Living Well With Diabetes

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Living Well with Diabetes
Lesson 5 Living Well With Diabetes
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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

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And The Good News

• Diabetes complications do not have to occur
• People with diabetes can live long, healthful and
  productive lives

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Three Keys To Living Well with Diabetes

• Education
• Early Detection
• Regular Doctor/Health Care Team Visits

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EDUCATION

• Learn as much as you can about diabetes and its
  complications
• How
• What
• Why

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EARLY DETECTION

• Learn earliest signs and symptoms of potential
  problems
• Know your lab test results
• Keep track of changes

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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

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Keep A Check

• At least once a year
• Physical exam
• Cholesterol
• Triglycerides
• Microalbumin
• Feet exam
• Dilated eye exam
• Flu shot
• Every 5 years
• Pneumonia vaccine

• Every Office Visit
• Blood glucose
• Blood pressure
• Weight
• Review meal plan
• Discuss concerns
• At least every 3-6 months
• A-1-C

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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

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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.

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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?

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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

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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

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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

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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

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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

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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)

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Dont 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

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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

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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!!!

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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

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Be Food Safe
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4 Basic Steps . . .

• Clean
• Separate
• Cook
• Chill

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Clean

• Wash hands and surfaces often

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Separate

• Dont cross-contaminate

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Cook

• Cook to proper temperatures

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Chill

• Refrigerate promptly

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Making Wise Food Choices

• Foods most likely to contain pathogens include
• Uncooked fresh fruits and vegetables
• Animal products

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Type of Food Higher Risk Lower Risk
Meat, Poultry Seafood Raw or undercooked Cooked to safe temperature
Milk Unpasteurized Pasteurized
Eggs Raw or undercooked Pasteurized
Sprouts Raw Cooked
Vegetables/Fruits Unwashed Washed
Cheese Soft Hard/processed/pasteurized
Hot Dogs/Deli Meats Not reheated Reheated
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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.
• Dont buy food displayed in unsafe or unclean
  conditions.

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Transportation Issues

• Pick up perishable foods last.
• Follow the 2 hour rule.
• Consider a cooler.

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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.

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Uh Oh . . .

• Know the symptoms
• Nausea
• Vomiting
• Diarrhea
• Fever

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I Dont Think Were in Kansas Anymore . . .

• Preparing for Emergencies

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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 youre using insulin)

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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.

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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!

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Have Diabetes. Will Travel.
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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

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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

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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

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Travel Preparations

• Keep insulin cool by packing in insulated bag
  with refrigerated gel packs.
• Pack a first-aid kit.
• Dont forget a sharps container.
• Notify airport security that you have diabetes.
• Have all medications and delivery systems clearly
  marked with prescription labels intact.

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You Can Be Your Own Worst Enemy . . .

• or Your Own Best Friend

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Acceptance of Diagnosis
Depression
Denial
Anger
Bargaining
Acceptance
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Worst Enemies

• Im tired and this is how I relax.
• These foods taste good.
• I eat more when I am stressed.
• I dont want to think about whether foods are
  healthful or not.
• I dont want to face my diabetes.
• Everyone is nagging me.
• I dont want to worry my family.
• Its too hard to make it to the doctor.

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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.

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Are You Ready to Change???

• Precontemplation
• Contemplation
• Preparation
• Action
• Maintenance

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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.
• Dont beat up on yourself.
• Dont let yourself get away with excuses.

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How Can I Help My Family Member?

• Learn about diabetes.
• Understand your loved ones diabetes.
• Find out what your loved one needs.
• Talk about your feelings.
• Offer practical help.
• Try a new approach.
• Get help.

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Diabetes Does Not Control Me

• I Control My Diabetes

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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 Agricultures Food Safety and
  Inspection Service
• Diabetes Prevention and Control Program
• Journey for ControlAdvancing Diabetes Education
  by Merck and Company

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Living Well With Diabetes
Prepared By Terri Crawford, Extension Agent,
Nutrition, Northeast Region Cathy Agan,
Extension Agent, FNP Ouachita Parish