Living Well with Diabetes Lesson 5 Living Well With Diabetes.

Living Well with DiabetesLiving Well with Diabetes

Lesson 5Lesson 5Living Well With DiabetesLiving 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!!!

Handy Sick Day Foods

• 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

Be Food Safe

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

Type of Food Higher Risk Lower RiskMeat, Poultry & Seafood

Raw or undercooked

Cooked to safe temperature

Milk Unpasteurized PasteurizedEggs Raw or

undercookedPasteurized

Sprouts Raw CookedVegetables/Fruits Unwashed WashedCheese Soft Hard/

processed/pasteurized

Hot Dogs/Deli Meats

Not reheated Reheated

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!

Have Diabetes. Will Travel.

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

Denial Depression

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 yourself you 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.

Diabetes Does Not Control Me

I Control My Diabetes

References• American Diabetes Association • National Diabetes Education Program• The Diabetic Bible by Dana Armstrong and Allen Bennett

King• Diabetes Life Lines – The University of Georgia Cooperative

Extension• U. S. Food and Drug Administration• U. S. Department of Agriculture’s Food Safety and Inspection

Service• Diabetes Prevention and Control Program• Journey for Control…Advancing Diabetes Education by

Merck and Company

Living Well With DiabetesLiving Well With Diabetes

Prepared By:

Terri Crawford, Extension Agent, Nutrition, Northeast Region

Cathy Agan, Extension Agent, FNPOuachita Parish