Diabetes General


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All diabetics do not develop complications. If the blood sugar levels are carefully controlled, in both Types 1 and 2 diabetes, complications may never develop. But in order to achieve this, lifestyle changes that are consistently maintained are also necessary.

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  • 29/07/09 Diabetes Action Group - 084 228 0993
  • 29/07/09 Diabetes Action Group - 084 228 0993
  • Diabetes General

    1. 1. DIABETES <ul><li>Presented by Sue Frye- DIABETES ACTION </li></ul><ul><li>084 228 0993 </li></ul><ul><li>Managing Diabetes </li></ul>Sue Frye - 084 228 0993
    2. 2. Chronic disease & wellness <ul><li>All diabetics do not develop complications. If the blood sugar levels are carefully controlled, in both Types 1 and 2 diabetes, complications may never develop. But in order to achieve this, lifestyle changes that are consistently maintained are also necessary. </li></ul><ul><li>Potential to increase productivity </li></ul><ul><li>Wellness programmes </li></ul><ul><li>Challenges in implementation </li></ul><ul><li>Imbibe a culture of health & wellness </li></ul>Sue Frye - 084 228 0993
    3. 3. The Global Challenge of Chronic Disease <ul><li>Chronic diseases caused approximately 60% of deaths worldwide in 2006 – wear a MedicAlert bracelet – speaks for you when you cannot </li></ul><ul><li>These included HIV/Aids, cancer, chronic respiratory diseases, diabetes with the resultant cardiovascular disease (stroke & heart disease); amputations; dialysis and blindness. </li></ul><ul><li>Deaths from chronic diseases will increase by 17% over the next 10 years, from 35 million to 41 million. </li></ul><ul><li>Only 3% of health expenditure was directed at prevention and public health in 2004 – prevention is not adequately financed. </li></ul>Sue Frye - 084 228 0993
    4. 4. Trend in deaths from chronic and communicable diseases from 2005 to 2030 <ul><li>Communicable diseases Chronic diseases </li></ul>Sue Frye - 084 228 0993
    5. 5. AGE IS NOT A FACTOR <ul><li>Chronic disease is not simply an issue for older generations. </li></ul><ul><li>Almost half of the people who die from chronic diseases are younger than 60 years </li></ul><ul><li>We are also reaching pandemic proportions amongst our young people!! </li></ul>Sue Frye - 084 228 0993
    6. 6. Causes and the economic cost of chronic disease <ul><li>The most important modifiable risk factors are poor diet , inadequate physical activity and tobacco use . </li></ul><ul><li>It is projected that 388 million people will die, worldwide, from chronic disease in the next 10 years. WHO estimates that 36 million of these deaths could be averted. </li></ul><ul><li>By 2025 Diabetes could be the first non-communicable disease to cause a negative growth rate. </li></ul><ul><li>This converts into millions of Rands annually </li></ul>Sue Frye - 084 228 0993
    7. 7. PREVENTION RATHER THAN CURE <ul><li>Helping to prevent a chronic disease such as diabetes requires the following : </li></ul><ul><li>A change in behaviour </li></ul><ul><li>Taking responsibility for your health </li></ul><ul><li>Eating a healthier diet </li></ul><ul><li>More exercise </li></ul><ul><li>There are no ‘quick fixes’ – a Russian Roulette approach!! </li></ul><ul><li>Individuals have the ultimate responsibility for ensuring they do not suffer from the risk factors – BUT given the right environment, incentives and tools they can be helped ! </li></ul>Sue Frye - 084 228 0993
    8. 8. PREVENTATION RATHER THAN CURE <ul><li>Therefore aim for programmes and strategies to tackle these areas </li></ul><ul><li>Extend these strategies to your home </li></ul>Sue Frye - 084 228 0993
    9. 9. The impact on the workplace <ul><li>It is absolutely vital that everyone is made aware of the symptoms of diabetes; </li></ul><ul><li>Regular blood sugar monitoring, together with BP and Cholesterol monitoring – the ‘Devil’s Triangle’ = ► ☻ ◄ </li></ul><ul><li>If higher than normal blood sugar levels are noted, >9% mm ℓ the person should be sent for immediate further investigation . An HbA ¹c should be conducted if there is any doubt. </li></ul>Sue Frye - 084 228 0993
    10. 10. Main symptoms of Diabetes Sue Frye - 084 228 0993 <ul><ul><li>Tired and listless </li></ul></ul><ul><ul><li>Frequent urination </li></ul></ul><ul><ul><li>Thirsty </li></ul></ul><ul><ul><li>Hungry </li></ul></ul><ul><ul><li>Mood swings </li></ul></ul><ul><ul><li>Sores and bruises that take longer to heal </li></ul></ul><ul><ul><li>Constipation </li></ul></ul><ul><ul><li>Diarrhoea </li></ul></ul><ul><ul><li>Erectile Dysfunction </li></ul></ul><ul><ul><li>Difficulty in conceiving </li></ul></ul>
    11. 11. What is Diabetes? <ul><li>Diabetes is a condition in which the body is unable to use sugar correctly. </li></ul><ul><li>Our body cells need to provide energy for living – just as a car needs petrol! </li></ul><ul><li>Our fuel comes from the food we eat, which is digested in the stomach and flows into the blood stream as glucose , a form of sugar; </li></ul><ul><li>To get into the body cells, the glucose needs the assistance of a hormone, called INSULIN . </li></ul><ul><li>Normally the pancreas makes the insulin which carries the glucose in the blood into the cells. In diabetes the pancreas fails to supply enough insulin, or the insulin does not work properly. </li></ul><ul><li>When the body cannot utilise the glucose in the food, sugar levels start rising and medical intervention is necessary. </li></ul>Sue Frye - 084 228 0993
    12. 12. Sue Frye - 084 228 0993  
    13. 13. Sue Frye - 084 228 0993
    14. 14. Trends in Diabetes Prevalence <ul><li>The number of people with diabetes has increased frighteningly during the past 20 years. </li></ul><ul><li>According to WHO – the number of people worldwide with diabetes increased from 30 million in 1985 to 171 million in 2000. We are currently standing at 16% above the predicted global rate of diabetes for the year 2010 – where will we be by then? </li></ul><ul><li>WHO has predicted that the global diabetes prevalence in adults will reach 6.4% by 2030, representing a 60% increase since 1995 and a 39% rise from 2000 to 2030. </li></ul><ul><li>Type 2 – previously known as “adult onset” diabetes – now found in children as young as 6 years. REASON FOR THIS is the change in diet and lack of exercise. Obesity due to bad eating habits – take away foods and lack of exercise. </li></ul>Sue Frye - 084 228 0993
    15. 15. Benefits of taking control <ul><li>Outcomes </li></ul><ul><li>BP reduction/control </li></ul><ul><li>Reduction in Cholesterol levels </li></ul><ul><li>Hba1C [%<9] </li></ul><ul><li>Reduced Stroke/heart attack rate </li></ul><ul><li>Reduced Amputation rate </li></ul><ul><li>Reduced Dialysis rate </li></ul><ul><li>Reduced Blindness rate </li></ul><ul><li>Reduced Impotence rate </li></ul>Sue Frye - 084 228 0993
    16. 16. Diabetes Action Sue Frye - 084 228 0993 Type 1 Occurs when the pancreas stops producing insulin. It usually starts in young people and may occur very suddenly. As Insulin is a hormone it must be injected Type 2 Is caused when the insulin which the pancreas produces is either not sufficient or does not work properly. Many people with Type 2 Diabetes are undiagnosed and it is during this time that the complications start. MANAGING YOUR DIABETES The goal of diabetes management is to bring your blood sugar levels to between 5.5 & 7.00 mm/l. There is no such thing as a ‘diabetic diet’ – only a healthy way of living. This is why the ‘team’ of dietician, diabetic educator, ophthalmologist, podiatrist and psychologist are vital.
    17. 17. EDUCATING FRIENDS & FAMILY <ul><li>Once a person has been diagnosed with Diabetes it is vital that friends & family, are educated to recognise the signs and symptoms of a sugar ‘low’ hypoglycaemia or a ‘high’ hyperglycaemia and how to assist. </li></ul><ul><li>Everybody responds differently to illness but a person with diabetes usually has a more severe reaction. The ‘patient’ should be closely monitored. </li></ul><ul><li>Always keep a note of emergency numbers of the person suffering with Diabetes. </li></ul><ul><li>Diabetes is like a marriage – “for better or worse, till death do us part” and yet marriage, in most cases is wonderful – nothing to be scared of!! </li></ul>Sue Frye - 084 228 0993
    18. 18. Sue Frye - 084 228 0993 <ul><ul><li>There are more people dying of diabetes complications than AIDS </li></ul></ul><ul><ul><li>Every 10 seconds a person dies from diabetes-related causes. </li></ul></ul><ul><ul><li>Every 10 seconds two people develop diabetes. </li></ul></ul><ul><ul><li>Every 3 seconds a lower limb is amputated worldwide. </li></ul></ul><ul><ul><li>Diabetes is the fourth leading cause of global death by disease. </li></ul></ul><ul><ul><li>At least 50% of all people with diabetes are unaware of their condition. In some countries this figure may reach 80%. </li></ul></ul><ul><ul><li>Up to 80% of type 2 diabetes is preventable by adopting a healthy diet and increasing physical activity . </li></ul></ul><ul><ul><li>Diabetes is the largest cause of kidney failure and blindness  </li></ul></ul><ul><ul><li>People with type 2 diabetes are over twice as likely to have a heart attack or stroke </li></ul></ul><ul><ul><li>Cardiovascular disease is the major cause of death in diabetes, accounting for some 55% of all diabetes fatalities </li></ul></ul><ul><ul><li>All damage caused by elevated blood glucose levels is not reversible </li></ul></ul><ul><ul><li>People with diabetes face the near certainty of premature death. </li></ul></ul><ul><ul><li>95% of Diabetics are type 2 :  90% of the complications are in type 2 diabetics </li></ul></ul>
    19. 19. CONTROL IS POSSIBLE <ul><li>In human and economic terms, diabetes is one of our most costly diseases and threatens to become the greatest public health problem of the modern era. A well controlled person with diabetes is a person who is a vital cog in the wheel of industry. </li></ul><ul><li>For every 1% a person’s HbA ¹c IS LOWERED the following results occur: </li></ul><ul><ul><li>Deaths are reduced by 21% </li></ul></ul><ul><ul><li>Heart attacks are reduced by 14% </li></ul></ul><ul><ul><li>Microvascular Complications by 37% </li></ul></ul><ul><ul><li>(kidneys & eyes) </li></ul></ul><ul><ul><li>Peripheral vascular disorders 43% </li></ul></ul><ul><ul><li>LET US FIGHT TOGETHER FOR A BETTER WORLD FOR OUR PEOPLE SUFFERING WITH DIABETES. THERE IS NO SUCH THING AS MILD DIABETES! </li></ul></ul>Sue Frye - 084 228 0993
    20. 20. DIET – No such thing as a Diabetic Diet, just a healthy way of eating Sue Frye - 084 228 0993
    21. 21. CARDIOVASCULAR DISEASE The Diabetic Scenario <ul><li>More than 65% of people with diabetes die from heart disease & stroke </li></ul><ul><li>With diabetes, heart attacks occur earlier in life & often result in death </li></ul><ul><li>Nearly all people with diabetes have abnormal cholesterol levels which contribute to their increased risk for heart attack & stroke </li></ul><ul><li>Approx. 73% of adults with diabetes have BP of ≥ 130/80 mmHg </li></ul>Sue Frye - 084 228 0993
    22. 22. CHECK BLOOD CHOLESTEROL LEVELS REGULARLY <ul><li>Cholesterol is a soft, fatty substance found in every cell of our body. </li></ul><ul><li>We acquire Cholesterol in 2 ways – we make it ourselves in our liver & we get it from the food we eat. </li></ul><ul><li>Cholesterol plays a vital role in the day to day functioning of our bodies. </li></ul><ul><li>It cannot travel around on its own because it will not dissolve in water. Instead it is transported as part of structures called lipoproteins. Think of these as lorries!! LDL (low density lipoprotein – lorry) OR </li></ul><ul><li>HDL – high density lipoprotein (lorry) </li></ul><ul><li>The LDL transports cholesterol from the liver to the tissues. It is the major cholesterol transporter in the blood. </li></ul><ul><li>HDL removes excess cholesterol from the tissues and brings it back to the liver for reprocessing or removal from the body altogether. </li></ul><ul><li>As a general rule, HDL cholesterol is ‘the good guy’ and LDL cholesterol and triglycerides are ‘the bad guys’. If too much LDL cholesterol is circulating in our bloodstream, over time it slowly builds up in the inner walls of the arteries. </li></ul><ul><li>The optimal goal for Diabetics is a LDL of less than 2.6 mmol/L Your HDL can be a bit higher </li></ul>Sue Frye - 084 228 0993
    23. 23. The food pyramid <ul><li>A healthy diet is NOT difficult; </li></ul><ul><li>Shift the “C” from compulsive eating to controlled eating </li></ul><ul><li>To assist with recovery and prevention a low GI diet is absolutely vital. </li></ul><ul><li>The rate at which a food releases its sugar. </li></ul><ul><li>Low GL (Glycaemic Load) </li></ul>Sue Frye - 084 228 0993
    24. 24. LOW GI vs LOW GL <ul><li>Glycaemic LOAD </li></ul><ul><li>It is a unit of measurement used to measure the amount of sugar and starch in foods </li></ul><ul><li>If you keep to a LOW GL diet </li></ul><ul><li>You will stop producing more glucose than you can use; </li></ul><ul><li>You will not suffer from food cravings </li></ul><ul><li>Your body will be reprogrammed to burn fat rapidly; </li></ul><ul><li>You will be able to lose weight and sustain your weight loss permanently and thereby improve your blood glucose levels. </li></ul><ul><li>Glycaemic INDEX </li></ul><ul><li>Is a scale of measurement that tells you how fast the sugar content of a food is released into your bloodstream and is absorbed; </li></ul><ul><li>When we eat carbohydrates – starches, fruit, vegetables, dairy products, legumes and sweet things – they are digested in the stomach and then absorbed into the bloodstream in the form of glucose. </li></ul><ul><li>Not all carbohydrates are digested and absorbed at the same rate. This means that different carbs have different effects on blood glucose and blood insulin levels. </li></ul>Sue Frye - 084 228 0993
    25. 25. DIETARY GUIDELINES <ul><li>Enjoy a variety of meals; </li></ul><ul><li>Make starchy foods the basis of most meals – foods rich in carbohydrates. A starchy food that has a low GI and/or is high in fibre; </li></ul><ul><li>Use fat and salt sparingly; </li></ul><ul><li>Eat plenty of vegetables and fruit every day; </li></ul><ul><li>Eat beans, peas, lentils and soya regularly; </li></ul><ul><li>Chicken, fish, milk (low fat), meat or eggs could be eaten daily; </li></ul><ul><li>Drink lots of water </li></ul><ul><li>If you drink alcohol – never drink on an empty stomach </li></ul><ul><li>When carefully planned, people with diabetes can enjoy a wide variety of foods, including sugar!! </li></ul>Sue Frye - 084 228 0993
    26. 26. Diabetes Complications <ul><li>Nephropathy [kidney disease] </li></ul><ul><li>CARDIOVASCULAR COMPLICATIONS </li></ul><ul><li>Strokes, heart attacks, heart disease. </li></ul><ul><li>Neuropathy [nerve damage] This leads to loss of sensation in the feet and they become particularly vulnerable to wounds and infection – often leading to infections, gangrene and then amputation </li></ul><ul><li>Retinopathy [eye damage] </li></ul><ul><li>Impotence & difficulty falling pregnant </li></ul>Sue Frye - 084 228 0993
    27. 27. HIV/AIDS therapy and Diabetes <ul><li>ARV Drugs used in HIV cause metabolic problems such as lipoatrophy </li></ul><ul><li>Lipoatrophy - is the abnormal distribution of body fat. This is also associated with abnormal blood levels of lipids and an increased risk of diabetes, hypertension and cardiovascular death. </li></ul><ul><li>The commonly used HIV therapy drugs can contribute to an increase in Auto Immune Disease; </li></ul><ul><li>Diet and exercise and special medication can help treat this condition </li></ul><ul><li>There may be a second epidemic of diabetes that follows the successful implementation of HIV drug treatment, because of this complication </li></ul>Sue Frye - 084 228 0993
    28. 28. ACTION GROUP <ul><li>When it comes to getting proper care for patients with diabetes the playing fields are totally uneven especially with regards to knowledge and education. </li></ul><ul><li>We are hoping to become YOUR VOICE in the wilderness of Diabetes. There are so many barriers facing people with Diabetes and our aim is to lead the learning process. Details of our courses are available. </li></ul><ul><li>Contact DIABETES ACTION on – 0842280993 or on the HIV911 database or www.diabetesaction.co.za </li></ul>Sue Frye - 084 228 0993
    29. 29. IN CONCLUSION <ul><li>There is no such thing as mild diabetes!! </li></ul><ul><li>Everyone must take greater cognisance of the wellness of their friends and family members. </li></ul><ul><li>A controlled person with diabetes is a constructive member of your TEAM. </li></ul><ul><li>Remember that DIABETES is not a DISEASE but a treatable CONDITION. </li></ul>Sue Frye - 084 228 0993
    30. 30. A WAKE UP CALL <ul><ul><li>If current trends continue, by the year 2025 Diabetes is going to be the first non-communicable condition to cause a negative population growth </li></ul></ul>Sue Frye - 084 228 0993