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Makethe Link Powerpoint

  1. 3. Diabetes-CVD Facts <ul><li>More than 65% of all deaths in people with diabetes are caused by cardiovascular disease. </li></ul><ul><li>Heart attacks occur at an earlier age in people with diabetes and often result in premature death. </li></ul>3
  2. 4. Diabetes-CVD Facts <ul><li>Up to 60% of adults with diabetes have high blood pressure. </li></ul><ul><li>Nearly all adults with diabetes have one or more cholesterol problems, such as: </li></ul><ul><ul><li>high triglycerides </li></ul></ul><ul><ul><li>low HDL (“good”) cholesterol </li></ul></ul><ul><ul><li>high LDL (“bad”) cholesterol </li></ul></ul>4
  3. 5. What is Diabetes ? <ul><li>Diabetes is a disorder of metabolism </li></ul><ul><li>After digestion, glucose enters the blood stream </li></ul><ul><li>Then Glucose goes to cell through out the body where it Is used for energy </li></ul><ul><li>However, a hormone called insulin must be present to allow glucose to entre the cells </li></ul><ul><li>Insulin is produced by the pancreas, a large gland behind the stomach </li></ul>
  4. 6. Continue… <ul><li>In people who do not have diabetes, the pancreas automatically produces the right amount of insulin to move glucose from blood into the cells </li></ul><ul><li>However, diabetes develops when the pancreas does not make enough insulin , or the cells in muscle,liver,and fats do not use insulin properly, or both. </li></ul>
  5. 8. Continue… <ul><li>As a result, the amount of glucose in the blood increases while the cells are starved of energy………….. </li></ul>
  6. 9. Complications
  7. 10. Complications <ul><li>Over time, high blood glucose levels damage nerves and blood vessels , leading to complications such as heart disease and stroke, the leading causes of death among people with diabetes </li></ul><ul><li>Uncontrolled diabetes can eventually lead to other health problems as well, such as vision loss , kidney failure </li></ul>
  8. 11. What is pre-diabetes ? <ul><li>Pre-diabetes is a condition in which blood glucose level are higher than normal but not high enough for a diagnosis of diabetes. </li></ul><ul><li>Also called impaired fasting glucose or impaired glucose tolerance </li></ul><ul><li>Many people with pre-diabetes develop type 2 diabetes within 10 years </li></ul><ul><li>With modest weight loss and moderate physical activity , people with pre-diabetes can delay or prevent type 2 diabetes and CHD </li></ul>
  9. 12. <ul><li>What is the connection </li></ul><ul><li>between </li></ul><ul><li>diabetes, heart disease and stroke ? </li></ul>
  10. 13. Connection b/n diabetes and CHD <ul><li>If you have a diabetes, you are at least twice as likely as someone who does not have diabetes to have heart disease or a stroke </li></ul><ul><li>People with diabetes also tend to develop heart disease or stroke at an earlier age than other people </li></ul><ul><li>If you are middle aged and have type 2 diabetes, some studies suggest that your chance of having a heart attack is as high as someone without diabetes who has already had one heart attack </li></ul>
  11. 14. Connection continue… <ul><li>Women who have not gone through menopause usually have less risk of heart disease than men of the same age. </li></ul><ul><li>But women of all ages with diabetes have an increase risk of heart disease because diabetes cancels out the protective effects of being a women in her child-bearing years. </li></ul>
  12. 15. Connection continue... <ul><li>People with diabetes who have already had one heart attack run an even greater risk of having a second one </li></ul><ul><li>Heart attacks in people with diabetes are more serious and more likely to result in death . </li></ul>
  13. 16. Connection continue… <ul><li>High blood glucose levels over time can lead to increase deposits of fatty materials on the insides of the blood vessel walls. </li></ul><ul><li>These deposits may affect blood flow, increasing the chance of clogging and hardening of blood vessels(atherosclerosis). </li></ul>
  14. 17. Connection continue…
  15. 18. Heart disease and stroke
  16. 19. <ul><li>What are the risk factors </li></ul><ul><li>For </li></ul><ul><li>Heart disease and Stroke </li></ul><ul><li>in </li></ul><ul><li>people with diabetes ? </li></ul>
  17. 20. Risk factors in diabetes <ul><li>Diabetes itself is a risk factor for heart disease and stroke </li></ul><ul><li>Many people with diabetes have other conditions that increase their chances of developing heart disease and stroke </li></ul><ul><li>This conditions are called ‘’ Risk factors’’ . </li></ul>
  18. 21. Risk Factors in diabetes patients <ul><li>Having a family history of heart disease </li></ul><ul><li>Having central obesity </li></ul><ul><li>Having abnormal blood fat (cholesterol) levels </li></ul><ul><li>Having high blood pressure </li></ul><ul><li>Smoking </li></ul>
  19. 22. <ul><li>1 </li></ul><ul><li>Family History </li></ul>
  20. 23. 1. Having Family history <ul><li>If one or more members of your family had a heart attack at an early age (before age 55 for men or 65 for women), you may be at increased risk </li></ul><ul><li>You can’t change whether heart disease runs in your family, but you can take steps to control the other risk factors </li></ul>
  21. 24. <ul><li>2 </li></ul><ul><li>Central obesity </li></ul>
  22. 25. 2. Having central obesity <ul><li>Central obesity means carrying extra weight around the waist, as opposed to the hips </li></ul><ul><li>A waist measurement of more than 40 inches for Gentle men and more than 35 inches for women means you have central obesity </li></ul>
  23. 28. Central obesity continue… <ul><li>Risk of heart disease is higher because abdominal fat increase the production of LDL (bad) cholesterol , the type of blood fat that can be deposited on the inside of blood vessel walls </li></ul>
  24. 29. Causes of central obesity
  25. 30. <ul><li>3 </li></ul><ul><li>Abnormal blood fat </li></ul><ul><li>(cholesterol) levels </li></ul>
  26. 31. 3. Abnormal blood fat levels <ul><li>LDL cholesterol can build up inside your blood vessels, leading to narrowing and hardening of your arteries </li></ul><ul><li>Triglycerides are another type of blood fat that can raise your risk of heart disease when the level are high </li></ul><ul><li>HDL (good) cholesterol removes deposits from inside your blood vessels and takes them to the liver for removal </li></ul><ul><li>Low level of HDL increase your risk factors of heart disease </li></ul>
  27. 32. Plasma cholesterol levels
  28. 34. <ul><li>4 </li></ul><ul><li>Having high blood pressure </li></ul>
  29. 35. 4. Having high blood pressure <ul><li>If you have high blood pressure, also called hypertension, your heart must work harder to pump blood </li></ul><ul><li>High blood pressure can strain the heart, damage blood vessels , and increase your risk of heart attack, stroke , eye problems and kidney problems </li></ul>
  30. 36. Complications of hypertension
  31. 37. Treatment of HPN <ul><li>Anti hypertensive drugs </li></ul><ul><li>And…………….. On the following slide </li></ul>
  32. 39. <ul><li>5 </li></ul><ul><li>Smoking </li></ul>
  33. 40. 5. Smoking <ul><li>Smoking doubles your risk of getting heart disease </li></ul><ul><li>Stopping smoking is especially important for people with diabetes because both smoking and diabetes narrow blood vessels </li></ul><ul><li>Smoking also increase the risk of other long-term complications, such as eye problems </li></ul>
  34. 41. <ul><li>What is Metabolic syndrome </li></ul><ul><li>and </li></ul><ul><li>How is it linked </li></ul><ul><li>to </li></ul><ul><li>Heart disease ? </li></ul>
  35. 42. Metabolic syndrome <ul><li>Metabolic syndrome is a grouping of traits and medical conditions that puts people at risk for both heart disease and type 2 diabetes </li></ul><ul><li>It is defined by the National Cholesterol Education Program as having any three of the following five traits and medical conditions : </li></ul><ul><li>Conditions are on following slide </li></ul>
  36. 45. <ul><li>What can you do to prevent or delay </li></ul><ul><li>Heart disease and stroke ? </li></ul>
  37. 46. 1. Heart healthy diet <ul><li>Make sure that your diet is ‘’heart healthy’’ </li></ul><ul><li>- Include at least 14 grams of fibers daily for every 1,000 calories consumed </li></ul><ul><li>- Cut down on saturated fat </li></ul><ul><li>- Keep your cholesterol in your diet to less than 300 mg a day </li></ul><ul><li>- Keep the amount of Trans fat in your diet minimum </li></ul>
  38. 47. 2. Physical activity <ul><li>2. Make physical activity part of your routine </li></ul><ul><li>- Aim for at least 30 min of exercise most days of the week </li></ul><ul><li>- Think of ways to increase physical activity, such as taking the stairs instead of elevator . </li></ul><ul><li>3. Reach and maintain a healthy body weight </li></ul><ul><li>- If you are over weight, try to be physically active for at least 1 hour a day </li></ul><ul><li>- Aim for a loss of no more than 1 to 2 pounds a week </li></ul>
  39. 48. <ul><li>If you smoke, quit </li></ul><ul><li>Ask your Doctor(if you are not) whether you should take aspirin </li></ul><ul><li>Get prompt treatment for transient ischemic attacks (TIAs) </li></ul><ul><li>- Early treatment for TIAs may help prevent or delay a future stroke </li></ul><ul><li>- Signs of a TIAs are , </li></ul><ul><li>- Sudden weakness - Confusion </li></ul><ul><li>- Blindness in one or both eyes - Double vision </li></ul><ul><li>- Difficulty speaking - Severe headache </li></ul>
  40. 49. <ul><li>How will you know whether your </li></ul><ul><li>diabetes treatment </li></ul><ul><li>is </li></ul><ul><li>working ? </li></ul>
  41. 50. The Good News… <ul><li>By knowing the ABCs in diabetes, people with diabetes can reduce their risk for heart disease and stroke. </li></ul><ul><ul><li>A stands for A 1C </li></ul></ul><ul><ul><li>B stands for B lood pressure </li></ul></ul><ul><ul><li>C stands for C holesterol </li></ul></ul>5
  42. 51. Ask About Your A1C <ul><li>A1C measures average blood glucose over the last three months. </li></ul><ul><li>Get your A1C checked at least twice a year. </li></ul>A1C Goal = less than 7% 6
  43. 52. Key Steps for Lowering A1C <ul><li>Eat the right foods. </li></ul><ul><li>Get daily physical activity. </li></ul><ul><li>Test blood glucose regularly. </li></ul><ul><li>Take medications as prescribed. </li></ul>7
  44. 53. Blood glucose targets <ul><li>Before meals 90 to 130 mg/dL </li></ul><ul><li>1 to 2 hour after the Less than 180 mg/dL </li></ul><ul><li>start of the meal </li></ul>
  45. 54. Beware of Your Blood Pressure <ul><li>High blood pressure raises your risk for heart attack, stroke, eye problems and kidney disease. </li></ul><ul><li>Get your blood pressure checked at every visit. </li></ul><ul><li>Target BP = less than 130/80 </li></ul>8
  46. 55. Key Steps for Lowering Blood Pressure <ul><li>Eat more fruits and vegetables! </li></ul><ul><li>Reduce the amount of salt in diet. </li></ul><ul><li>Lose weight. </li></ul><ul><li>Lower alcohol intake. </li></ul><ul><li>Quit smoking. </li></ul><ul><li>Take blood pressure pills. </li></ul><ul><ul><li>many people require more than one pill </li></ul></ul>9
  47. 56. Check Your Cholesterol <ul><li>Several kinds of blood fats: </li></ul><ul><ul><li>LDL (“bad”) cholesterol - can narrow or block blood vessels </li></ul></ul><ul><ul><li>HDL (“good”) cholesterol - helps remove cholesterol deposits </li></ul></ul><ul><ul><li>Triglycerides - can raise your risk for heart attacks/stroke </li></ul></ul>10
  48. 57. ADA Goals for Cholesterol Target LDL = less than 100 Target HDL = above 40 (men) above 50 (women) Target triglycerides = less than 150 11
  49. 58. Key Steps for Controlling Your Cholesterol <ul><li>Eat less saturated fat </li></ul><ul><li>Foods high in saturated fat: fatty meats, high-fat dairy products, tropical oils </li></ul><ul><li>Eat foods high in fiber </li></ul><ul><li>Examples: oatmeal, beans, peas, </li></ul><ul><li>citrus fruits </li></ul><ul><li>Take cholesterol-lowering medication </li></ul><ul><li>Exercise regularly </li></ul>12
  50. 59. <ul><li>What type of heart and blood vessel </li></ul><ul><li>Disease occur in </li></ul><ul><li>The people with diabetes ? </li></ul>
  51. 60. Heart & blood vessel disease in diabetes <ul><li>Two major type of cardiovascular disease are common in people with diabetes </li></ul><ul><li>Coronary artery disease (CAD) </li></ul><ul><li>Cerebral vascular disease </li></ul><ul><li>People with diabetes are also at risk for heart failure </li></ul><ul><li>Narrowing or blockage of the blood vessels in the legs , a condition called (PAD) also occurs in people with diabetes </li></ul>
  52. 61. <ul><li>Coronary Artery Disease </li></ul>
  53. 62. Coronary Artery Disease <ul><li>CAD also called ischemic heart disease, is caused by hardening or thickening of the walls of blood vessels that go to the heart </li></ul><ul><li>If the blood vessels to the heart become narrowed or blocked by fatty deposits, the blood supply is reduced or cut off, resulting in the heart attack </li></ul>
  54. 63. <ul><li>Cerebral Vascular Disease </li></ul>
  55. 64. Cerebral Vascular Disease <ul><li>Cerebral vascular disease affects blood flow to the brain, leading to strokes and TIAs. </li></ul><ul><li>It is caused by narrowing, blocking, or hardening of the blood vessels that go to the brain or by high blood pressure </li></ul>
  56. 65. <ul><li>Stroke </li></ul>
  57. 66. Stroke <ul><li>A stroke result when the blood supply to the brain is suddenly cut off , which can occur when a blood vessel in the brain or neck is blocked or bursts </li></ul><ul><li>Brain cells are then deprived of oxygen and die </li></ul><ul><li>A stroke can result in problem with speech or vision or can cause weakness or paralysis and coma. </li></ul>
  58. 67. Stroke continue… <ul><li>People with diabetes are at increase risk for strokes caused by blood clots </li></ul><ul><li>A stroke may also be caused by bleeding blood vessel in the brain Called an aneurysm, a break in a vessel can occur as a result of high blood pressure </li></ul>
  59. 68. <ul><li>Transient ischemic attacks </li></ul>
  60. 69. Transient ischemic attacks(TIAs) <ul><li>TIAs are caused by a temporary blockage of a blood vessel to the brain </li></ul><ul><li>This blockage lead to a brief, sudden change in brain function , such as temporary numbness or weakness on one side of the body </li></ul><ul><li>However, most symptoms disappear quickly and permanent damage is unlikely </li></ul><ul><li>If symptoms do not resolve in a few minutes, rather than a TIAs, the event could be a stroke </li></ul><ul><li>TIAs means that a person is at risk for a stroke sometimes in future. </li></ul>
  61. 70. <ul><li>Heart failure </li></ul>
  62. 71. Heart failure <ul><li>Heart failure is a chronic condition in which the heart can not pump blood properly – it does not mean that heart suddenly stop working </li></ul><ul><li>Heart failure develops over a period of years, and symptoms can get worse over time </li></ul><ul><li>People with diabetes have at least twice the risk of heart failure as other people </li></ul>
  63. 72. Heart failure continue… <ul><li>One type of heart failure is congestive heart failure , in which fluid builds up inside body tissue </li></ul><ul><li>If the buildup is in the lungs, breathing becomes difficult </li></ul><ul><li>Blockage of the blood vessels and high blood glucose levels also can damage heart muscle and cause irregular heart beats </li></ul>
  64. 73. Heart failure continue… <ul><li>People with damage to heart muscle, a condition called cardiomyopathy , may have no symptoms in the early stages, but later they may experience </li></ul><ul><li>- Weakness - Fatigue </li></ul><ul><li>- Shortness of breath - Swelling of the legs and feet </li></ul><ul><li>- Severe cough </li></ul><ul><li>diabetes also interfere with pain signals normally carried by the nerves </li></ul><ul><li>That is why a person with diabetes may not experience the typical warning signs of a heart attack. (Silent killer) </li></ul>
  65. 74. <ul><li>Peripheral Arterial Disease </li></ul>
  66. 75. Peripheral Arterial Disease <ul><li>Common in people with diabetes </li></ul><ul><li>With this condition, the blood vessel in the legs are narrowed or blocked by fatty deposits, decreasing blood flow to the legs and feet </li></ul><ul><li>PAD increase the chances of a heart attack or stroke occurring </li></ul><ul><li>Some times people with PAD develop pain in the calf or other parts of the legs when walking , which is relieved by resting for few minutes </li></ul>
  67. 76. <ul><li>How will I know </li></ul><ul><li>whether </li></ul><ul><li>I have heart disease ? </li></ul>
  68. 77. Signs & symptoms of heart attack <ul><li>Chest pain or discomfort (angina) </li></ul><ul><li>Pain or discomfort in your arms, back, jaw, neck, or stomach </li></ul><ul><li>Shortness of breathing </li></ul><ul><li>Sweating </li></ul><ul><li>Nausea </li></ul><ul><li>Light-headedness </li></ul>
  69. 78. Symptoms continue… <ul><li>Symptoms may come and go </li></ul><ul><li>However, in some people, particularly those with diabetes, symptoms may be mild or absent due to nerve damage caused by diabetes </li></ul><ul><li>Women may not have chest pain but more likely to have SOB, nausea, or back and jaw pain </li></ul><ul><li>If you have symptoms like that call 911 right away </li></ul><ul><li>Because treatment is most effective if given within an hour of heart attack, if delay lead permanent damage of heart </li></ul>
  70. 79. <ul><li>What are the treatment options </li></ul><ul><li>For </li></ul><ul><li>Heart disease </li></ul>
  71. 80. Treatment for heart disease <ul><li>Treatment for heart disease includes meal planning to ensure a heart-healthy diet and physical activity </li></ul><ul><li>In addition, you may need medications to treat heart damage or to lower your blood glucose, BP, and cholesterol </li></ul><ul><li>You also may need surgery or some other medical procedure </li></ul>
  72. 81. <ul><li>How will I know </li></ul><ul><li>Whether </li></ul><ul><li>I have had a stroke ? </li></ul>
  73. 82. Signs & symptoms of stroke <ul><li>Sudden weakness or numbness of your face, arm, or leg on one side of your body </li></ul><ul><li>Sudden confusion, trouble talking, or trouble walking </li></ul><ul><li>Sudden trouble seeing out of one or both eyes or sudden double vision </li></ul><ul><li>Sudden severe headache </li></ul><ul><li>If you have any of these symptoms </li></ul><ul><li>call 911 right away </li></ul>
  74. 83. <ul><li>What are the treatment options </li></ul><ul><li>For </li></ul><ul><li>Stroke </li></ul>
  75. 84. Treatment for stroke <ul><li>At the first sign of a stroke, you should get medical care right away </li></ul><ul><li>If blood vessels to your brain are blocked by blood clots, ‘’clot-busting’’ drugs is useful </li></ul><ul><li>The drug must be given soon after a stroke to be effective </li></ul><ul><li>Subsequent treatment for stroke includes medications and physical therapy , as well as surgery to repair the damage </li></ul><ul><li>Meal planning and physical activity may be part of your ongoing care </li></ul><ul><li>In addition, you may need medications to lower your blood glucose , blood pressure , and cholesterol and to prevent blood clots </li></ul>
  76. 85. Key Points Review <ul><li>People with diabetes are at a very high risk for heart attack and stroke. </li></ul><ul><li>More than 2 out of 3 of people with diabetes die of heart disease or stroke. </li></ul><ul><li>Diabetes is more than managing blood glucose. It’s managing blood glucose and blood pressure and cholesterol. </li></ul><ul><li>Know the ABCs of Diabetes. </li></ul><ul><li>More treatments are available than ever before. Talk to your healthcare provider and learn what you can do to manage your ABCs. </li></ul>17
  77. 86. General Tips <ul><li>Take steps to lower your risk of D-CVD complications: </li></ul><ul><ul><li>A1C < 7. </li></ul></ul><ul><ul><li>Blood pressure < 130/80. </li></ul></ul><ul><ul><li>Cholesterol (LDL) < 100. </li></ul></ul><ul><ul><li>Cholesterol (HDL) > 40 (men) and > 50 (women). </li></ul></ul><ul><ul><li>Triglycerides < 150. </li></ul></ul><ul><ul><li>Get help to quit smoking. </li></ul></ul><ul><ul><li>Be active. </li></ul></ul><ul><ul><li>Make healthy food choices. </li></ul></ul><ul><ul><li>Talk to your doctor about medication . </li></ul></ul>18
  78. 87. For More Information <ul><li>Call: 1-800-DIABETES </li></ul><ul><li>Visit: </li></ul><ul><li>Email: [email_address] </li></ul>20