Diagnosed With Diabetes, Now What?

Diagnosed with Diabetes, Now What?

Maskwacis Health Diabetes Conference, 2012

Plan for today

 Now what?

 Diabetes management

 Diabetes complications?


NOW WHAT?

 Shock
 Denial
 Relief
 Fear
 Acceptance


Acceptance?
 Management

 Control blood sugar
 Know your blood sugar (test / finger pokes)
 Lifestyle balance
 Medicine if necessary

 Avoid complications

Know your ABC & D’s
A is for A1C!
< or = 7.0%

B is for blood
D is for diet! pressure
Balance
5% weight loss < 130/80

C is for cholesterol
LDL < or = 2.0
HDL > 1.3 for women, > 1.0 for
men


You need a TEAM
Family

Nurse and
Pharmacist YOU dietitian

Doctor


You need to fight High Blood Sugar

Too much food Stress
Not enough activity

Illness

Too little insulin/medication


You need to avoid LOW Blood Sugar

Too LITTLE food Stress
TOO MUCH activity

Illness

Too MUCH insulin/medication


What is Type 2 Diabetes?
How can it be managed?
Leaky Liver Pooped out Cell Resistance
The liver leaks
Lifestyle Pancreas
Lifestyle The cells don’t
Lifestyle
too much The pancreas is not allow insulin to
sugar.mainly
Pills, Blood making enough
Pills, diabeta, bring the sugars
Pills, mainly
sugars rise
metformin diamicron, the
insulin. Or into the cell.
metformin
insulin is too tired
gluconorm, januvia Blood sugars rise.
and not able to
Insulin, the work properly.
Insulin, the Insulin, the
needle needle sugars rise.
Blood needle

Acknowledgement Aboriginal Diabetes Wellness Program

AVOID Complications

High blood sugar can
damage the Blood
Vessels & Nerves

This damage can cause
problems in many parts of
the body: heart, brain,
kidneys, eyes, sex
organs, legs and feet

Blood Vessels Nerves


Diabetes & Blood Vessel
Disease
High Blood Sugar can break down the blood vessel walls
Plaque build up
decreasing
circulation

Blood clot Build up of
blocking plaque,
circulation cholesterol,
fat


Diabetes & Cholesterol

HDL (good cholesterol)

LDL (bad cholesterol)


Diabetes & High Blood
Pressure
 Top number = when the heart Blood Pressure is the measure of
pumps blood into the vessels force on the artery walls
Should be lower than 130

 Bottom number = when the
heart is at rest

Should be lower than 80

 IDEALLY: less than 130/80


Diabetes & Heart Disease
 Angina / chest pain - partial
blockage to the arteries in heart

 Heart Attack / chest pain - total
blockage to arteries in heart

 Peripheral Blood Vessel
Damage - blockage to the small
blood vessels in the legs and
arms


Diabetes & Heart Attack

Signs of Heart Attack
•Shortness of breath
•Cold sweat
•Nausea
•Light-headedness
•Sensation of pressure,
fullness, or pain.
•Pain or discomfort in
one or both arms, the
back, neck, jaw, or
stomach.


Diabetes and Stroke
Stroke: Blocked blood flow to
the brain Stroke
Signs of Stroke
Weakened/diseased
Weakness: Sudden loss or sudden numbness
blood vessels ruptured
in the face, arm or leg, even temporary.

Trouble speaking: Sudden difficulty speaking or
understanding or sudden confusion, even
temporary.

Vision problems: Sudden trouble with vision,
even temporary.

Headache: Sudden severe and unusual
headache. Blood leaks into brain

Dizziness: Sudden loss of balance, especially
with any of the above signs.


Diabetes Heart Disease and Stroke
Prevention
Staying Active and Eating Healthy

 Balanced meals with regular exercise
Blood Pressure monitoring

 Below 130/80
Blood Work

Cholesterol Levels

 Blood fats: LDL, HDL, triglyceride & total cholesterol
 LDL cholesterol can clog the artery walls but can be treated if caught early
A1c:

 Measures average blood sugar levels over 3 months
 It should be measured 4 times a year

Diabetes Heart Disease and
Stroke Prevention
A is for A1C!
< or = 7.0%

B is for blood
Balance

LDL < or = 2.0
men


Diabetes Complications

 Heart attacks and strokes, foot problems

 Nerve damage, foot problems

 Kidney damage


Diabetes and Nerve Damage
 Nerves transmit information
to and from the brain to all parts
of the body

 Nerves provide sensation
such as pain, pressure, hot and
cold.

 Nerves regulate our organs
and sweat glands

 High blood sugars can
damage nerves interrupting the
flow of information to and from
the brain


Diabetes and
Nerve Damage
Nerve Damage can:

 Disrupt the sensation of pain and
pressure causing numbness

 Mix up our feelings of hot/cold

 Affect nerves that control the heart,
regulates blood pressure & controls
blood sugar levels


Diabetes and Nerve Damage


Diabetes and
Nerve Damage Prevention
Foot Exam:
•Remove your shoes & socks for a foot
check at each appointment with your
healthcare provider
•Check your feet daily to prevent problems

Monofilament:
Testing for
sensation


Diabetic Foot Exam
Maskwacis Health Diabetes
Overview
Conference, 2012

Diabetes and
Nerve Damage Prevention
A is for A1C!
< or = 7.0%

B is for blood
Balance

LDL < or = 2.0
men


Diabetes and Kidney Damage
 Your kidneys are filters that clean your blood
 High blood sugars can cause damage to the blood
vessels that supply the kidneys

 If they are damaged, waste and fluids build up in your
blood instead of leaving your body

 Protein can leak out into the urine
 High blood pressure & smoking also contribute


Diabetes Kidney Disease
Prevention
Urine Test: Yearly

Microalbumin:

 Microalbumin measures
small amounts of protein in
the urine

 If you catch the problems
early, they can be treated

 Goal < 2.0


Treatments
Treatments: Medication
 Blood Pressure medications helps reduce
damage to the kidneys


Diabetes and Kidney Disease
management and treatment
A is for A1C!
< or = 7.0%

B is for blood
Balance

LDL < or = 2.0
men


Treatment
Treatments: Dialysis

Peritoneal Dialysis Hemodialysis


Treatment

Treatments: Transplant
 The transplanted kidney takes over
the work of the failed kidneys and
you no longer need dialysis.

 Kidneys can come from live donors
(family) or


Management of
Complications
 Honoring our 4 Bodies: Mind,
Body, Spirit, Emotion

 Healthy Eating, Active Living
 Control blood sugar levels
 Control blood pressure
(check BP with every visit)

 Weight loss
 Regular Dr’s visits for blood
and urine tests and foot
examinations


What is needed for health?

Access to
quality
health care

Self: genetics,
health beliefs, self
esteem, resources

Family and friends

Community leadership

Social determinants of health

Toth 2010

Questions?


Diagnosed With Diabetes, Now What?

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