Include fish in meals 2-3 times a week. Choose lean meats beef and pork "loin". Remove the skin from chicken and turkey. Choose non-fat dairy skim milk, non-fat yogurt and non-fat cheese. Choose liquid oils for cooking instead of solid fats (high in saturated and trans fats) Remember that fats are high in calories. If you're trying to lose weight, watch your portion sizes of added fats.

  21. KEY MESSAGEMeal Plan for Diabetics Carbohydrates raise blood sugar most Eat 3 balanced meals per day Avoid skipping meals Moderation – Avoid seconds Use a small plate Steam vs. Fry Choose diet drinks or water Encourage not to snack Keep sugar and added fats to a minimum

  22. PHYSICAL ACTIVITYEXERCISE

  23. Diabetes and Lifestyle Lifestyle changes can mean the difference between developing diabetes or not • Sedentary living, unhealthy dietary patterns, obesity, lack of exercise and socio-economic pressures all contribute to the development of diabetes • Make a commitment to a healthy lifestyle and you will not only reduce the risk of developing type 2 diabetes, but will also enjoy a much better quality of life!

  24. Exercise Recommendations for general public: • All adults should accumulate at least 30 minutes of at least moderate intensity physical activity each day • Equivalent to walking about 1.5 miles at a pace of 3-4 mph (brisk walk) • More exercise and perhaps more strenuous exercise may produce additional health benefits • Resistance and flexibility exercises provides health benefits

  25. Flexibility training (stretching) may be included as part of a PA program, although it should not substitute for other training. Older adults increasing joint range of motion (ROM) reducing risk of injury

  26. At least twice weekly on nonconsecutive days Ideally three times a week as part of a PA program for individuals with T2DM 30 - 60 minutes Minimally include 5-10 exercises major muscle groups (upper & lower body, with regular aerobic activities.

  27. Suggestions on Activity 1. Scheduled physical activity a. Walking, treadmill, jogging, walking dog b. Swimming, biking, volleyball c. Resistant training and stretching 2. Lifestyle physical activity a. Walk more stairs at work, walking for errands, parking farther away in parking lots b. Housework, gardening

  28. DiabetesSummary and Resources

  29. Diabetes and Lifestyle A healthy lifestyle, like everything else in diabetes, is essentially about balance • A healthy lifestyle means combining a balanced diet with regular physical activity for good blood glucose control • Everyone with diabetes has the potential to lead a normal and active life by learning to manage their condition III.16

  30. RESOURCES OSUMC DRC EDUCATION CLASSES Group & individual education for Type 1 diabetes, Type 2 diabetes, and pre-diabetes. Diabetes Technology Classes on insulin pumps and continuous glucose monitors. To attend a diabetes class call (614) 292-3800 RESEARCH STUDIES The Diabetes Research Center is actively recruiting for the following studies/trials: TECOSStudy: age 50 or older, diagnosis of type 2 diabetes and heart disease SPRINTTrial: age 50 or older,diagnosis of high blood pressure, no stroke or diabetes. To see if you qualify for a research study call 1-(800)-678-6156

  31. SUPPORT GROUP Meetings are held every third Tuesday of the month from 6:00-7:00pm. Located at Care Point East, Diabetes Research Center, 543 Taylor Ave, Room 3053. WEB-BASED COMMUNICATION Like our Facebook Page! “Diabetes Research Center at Ohio State” Learn more at www.diabetesresearch.osu.edu/patientcare/classes/index.com RESOURCES

  32. OTHER RESOURCES • The Learn Program for Weight Management and Nutrition • Ohio State’s Center for Wellness and Prevention is offering group personal training sessions • Cardiac or Pulmonary Rehab Programs • Referral Questions 293-5123 • Updated physician referral guides: medicalcenter.osu.edu/referringphysicians • Or guides from Physician Relations 293-4326

  33. Thank you, Thank you very much Cara Harris NP,CDE Cara.Harris@osumc.edu

  34. Interested In Learning More??? Call (614)292-4700 TODAY to learn more about Care Coordination or Health Coaching!

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