A research project on the health barriers affecting people living in low socioeconomic status in Pontiac, MI, led my colleague, Markia Jones, RN BSN, and I to develop this utilization tool. This is a booklet we created to promote diabetes awareness, discuss complications of the disease and offer resources for those living in Pontiac, MI.

1. +
Diabetes &
Me
+
What is diabetes anyway?
Diabetes is a disease characterized by too much sugar in the blood.
Normally the hormone, insulin, carries the glucose to all the body’s
cells to create energy. In Type 2 Diabetes, the insulin is either not
functioning properly or at all. The high levels of sugar left in the
blood can starve your body’s cells from energy. Uncontrolled
diabetes can damage your eyes, kidneys, nerves, and blood vessels.
Diabetes can also lead to a premature death.

2. + I have diabetes.
So what does this really mean?
Diabetes is a disease in which glucose (or very dangerous. Monitoring your blood sugar
sugar) is not properly broken down by the with a home blood glucose (sugar) monitor is
body. There are two main types of diabetes. important if you have diabetes so you can
They are called Type 1 Diabetes and Type 2 avoid dangerous, and even life-threatening
Diabetes. More than 90% of people with the high or low blood sugar levels.
disease have Type 2 Diabetes. This booklet
Low blood sugar (less than 70 mg/dL) can
will focus on Type 2 Diabetes and what you
cause sweating, nervousness, shakiness,
can do to live a long, healthy life.
weakness and hunger. When this occurs, you
In Type 2 Diabetes, the pancreas produces must act quickly to raise your blood sugar.
insulin but the body’s cells do not use the Try drinking a cup of fruit juice or a regular
insulin properly. This is called insulin soda. When you are starting to feel better,
resistance. Type 2 Diabetes can be controlled follow up with a bowl of cereal or some
with proper diet and exercise, sometimes crackers and milk.
combined with medications or insulin
High blood sugar (greater than 130 mg/dL)
injections.
can cause increased thirst and urination,
Normal blood sugar ranges between 70-130 nausea, vomiting and confusion. If you have
mg/dL before meals. Blood sugar that is too these symptoms, check your blood sugar. Get
low is called hypoglycemia. Blood sugar that is emergency care if you have difficulty
too high is called hyperglycemia. Both can be breathing.
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3. I feel fine now.
How can diabetes
affect my life
later?
Not all people experience the symptoms of diabetes.
In fact, lots of people who have diabetes don’t even
know it because they do not feel any different. It is
important to know that even if you feel fine, you still
must manage diabetes through diet, exercise and
medications, if prescribed. It is also necessary to
check your blood sugar regularly. Uncontrolled
diabetes can lead to serious complications.
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4. +
Complications in Diabetes
High blood glucose (or blood sugar) can damage many parts of the body, such as the heart, blood vessels, eyes,
and kidneys. By keeping your blood sugar within normal ranges, you can prevent complications of diabetes.
Infection
People with diabetes are at higher risk of getting infections. High blood sugar causes
high levels of sugar in your body’s tissues. Bacteria thrive in areas that have sugar
and infections result because of this. The body’s defense system is also decreased in
people with diabetes. The most common places for infection are your bladder,
kidneys, vagina, gums, feet and skin. Early treatment of infections can prevent more
serious complications. The diabetic person should treat even a small cut seriously.
Neuropathy
Neuropathy is a type of nerve damage that in diabetics tend to be in the arms, legs,
hands and feet. Neuropathy can feel like pins and needles, tingling, burning,
stabbing or shooting pain. A loss of sensation to touch or temperature may also
occur. Complications may result from not being able to feel pressure or injury to the
feet. Blisters and sores may go unnoticed because diabetics are unable to feel them.
Infections in the feet can get so serious that an amputation may be necessary.
Heart and Blood Vessel Disease (or Cardiovascular Disease)
Cardiovascular disease (CVD) is a disease of the heart and blood vessels in which the
vessels can get hardened or clogged. The diseased vessels can lead to heart attacks
and strokes. People with diabetes are four times more likely to get cardiovascular
disease than non-diabetics. This is the number one killer of people with diabetes.
Diabetes can also lead to heart failure, peripheral arterial disease or cerebral
vascular disease. A doctor or nurse can help you prevent symptoms of CVD.
Kidney Failure
Your kidneys work as filters to clean your blood and flush out wastes. High blood
sugar and high blood pressure can damage the filters in your kidneys. There is no
cure to kidney failure. Over time, the damage to the filters may get so bad that your
kidneys may fail at doing their job. You may have to have a special machine clean
your blood for you through a process called dialysis. Sometimes a kidney transplant
may be necessary. Blood sugar control can help prevent kidney failure.
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5. +
Complications in Diabetes
By keeping your blood sugar within normal ranges, you can avoid long-term complications of diabetes.
Sexual Dysfunction
People with diabetes can develop sexual problems due to damage to the nerves and
blood vessels in sexual organs. Sexual dysfunction can happen to men and women
alike. In men, erectile dysfunction, or the inability to have an erection may occur.
Men may also experience retrograde ejaculation, a dysfunction where the semen
goes into the bladder instead of ejaculated out of the penis. Women may experience
decreased sexual excitement or inability to become aroused.
Diabetic Retinopathy
Diabetic retinopathy is a disease of the eyes. The high amounts of sugar in the blood
damage the tiny blood vessels in the eyes. Diabetic retinopathy is the leading cause
of blindness in adults. The longer you have diabetes, the higher your risk is for
developing retinopathy. Symptoms include seeing spots or floaters in your vision,
having blurred vision, having dark or empty spots in the center of your vision or
difficulty seeing well at night.
Depression
Everyone feels down once in a while. But when life seems hopeless and that feeling
won’t go away for more than two weeks, you may be experiencing depression. The
daily stress of managing diabetes may overwhelm you at times. Or the symptoms of
complications related to diabetes may become very bothersome to you. If you start
feeling depressed, talk to your doctor or nurse about it. Counseling, antidepressants
or a combination of the two may be the solution to help you through difficult times.
Oral Health
People who have diabetes have a higher risk of getting oral infections due to high
blood sugar. Bacteria thrive in tissues that have high amounts of sugar and can cause
infections. Sometimes these infections get so bad that you can loose your teeth.
People with uncontrolled diabetes may develop bleeding and sore gums. This can
further develop into an infection called periodontitis. If you notice red, swollen, or
painful gums, it is a good idea to see a dentist to prevent worsening oral health.
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6. + The diabetic diet
Tastes great!
The key to a diabetic diet is controlling your types of foods will make a diabetic condition
blood sugar levels. The best way to control worse. If buying fresh fruits and vegetables is
blood sugar levels is by eating a wide variety too expensive of an option for you, rinse
of fruits and vegetables. canned and frozen foods before cooking them
to reduce the salt level.
Another goal of a diabetic diet is consistency.
Try keeping a regular schedule of what and When planning a diabetic diet, it is important
when you eat by eating meals and snacks at to consider the sources of carbohydrates,
the same time every day. The meals should be proteins, and fats. Carbohydrates have the
at four to five hour intervals, and it is important greatest impact on blood sugar levels.
not to skip meals. Including quality carbohydrate options like
whole grain toast, apples, or corn on the cob at
The most important aspect of the diabetic diet
each meal will help maintain proper blood
is making proper decisions when selecting
sugar levels. Simple carbohydrates increase
foods. The best choices are fresh fruits,
blood sugar. Lean proteins should be paired
vegetables, and whole grains. These options
with a variety of fruits and vegetables. Fats
should be a cornerstone of your daily meal
should be limited to only good fats like olive
planning and should be accompanied by foods
oil.
with less sugar, less fat, and less salt. Foods
high in sugar, fat, and salt are leading causes It is important to limit the amounts of sweets
in the development of diabetes. And, these you have and have portion control in all meals.
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7. + Exercise
Lots of opportunities right here in Pontiac!
No matter where you live in Pontiac, you Another great, low cost way to make Other recreational opportunities abound
are near free or low cost outdoor exercise fun is playing a round of golf at in Pontiac. Walking and jogging can
exercise opportunities. Pontiac has 14 Pontiac Municipal Golf Course. The golf occur anywhere. If you want to keep
city parks and a municipal golf course. course is located on Golf Drive just 1/8 track of the distance you walk try the
mile east of Telegraph Road. The course track at Wisner Memorial Stadium.
Pontiac parks come in all sizes. From
offers a wonderful day walking through Located on Cesar E. Chavez Avenue, just
small neighborhood parks, like
wetlands, ponds, wooded areas, and northwest of downtown, Wisner Memorial
Richardson Park near downtown, to large
along the shore of Crystal Lake. This Stadium has a full outdoor athletic track
wooded parks, such as Hawthorn Park.
municipal course offers very low cost open to the public.
All parks offer outdoor recreation
exercise to Pontiac residents.
possibilities including walking, cycling, Another great opportunity is the Clinton
jogging, or playing with children or Golf offers great exercise. A round of golf River Trail. The trail crosses Pontiac as
grandchildren. can include as much as four miles of part of a 16-mile trail network crossing
walking. In order to increase the health several southeast Michigan cities.
Try taking a walk through Beaudette
benefit of golf, you should walk the
Park. Beaudette Park is located off of One of the best ways to add exercise into
course while carrying or pulling your
Orchard Lake Road on River Bank Drive. your life is to walk your own
clubs. A recent study by the Rose Center
Beaudette Park is home to Dawsons Mill neighborhood. Walking where you live
for Health and Sports Sciences found that
Pond, which is part of the Clinton River. A does not just provide quality exercise,
a golfer who walks a nine hole course can
relaxing stroll by the pond is a great form but allows you to better know your
burn up 721 calories and 36 holes a week
of exercise. neighbors.
burns up to nearly 3,000 calories.
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8. Guidelines for checkups
When to see my doctor or nurse
In addition to eating a healthy diet and exercising In addition to getting your blood levels checked, it is
regularly, it is important to follow up with a health care important for you to get routine physical examinations,
professional. Following the ABCs of Diabetes can eye care and foot care done by your doctor or nurse.
significantly reduce the chances of preventing or
Your health care provider may refer you to see a
delaying the complications of diabetes.
special eye doctor called an ophthalmologist. The
A: Hemoglobin A1C – This is a type of blood test that ophthalmologist will assess your eyes by checking to
tests your blood sugar over time. Get this tested once a see how far and well you can see. You may get special
year. A good goal is to keep this level under 7%. eye drops during the exam to better assess for eye
problems.
B: Blood Pressure – Get your blood pressure checked
every time you go to the clinic. Your blood pressure Foot care involves careful examination by a doctor or
should be around 130/80. Talk to your health care nurse to check for any cuts, wounds or nerve pain that
provider about achieving a healthy blood pressure with accompanies diabetes.
medications if diet and exercise does not reduce your
The best way to avoid complications of diabetes is to
blood pressure.
maintain a normal blood sugar through a proper diet,
C: Cholesterol – Check this blood level once a year. regular exercise and by following a personalized plan
Your LDL or “bad” cholesterol should be less than 100. recommended to you by a doctor or nurse.
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9. Local resources for diabetes Diabetes
+ care, medications, & supplies
Care in
Pontiac
Medical & Dental Care Health Insurance Assistance
Diabetes Self-Care Management Program Oakland County Dept. of Human Services
St. Joseph Mercy Hospital S
Saginaw Street District
44405 Woodward Ave 235 N. Saginaw Pontiac MI 48342
Pontiac, MI 48341 248-975-5200
248-858-6653 Ask about eligibility for:
• Supplemental Security Income
Oakland Primary Health Services • Aged, Blind, Disabled program
1701 Baldwin Road • MIChoice
Suite 101 • Medicare Savings Program
Pontiac, MI 48340 • Adult Medical Program
248-332-6747 • Low Income Families
• Special N Support
Gary Burnstein Community Clinic
• Transitional Medical Assistance
90 West University Drive
Pontiac, MI 48342
Prescription Assistance
248-758-6090
Mi Rx Discount Card
Call 1-800-755-6479 for application
Mercy Place Clinic
(Then press 2, then 1)
55 Clinton Street
Pontiac, MI 48342
Partnership for Prescription Assistance MI
248-333-0978
*Must use online application at:
www.pparx.org
Oakland County Health Division
Dental Program County Service Center
Diabetic Supplies
1200 North Telegraph Road, Building 36
American Medical Services
Pontiac, MI 48341
825 W. Huron St.
248-858-1306
Pontiac, MI 48341
248-332-6688
Father Pops Clinic
*Offers free diabetic testing supplies with
400 South Blvd W
most insurance programs along with free in-
Pontiac, MI 48341
home training and support from a diabetic
248-334-2126
specialist.
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10. +
Remember, a proper
diet, regular exercise,
& routine blood sugar
monitoring is key to
maintaining a healthy
life with diabetes.
Created by:
Markia Jones, BSN, RN
Karishma Guha, BSN, RN