Complications of diabetes
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  • Coronary artery (heart) disease is caused by a narrowing or blocking of the blood vessels to your heart. It’s the most common form of heart disease. These blood vessels to the heart are important because the blood flowing through them carries oxygen and other necessary materials to your. Unfortunately, these blood vessels can become partially or totally blocked by fatty deposits. A heart attack occurs when the blood supply to your heart is reduced or cut off.
  • Having diabetes means that you are more likely to have coronary artery disease, a heart attack, or stroke. Luckily, there are steps that can be taken to prevent heart disease or reduce the chances of having another heart attack. You can lower your risk by keeping ABCs of diabetes on target with wise food choices, physical activity, and medication.
  • A is for A1C: A1C is the blood glucose check “with a memory.” It allows one to determine average blood glucose control over the past 2 to 3 months. The American Diabetes Association recommends an A1C below 7. B is for blood pressure: Blood pressure numbers tell the force of blood inside your blood vessels. With a high blood pressure, this means that your heart is having to work harder than it should. The ADA recommends a blood pressure below 130/80. C is for cholesterol: Cholesterol numbers tell you the amount of fat in your blood. Some kinds, such as HDL, help protect the heart. Other kinds, such as LDL, can clog your blood vessels, leading to heart disease. Triglycerides are another kind of blood fat that can raise your risk for heart disease.
  • The job of kidneys in the body is to remove waste products from the blood. Inside of the kidneys are millions of tiny blood vessels (capillaries) that act as filters. When our bodies digest the protein we eat, this process creates waste products. Normally, as blood flows through the small capillaries, tiny molecules (waste products) squeeze through the holes and become incorporated in urine for removal from the body. Useful substances, such as protein and red blood cells are too big to pass through the filter and remain in the blood.
  • High levels of blood sugar can make the kidneys filter too much blood, putting extra stress on the kidneys. After years of damage, the kidneys start to leak. Useful protein becomes lost in the urine. Having small amounts of protein in the urine is a condition known as microalbuminuria. When kidney disease is diagnosed early (during microalbuminuria), there are several treatments that may keep the kidney disease from getting worse. However, when kidney disease is caught later (during macroalbuminuria), end-stage renal disease, or ESRD, usually follows.
  • With time, the stress of overwork causes the kidneys to lose their filtering ability. Waste products begin to build up in the blood. Finally, the kidneys fail. ESRD is a very serious condition requiring either a kidney transplant or regular visits to a dialysis clinic in which their blood is filtered by a machine which contains an artificial kidney.
  • Not everyone with diabetes will develop kidney disease. Factors that influence kidney disease development include: Genetics Blood pressure Blood sugar control Of course, genetics are beyond our control. On the other hand, one can work on getting blood sugar and blood pressure in check. The better a person controls diabetes and keeps blood pressure in control, the lower their chance of developing kidney disease.
  • 10-21% of all people with diabetes have nephropathy. Approximately 43% of new cases of ESRD are attributed to diabetes. The risk of ESRD is 12 times higher in people with type 1 diabetes than in those with type 2. In the US, the incidence of reported ESRD in people with diabetes is more than 4 times as high in African Americans, 4 to 6 times as high in Mexican Americans and 6 times as high in Native Americans than in the general population of diabetes patients.
  • People with diabetes do have a higher risk of blindness than people without diabetes, but most people with diabetes have nothing more than minor eye disorders. Luckily, there are ways to keep minor problems minor and to treat major problems if they do arise if you begin treatments right away
  • Glaucoma occurs when pressure builds up in the eye. The pressure pinches the blood vessels that carry blood to the retina and optic nerve. Vision is gradually lost because the retina and nerve are damaged. People with diabetes are 40% more likely to suffer from glaucoma than people without diabetes. Risk increases with age and duration the individual has had diabetes for. Luckily, there are several effective treatments for glaucoma. For some, drugs are used to reduce the pressure in the eye, and for others, surgery is an option.
  • In cataracts the eye’s clear lens clouds, blocking light. The best thing to do at this point is to Wear sunglasses Use glare-control lenses in eyeglasses as much as possible to prevent further damage by solar radiation. If the lenses are damaged so that the person does not see clearly any more the treatment is to Remove the lens and get a lens transplant. This is a routine operation today and commonly done.
  • Individuals with diabetes are: 60% more likely to develop cataracts Likely to get cataracts at a younger age Likely to have a faster progression of cataracts Likely to have problems if removal of the lens is necessary due to the beginning stages of glaucoma
  • Diabetic retinopathy is a general term for all disorders of the retina caused by diabetes. There are 2 major types of retinopathy: Nonproliferative : This is the common, mild form. It usually has no effect on vision and needs no treatment. Yearly monitoring is important, however, to make sure the condition isn’t worsening. Proliferative : This form is much more serious. With proliferative retinopathy, blood vessels are so damaged that they close off. In response, new vessels begin growing in the retina. These vessels are weak and can leak blood, blocking ones vision– a condition known as vitreous hemorrhage. A more serious condition that can occur in this form is retinal detachment.
  • There are several factors that influence whether you get retinopathy: Blood sugar control Blood pressure levels How long you have had diabetes Genetics Almost everyone with type 1 diabetes will eventually develop nonproliferative retinopathy, but luckily, the retinopathy that destroys vision, proliferative retinopathy, is far less common
  • About half of all people with diabetes have some form of nerve damage. Nerve damage from diabetes is referred to as diabetic neuropathy. It’s more common in those who have had the disease for many years. The upside of things is that if you keep your blood glucose levels on target , you can help prevent or delay nerve damage.
  • Sensorimotor neuropathy : Also known as “peripheral neuropathy” Can cause tingling, pain, numbness, or weakness in hands and feet. Autonomic neuropathy : Can lead to Digestive problems such as feeling full, nausea Vomiting, diarrhea, or constipation Problems with how well the bladder works Problems having sex Dizziness or faintness Loss of the typical warning signs of a heart attack Loss of warning signs of low blood glucose Increased or decreased sweating Changes in how your eyes react to light and dark
  • It is important to: Report all possible signs of diabetic neuropathy Get treatment right away if you have problems. Early treatment can help prevent more problems later on. Take good care of your feet, checking them every day. If you no longer feel pain in your feet, then you might not notice a foot injury. Therefore, rely on your eyes to find any potential problems. Protect your feet . Wear shoes and socks that fit well and wear them all the time. Use warm water to wash your feet and dry them carefully afterwards. Purchase special shoes , if they are needed. Medicare may even cover the cost of these. Be careful with exercising . Some activities are not safe for individuals with neuropathy.
  • These are some common foot complications seen in diabetes: Skin Changes Calluses Foot Ulcers Poor Circulation Amputation
  • Skin Changes: Diabetes can cause feet to be very dry at times. This is because the nerves that control the oil and moisture in your foot are no longer working. After bathing, dry feet and seal remaining moisture in with plain petroleum jelly, unscented hand cream, or a similar product. It is important not to put oils or creams between toes– extra moisture can lead to infection. Calluses Occur more often and build up faster on the feet of people with diabetes. Too much callus may mean that you need therapeutic shoes and inserts. Calluses, if not trimmed, get very thick, can break down and turn into ulcers (open sores). Never try to cut calluses yourself– this can lead to infection. Let your healthcare provider cut them.
  • Foot Ulcers Even though some ulcers do not hurt, every ulcer should be seen by your health care provider right away. Neglecting ulcers can result in infections, potentially leading to loss of a limb. Also, keeping off of your feet is very important. Walking on the ulcer can make it get larger and force the infection deeper into your foot. Poor Circulation Poor blood flow can make your foot less able to fight infection and heal. You can control some of the things that cause poor blood flow such as: Stop smoking and keep blood pressure and cholesterol in check Also, exercise is good for poor circulation. It stimulates blood flow in the legs and feet. Exercise is a good idea for individuals who currently do not have any open sores on the foot. Proper shoes are essential.
  • People with diabetes are far more likely to have a foot or leg amputated than other people. The problem is that many people with diabetes have artery disease, which reduces blood flow to the feet. Also, individuals with diabetes often have nerve damage, which reduces sensation. These two problems together make it much more likely to get ulcers and infections that may lead to amputation. Luckily, most amputations are preventable with regular care and proper footware.
  • Taking good care of your feet is essential to prevent this event. Always follow your health care provider’s advice when caring for foot problems. One of the biggest threats to your feet is smoking ! Smoking affects small blood vessels by decreasing their blood flow to the feet making wounds heal slower. Cessation of smoking is a good way to decrease the likelihood serious problems, such as amputation.
  • Those with diabetes can have many skin complications: Bacterial infections Fungal infections Itching Diabetic Dermopathy Necrobiosis Lipoidica Diabeticorum Atherosclerosis Allergic Reactions Diabetic Blisters Eruptive Xanthomatosis Digital Sclerosis Disseminated Granuloma Annulare Acanthosis Nigricans
  • Bacterial infections Several kinds of bacterial infections occur in individuals with diabetes. Styes are infections of the glands of the eyelid. Boils are infections of the hair follicles. Carbuncles are deep infections in the skin and the tissue underneath. Inflamed tissues are usually hot, swollen, red, and painful. Today, antibiotics are the response to such infections . Fungal infections Candida albicans is a yeast-like fungus which is often responsible for fungal infections in individuals with diabetes. Common fungal infections include: jock itch, athlete’s foot, ringworm, and vaginal infections. If you suspect having a yeast or fungal infection, contact your doctor. He can prescribe medication to treat it.
  • Itching Localized itching is often caused by diabetes. Itching can be caused by a yeast infection, dry skin, or poor circulation. When poor circulation is the cause, the itchiest regions are often the lower parts of the legs. Limiting how often you bathe, particularly when humidity is low, using mild soap with moisturizer, and applying skin cream after bathing may help resolve the issue. Diabetic Dermopathy Refers to changes in the small blood vessels caused by diabetes Dermopathy looks like light brown, scaly patches often mistaken for age spots. The disorder most often occurs on the front of both legs. The patches do not hurt, open up, or itch. Dermopathy is harmless and does not require treatment.
  • Atherosclerosis Refers to thickening of the arteries People with diabetes tend to get atherosclerosis at younger ages. As atherosclerosis narrows blood vessels, skin changes occur. It becomes hairless, thin, cool, and shiny. Because blood carries the infection-fighting white cells, affected legs heal slowly when the skin is injured. Allergic Reactions Skin reactions can occur in response to medications, such as insulin or diabetes pills. If you think you are having a reaction to a medication, contact your doctor immediately. Be on the lookout for rashes, depressions, or bumps around the sites where you inject insulin.
  • Diabetic Blisters Occurs rarely in individuals with diabetes They can occur on the backs of fingers, hands, toes, feet, and on legs or forearms. They are sometimes large and resemble burn blisters. Painless and with no redness around them, they often heal themselves within 3 weeks. The only treatment is to bring blood sugar levels under control. Eruptive Xanthomatosis This is a condition caused by diabetes that is out of control. Consists of firm, yellow, pea-like enlargements in the skin. The disorder usually occurs in young men with type 1 diabetes. Like diabetic blisters, these bumps disappear when diabetes control is restored.
  • Digital Sclerosis Consists of tight, thick, waxy skin on the back of the hands. The finger joints become stiff and can no longer move the way they should. Rarely, knees, ankles, or elbows also get stiff. Happens to about 1/3 of people with type 1 diabetes The only treatment is to bring blood sugar levels under control. Disseminated Granuloma Annulare Consists of sharply defined ring-shaped or arc-shaped raised areas on the skin. Rashes most often occur on parts of the body far from the trunk (i.e., ears or fingers), but sometimes the raised areas occur on the trunk. Contact your doctor if you see rashes like this. Certain drugs can help clear up the condition
  • Acanthosis Nigricans This is a condition in which tan or brown raised areas appear on the sides of the neck, armpits, and groin. Usually strikes people who are overweight. The best treatment is to lose weight. Some creams can help the spots look better.
  • Occurs when the nerves to the stomach are damaged or stop working The muscles of the stomach and intestines do not work normally, and the movement of food is slowed or stopped. Signs and symptoms : Heartburn Nausea Vomiting of undigested food An early feeling of fullness when eating Weight loss Abdominal bloating Erratic blood glucose (sugar) levels Lack of appetite Gastroesophageal reflux Spasms of the stomach wall
  • Gastroparesis can worsen diabetes by making it harder to manage blood glucose. Food staying in the stomach too long can: Cause problems like bacterial overgrowth due to fermentation Harden into solid masses called bezoars that may cause nausea, vomiting, and obstruction of the stomach Bezoars can be dangerous if they block the passage of food into the small intestine.
  • The most important treatment goal for diabetes-related gastroparesis is to manage your blood glucose levels as well through the usage of: Insulin: May need to take more often and taken after meals rather than before for best results. Medication: There are several available drugs that can be used to treat gastroparesis. Different drugs or combinations of drugs may need to be tried before finding the most effective treatment. Meal and food changes: This can help control your gastroparesis. Your doctor or dietitian will give you specific recommendations. Feeding tube: If other approaches do not work, surgery may be required. A feeding tube allows for the insertion of nutrients directly into the small intestine, bypassing the stomach altogether.
  • If you are feeling symptoms of depression, don’t keep them bottled up. Talk to your doctor. There may be a physical cause for your depression. Diabetes that is in poor control can cause symptoms that look like depression: High or low blood sugar during the day can make you feel tired or anxious Low blood sugar levels can also lead to hunger and eating too much Low blood sugar n the night could disturb sleep High blood sugar in the night can lead to frequent urinating and then feeling tired throughout the next day
  • There are many potential complications of diabetes. When diabetes is diagnosed early in the course of the disease, and glucose and insulin levels are controlled well, complications can be minimized. It is important to discuss any of the above mentioned conditions with the physician immediately upon occurrence to minimize the side effects.

Transcript

  • 1. PPT# 29Complications of Diabetes Pennington Biomedical Research Center Division of Education PBRC 2013 1
  • 2. Common Potential Complications of Diabetes Heart Disease  Foot Complications Kidney Disease/Kidney  Skin Complications Transplantation  Gastroparesis and Diabetes Eye Complications  Depression Diabetic Neuropathy and Nerve Damage PBRC 2013 2 of 39
  • 3. Heart Disease Caused by a narrowing or blocking of the blood vessels to your heart. The vessels carry oxygen and nutrients to your heart. Vessels can become partially or totally blocked by fatty deposits. A heart attack - when the blood supply to your heart is reduced or cut off. PBRC 2013 3 of 39
  • 4. Heart Disease and Diabetes Diabetes increases the risk for coronary artery disease, a heart attack or stroke. Take preventive steps now. Keep your ABCs of diabetes on target. PBRC 2013 4 of 39
  • 5. “The ABCs”“A” is for A1C A1C is the blood glucose check “with a memory” over the past 2 to 3 months.“B” is for The ADA recommends a blood pressure below 130/80.blood pressure“C” is for HDL protects your heart.cholesterol LDL can clog your blood vessels, leading to heart disease. Triglycerides can increase your risk for heart disease. PBRC 2013 5 of 39
  • 6. Kidney Function Kidneys act as filters. Kidneys remove waste products from the blood. We create waste products from digestion. Normally, waste products are eliminated in urine from the body. Protein and red blood cells are too big to pass through the filter and remain in the blood. PBRC 2013 6 of 39
  • 7. Kidney Disease High levels of blood sugar can put extra stress on the kidneys. After years of damage, the kidneys start to leak. Useful proteins are lost in the urine. Get a condition known as microalbuminuria.  There are several treatments at this point that may keep the kidney disease from getting worse. When kidney disease is diagnosed later, during macroalbuminuria, end-stage renal disease (ESRD) usually follows. PBRC 2013 7 of 39
  • 8. Kidney Disease Kidneys lose their filtering ability. Waste products begin to build up in the blood. Finally, the kidneys fail. ESRD  kidney transplant or  regular visits to a dialysis clinic. PBRC 2013 8 of 39
  • 9. Who Gets Kidney Disease? Factors that influence kidney disease development include:  Genetics  Blood pressure  Blood sugar control Controlling blood sugar and blood pressure are very important in reducing the chances of developing kidney disease. PBRC 2013 9 of 39
  • 10. Facts About Diabetes and Kidney Disease Nephropathy - 10-21% of diabetes cases. ~ 43% of new cases of ESRD are attributed to diabetes.  12 times higher in people with type 1 diabetes  4 times higher in African Americans,  4 to 6 times higher in Mexican Americans  6 times higher in Native Americans than in the general population of diabetes patients. PBRC 2013 10 of 39
  • 11. ---Eye Complications--- Higher risk of blindness. Many have minor eye disorders. Early treatments critical. PBRC 2013 11 of 39
  • 12. Glaucoma Pressure build-up in the eye.  Pinches the blood vessels.  Damages nerves.  Vision is gradually lost. 40% more likely to suffer from glaucoma. Risk increases with age and duration of diabetes. PBRC 2013 12 of 39
  • 13. Cataracts The eye’s clear lens clouds, blocking light.  Wear sunglasses  Use glare-control lenses in eyeglasses. Damaged lens –  remove.  transplant. PBRC 2013 13 of 39
  • 14. Cataracts Individuals with diabetes are:  60% more likely to develop cataracts  at a younger age  faster progression  have problems if removal of the lens is necessary due to the beginning stages of glaucoma PBRC 2013 14 of 39
  • 15. Retinopathy Diabetic retinopathy is a general term for all disorders of the retina caused by diabetes. There are 2 major types of retinopathy:  Nonproliferative: This is the common, mild form.  Proliferative: This form is much more serious. PBRC 2013 15 of 39
  • 16. Retinopathy There are several factors that influence whether you get retinopathy:  Blood sugar control  Blood pressure levels  How long you have had diabetes  Genetics Almost everyone with type 1 diabetes will eventually develop nonproliferative retinopathy. PBRC 2013 16 of 39
  • 17. Diabetic Neuropathy & Nerve Damage ~50% have some form of nerve damage. It’s more common in those who have had the disease for many years. Blood glucose control can help prevent or delay nerve damage. PBRC 2013 17 of 39
  • 18. 2 Common Types of Nerve Damage Sensorimotor neuropathy:  Also known as “peripheral neuropathy”  Can cause tingling, pain, numbness, or weakness in hands and feet. Autonomic neuropathy: Can lead to  Digestive problems such as feeling full, nausea  Vomiting, diarrhea, or constipation  Problems with how well the bladder works  Problems having sex  Dizziness or faintness  Loss of the typical warning signs of a heart attack  Loss of warning signs of low blood glucose  Increased or decreased sweating  Changes in how your eyes react to light and dark PBRC 2013 18 of 39
  • 19. Keep Your Blood Glucose Levels in Your Target Range It is important to:  Report all possible signs of diabetic neuropathy  Get treatment right away if you have problems.  Take good care of your feet, checking them every day.  Protect your feet. Wear shoes and socks that fit well and wear them all the time.  Purchase special shoes, if they are needed.  Be careful with exercising. Some activities are not safe for individuals with neuropathy. PBRC 2013 19 of 39
  • 20. Foot complications Skin Changes Calluses Foot Ulcers Poor Circulation Amputation PBRC 2013 20 of 39
  • 21. Skin Changes and Calluses Skin Changes:  Dry skin and feet.  Seal remaining moisture in with plain petroleum jelly, unscented hand cream, or a similar product.  It is important not to put oils or creams between toes. Calluses  Occur more often and build up faster.  May need therapeutic shoes and inserts.  Calluses can lead to ulcers (open sores).  Never try to cut calluses yourself– this can lead to infection.  Let your healthcare provider cut them. PBRC 2013 21 of 39
  • 22. Foot Ulcers and Poor Circulation Foot Ulcers  Every ulcer should be seen by your health care provider immediately.  Can result in infections, potentially leading to loss of a limb.  It is important to keep off of your feet. Poor Circulation  Can lead to infection and delay healing.  To improve poor circulation:  Stop smoking and keep blood pressure and cholesterol in check  Exercise improves circulation. It increases blood flow. Exercise is a good idea for individuals who currently do not have any open sores on the foot. Proper shoes are essential. PBRC 2013 22 of 39
  • 23. Amputation Highly likely in diabetes. Due to artery disease, which reduces blood flow to the feet and nerve damage, which reduces sensation. These can lead to ulcers and infections that may lead to amputation. Amputations are preventable. PBRC 2013 23 of 39
  • 24. Amputation - Prevention Take good care of your feet. Always follow your health care provider’s advice when caring for foot problems. Stop smoking!  Smoking decreases blood flow to the feet. PBRC 2013 24 of 39
  • 25. Skin Complications Bacterial infections  Diabetic Blisters Fungal infections  Eruptive Xanthomatosis Itching  Digital Sclerosis Diabetic Dermopathy  Disseminated Granuloma Necrobiosis Lipoidica Annulare Diabeticorum  Acanthosis Nigricans Atherosclerosis Allergic Reactions PBRC 2013 25 of 39
  • 26. Bacterial and Fungal Infections Bacterial infections, many kinds  Styes  Boils  Carbuncles  Inflamed tissues are usually hot, swollen, red, and painful  Treated by antibiotics Fungal infections  Candida albicans is a yeast-like fungus. Leads to common fungal infections  Can be treated by medication PBRC 2013 26 of 39
  • 27. Itching and Diabetic Dermopathy Itching  Localized.  Can be caused by a yeast infection, dry skin, or poor circulation.  Occurs often in the lower parts of the legs.  Use mild soap with moisturizer, and apply skin cream after bathing to help resolve the issue. Diabetic Dermopathy  Changes in the small blood vessels.  Looks like light brown, scaly patches.  The disorder most often occurs on the front of both legs.  The patches do not hurt, open up, or itch.  Dermopathy is harmless and does not require treatment. PBRC 2013 27 of 39
  • 28. Atherosclerosis and Allergic Reactions  Atherosclerosis  Thickening of the arteries  Occurs at younger ages.  Can lead to skin changes.  Skin becomes hairless, thin, cool, and shiny.  Affected legs heal slowly when the skin is injured.  Allergic Reactions  In response to medications, such as insulin or diabetes pills.  If you think you are having a reaction to a medication, contact your doctor immediately.  Report any rashes, depressions, or bumps around the insulin injection sites immediately. PBRC 2013 28 of 39
  • 29. Diabetic Blisters and Eruptive Xanthomatosis  Diabetic Blisters  Occurs rarely in individuals with diabetes  They can occur on the backs of fingers, hands, toes, feet, and on legs or forearms.  They are sometimes large and resemble burn blisters.  Painless and with no redness around them, they often heal themselves within 3 weeks.  The only treatment is to bring blood sugar levels under control.  Eruptive Xanthomatosis  This is a condition caused by diabetes that is out of control.  Consists of firm, yellow, pea-like enlargements in the skin.  The disorder usually occurs in young men with type 1 diabetes.  Like diabetic blisters, these bumps disappear when diabetes control is restored. PBRC 2013 29 of 39
  • 30. Digital Sclerosis andDisseminated Granuloma Annulare Digital Sclerosis  Consists of tight, thick, waxy skin on the back of the hands.  The finger joints become stiff and can no longer move the way they should.  Rarely, knees, ankles, or elbows also get stiff.  Happens to about 1/3 of people with type 1 diabetes  The only treatment is to bring blood sugar levels under control. Disseminated Granuloma Annulare  Consists of sharply defined ring-shaped or arc-shaped raised areas on the skin.  Rashes most often occur on parts of the body far from the trunk (i.e., ears or fingers), but sometimes the raised areas occur on the trunk.  Contact your doctor when rash appears.  Certain drugs can help clear up the condition. PBRC 2013 30 of 39
  • 31. Acanthosis Nigricans Acanthosis Nigricans  This is a condition in which tan or brown raised areas appear on the sides of the neck, armpits, and groin.  Usually strikes people who are overweight.  The best treatment is to lose weight.  Some creams can help the spots look better. PBRC 2013 31 of 39
  • 32. Gastroparesis and Diabetes Due to nerve damage that control the stomach. Leads to poor muscle control of the stomach and intestines. Movement of food is slowed or stopped. Signs and symptoms:  Heartburn  Nausea  Vomiting of undigested food  An early feeling of fullness when eating  Weight loss  Abdominal bloating  Erratic blood glucose (sugar) levels  Lack of appetite  Gastroesophageal reflux  Spasms of the stomach wall PBRC 2013 *These symptoms may of 39mild 32 be or severe, depending on the person.*
  • 33. Complications of Gastroparesis Gastroparesis makes it harder to manage blood glucose. Slower digestion can result in:  Bacterial overgrowth due to fermentation  Food can harden into solid masses called bezoars that may cause nausea, vomiting, and obstruction of the stomach  Bezoars can be dangerous if they block the passage of food into the small intestine. PBRC 2013 33 of 39
  • 34. Treatment of Gastroparesis The most important treatment goal for Insulin May need to adjust schedule. diabetes-related gastroparesis is to Medication May need drugs to treat manage your blood gastroparesis. glucose levels as well through the usage of: Meal and Refer to your physician or a food dietitian for more information. changes Feeding May be used in severe cases. tube PBRC 2013 34 of 39
  • 35. Depression Consult your doctor to eliminate any physical cause for your depression. Poorly controlled diabetes can cause depression like symptoms:  High or low blood sugar during the day can make you feel tired or anxious  Low blood sugar levels can also lead to hunger and eating too much  Low blood sugar n the night could disturb sleep  High blood sugar in the night can lead to frequent urinating and then feeling tired throughout the next day PBRC 2013 35 of 39
  • 36. Conclusions There are many potential complications of diabetes. Complications can be minimized with good blood glucose control. Discuss any developments with the physician immediately. PBRC 2013 36 of 39
  • 37. Division of Education Heli J. Roy, PhD, RD Division of Education Phillip Brantley, PhD, Director Pennington Biomedical Research Center Steve Heymsfield, MD, Executive Director Edited : 1/13 PBRC 2013 37
  • 38. Pennington Biomedical Research CenterVISIONOur vision is to lead the world in eliminating chronic diseases. MISSIONOur mission is to discover the triggers of chronic diseases through innovative research that improveshuman health across the lifespan.  We are helping people live Well Beyond the Expected. The Pennington Center has several research areas, including:Clinical Obesity ResearchExperimental ObesityFunctional FoodsHealth and Performance EnhancementNutrition and Chronic DiseasesNutrition and the BrainDementia, Alzheimer’s and healthy agingDiet, exercise, weight loss and weight loss maintenanceThe research fostered in these areas can have a profound impact on healthy living and on the prevention ofcommon chronic diseases, such as heart disease, cancer, diabetes, hypertension and osteoporosis. The Division of Education provides education and information to the scientific community and the publicabout research findings, training programs and research areas, and coordinates educational events for thepublic on various health issues. We invite people of all ages and backgrounds to participate in the exciting research studies beingconducted at the Pennington Center in Baton Rouge, Louisiana. If you would like to take part, visit theclinical trials web page at www.pbrc.edu or call (225) 763-3000. PBRC 2013 38 of 39
  • 39. References All information used was obtained from:  American Diabetes Association  http://www.diabetes.org Copyright, 2013 PBRC # PPT29 PBRC 2013 39 of 39