Diabetes sweet kiiler


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Diabetes sweet kiiler

  1. 1. <ul><li>Diabetes: A sweet killer in 21st century </li></ul>
  2. 2. <ul><li>Provide practical guidance on improving diabetes care through highlighting the need for: </li></ul><ul><li>Increased patient understanding of type 2 diabetes and the importance of reaching glycemic goals </li></ul><ul><li>A multidisciplinary team approach to treating type 2 diabetes </li></ul>AIM :
  3. 3. Diabetes <ul><li>Patients of diabetes are present all across the world. Not only you, but in India one in every 30 people is affected by this disease. There is no cure for diabetes, you can only keep it under control. </li></ul>
  4. 4. <ul><li>Now sit back & go through this information carefully. Do not forget to discuss it with your doctor. This will help you manage your disease better. </li></ul>
  6. 6. ABCs for Good Health Campaign A – A1c – 7% or less B – Blood Pressure 130/80 or less C – Cholesterol – 200 or less
  8. 8. What Does Insulin Do ? <ul><li>Insulin is a hormone which is needed by the body to convert sugar, starches and other food into energy needed for daily life. </li></ul>
  9. 9. <ul><li>Presence of insulin maintains normal level of glucose in the blood. </li></ul><ul><li>Lack of insulin leads to increase in levels of glucose in the blood (HYPERGLYCEMIA) </li></ul>What Does Insulin Do ?
  10. 10. <ul><li>Family history </li></ul><ul><li>Obesity/central obesity </li></ul><ul><li>Hypertension </li></ul><ul><li>Abnormal lipids </li></ul><ul><li>Hyperglycemia during pregnancy </li></ul><ul><li>Age above 30 yrs </li></ul><ul><li>Stress </li></ul><ul><li>Sedentary lifestyle </li></ul><ul><li>Impaired glucose tolerance </li></ul>Risk factors for Diabetes
  11. 11. GLOBAL PROJECTIONS FOR THE NUMBER OF PEOPLE WITH DIABETES (20-79 AGE GROUP), 2007 and 2025 (MILLIONS) Highly Dense Diabetic Population
  12. 13. <ul><li>This is a disease in which the body does not produce insulin. </li></ul><ul><li>It develops more frequently in children, but can also occur in adults </li></ul><ul><li>Such people have to take daily insulin injections to stay alive! </li></ul>Type 1 Diabetes
  14. 15. What is Type 2 Diabetes ? <ul><li>This is a disorder due to the body’s inability to make enough insulin or properly use insulin. </li></ul><ul><li>It develops more in adults, but it is now found to occur even in adolescents </li></ul><ul><li>They need medicines to correct this problem. </li></ul>
  15. 16. Can diabetes be life threatening? <ul><li>Yes, if not managed properly. </li></ul><ul><li>Affects quality of life </li></ul><ul><li>May lead to diseases of heart, kidney,eyes. </li></ul><ul><li>Impotence, amputation , paralysis. </li></ul><ul><li>Can diabetes be cured? </li></ul><ul><li>No, but if properly managed, people with diabetes can lead a healthy, normal life </li></ul>
  16. 17. Can diabetes (type 2) be prevented? <ul><li>Yes. </li></ul><ul><li>All high risk individuals should </li></ul><ul><ul><li>Aim at ideal weight </li></ul></ul><ul><ul><li>Increase physical activity </li></ul></ul><ul><ul><li>Adopt a healthy, balanced diet </li></ul></ul><ul><ul><li>Use of metformin (consult your doctor) </li></ul></ul>
  17. 18. Management of diabetes <ul><li>Get your blood Sugar under control by : </li></ul><ul><li>Lifestyle modification </li></ul><ul><ul><li>Diet </li></ul></ul><ul><ul><li>Exercise </li></ul></ul><ul><li>Medications </li></ul>
  18. 19. How to control Diabetes ? <ul><li>Diet </li></ul><ul><li>Avoid deep fried food </li></ul><ul><li>Avoid sweet food </li></ul><ul><li>Consume food that is rich in fibre </li></ul><ul><li>Divide your meals in 3-4 parts, take smaller meals at regular intervals </li></ul><ul><li>Decide your meal as per the calories advised by your doctor or dietician </li></ul>
  19. 21. GrainGroup <ul><li>Make half your grains whole </li></ul><ul><li>Eat at least 84 gm of whole grains every day </li></ul><ul><ul><li>Cereal -Breads </li></ul></ul><ul><ul><li>Rice </li></ul></ul><ul><ul><li>Pasta </li></ul></ul>
  20. 22. VegetableGroup <ul><li>Vary your veggies </li></ul><ul><li>Eat more dark green veggies like broccoli, spinach and other dark, leafy greens </li></ul><ul><li>Eat more orange vegetables like carrots and sweet potatoes </li></ul>
  21. 23. Fruit Group <ul><li>Focus on fruits </li></ul><ul><li>Eat a variety of fruits </li></ul><ul><li>Choose fresh, frozen, canned, or dried fruit </li></ul><ul><li>Go easy on fruit juices </li></ul>
  22. 24. How to control Diabetes ? <ul><li>Regular exercise </li></ul><ul><ul><li>L ike brisk-walking, swimming, dancing, cycling, or outdoor sports that can give exercise to your body should be done every day. </li></ul></ul><ul><li>Advantages of Exercise </li></ul><ul><ul><li>R educes & controls weight </li></ul></ul><ul><ul><li>Helps to reduce blood glucose </li></ul></ul><ul><ul><li>Keeps your heart & lungs healthy </li></ul></ul><ul><ul><li>Gives a sense of well being </li></ul></ul>
  23. 25. Exercise <ul><li>There is no universal exercise program for all. </li></ul><ul><li>30 min. daily for minimum 5 days a week </li></ul><ul><li>Drink fluids before and after exercise </li></ul><ul><li>Even elderly & Arthritic can exercise : Stretching, Strengthening muscles </li></ul>
  24. 26. How to control Diabetes ? <ul><li>Drugs </li></ul><ul><li>Regular intake of drugs as per the advice of your doctor is very important </li></ul>
  25. 27. Why to control Diabetes ? <ul><li>If not controlled Diabetes can lead to serious complications of eyes, kidneys, heart, nervous system. </li></ul><ul><li>Therefore, diabetes needs to be controlled strictly. </li></ul>
  26. 28. Heart Disease - Cardiovascular Disease <ul><li>People with diabetes are about three times more likely to have significant heart disease. </li></ul>Complications of Diabetes
  27. 29. Heart Disease - Cardiovascular Disease <ul><li>Why are they at such high risk ? </li></ul><ul><li>The extra glucose leads to the clogging of the blood vessels that nourish the heart. </li></ul>Complications of Diabetes
  28. 30. Heart Disease: Risk Factors <ul><li>Smoking with Diabetes is Especially bad for the Heart </li></ul>Complications of Diabetes Smoking High Cholesterol High Blood Pressure 350 200 100
  29. 31. Heart Disease: Symptoms <ul><li>Common symptoms are : </li></ul>Complications of Diabetes Breathlessness Dizziness Pain in Chest, arms, shoulder, back Visual Disturbances
  30. 32. Eye Diseases: Retinopathy Complications of Diabetes <ul><li>Retinopathy is an impairment of the retina. Retina : The nerve-rich, light-sensing area in the back of the eyeball, that is crucial for sight. </li></ul><ul><li>Diabetes destroys the small blood vessels that nourish retina. </li></ul><ul><li>People with diabetes are four times more likely to become blind </li></ul><ul><li>Each year, diabetes is the underlying cause of 12% of new blindness diagnoses. </li></ul>
  31. 33. Eye Diseases: Retinopathy Complications of Diabetes Who’s most at Risk for Retinopathy ? <ul><li>People with poor blood sugar control. </li></ul><ul><li>Long duration of Diabetes </li></ul><ul><li>Kidney disease </li></ul><ul><li>High blood pressure. </li></ul>
  32. 34. Complications of Diabetes <ul><li>Kidney Disease: How can you delay the progression? </li></ul><ul><li>Control high blood pressure </li></ul><ul><li>Practice tight control of glucose </li></ul><ul><li>Consult your doctor for the prescription of medicine that delays kidney failure </li></ul>
  33. 35. Diabetes and Stress <ul><li>Stress can make blood sugar control difficult </li></ul><ul><li>What is stress ? </li></ul><ul><ul><li>Body feels as if it is under attack like physical injury or illness and mental stress due to domestic or professional reasons </li></ul></ul><ul><ul><li>Body responds to stress by increasing levels of many hormones causing release of stored sugar & fat </li></ul></ul>
  34. 36. Diabetes and Stress <ul><li>People with stress : </li></ul><ul><ul><li>Drink more alcohol </li></ul></ul><ul><ul><li>Exercise less </li></ul></ul><ul><ul><li>Irregularity in blood sugar monitoring </li></ul></ul><ul><ul><li>Improper plan of meals </li></ul></ul>
  35. 37. Diabetes and Stress <ul><li>Coping with stress : </li></ul><ul><ul><li>Relaxation, Meditation </li></ul></ul><ul><ul><li>Gardening, Music </li></ul></ul><ul><ul><li>Breathing exercises at least once a day </li></ul></ul><ul><ul><li>Lifestyle modification </li></ul></ul>
  36. 38. Complications of Diabetes <ul><li>Oral Infections </li></ul>Minimize your Risk of Infections <ul><li>Brush and floss daily to keep bacteria between teeth and gums in check, and see your dentist at least twice a year. </li></ul>
  37. 39. Complications of Diabetes <ul><li>Skin Infections </li></ul>When to see skin specialist ? <ul><li>There is redness, swelling, itching, pus or pain </li></ul><ul><li>Rashes, bumps or pits near Insulin injection sites </li></ul>
  38. 40. Complications of Diabetes <ul><li>Constipation can be another complication </li></ul><ul><li>Among those who’ve had diabetes for a long time, an estimated 25% complain of constipation </li></ul><ul><li>Never ignore the urge to go </li></ul><ul><li>Get regular exercise </li></ul><ul><li>Drink plenty of fluids </li></ul><ul><li>Eat a high-fiber diet: bran cereals, whole grain items, fruits, vegetables </li></ul><ul><li>Consult your doctor for further medication. </li></ul>
  39. 41. Foot Care <ul><li>What to look for </li></ul><ul><li>Any abnormal sensation </li></ul><ul><li>Severe pain </li></ul><ul><li>Dry scaly or cracked skin </li></ul><ul><li>Any new growth on the feet </li></ul><ul><li>Soreness and redness of the feet </li></ul><ul><li>Changes in the shape of the foot </li></ul><ul><li>Ulcers and pus formation </li></ul>
  40. 42. <ul><li>Keep feet clean and dry </li></ul><ul><li>Wash feet daily with warm water </li></ul><ul><li>Use a mild soap and rinse well </li></ul><ul><li>Dry feet thoroughly, particularly between the toes </li></ul><ul><li>Do not go barefeet </li></ul><ul><li>Trim your toenails straight across </li></ul><ul><li>Powder feet and shoes every day </li></ul><ul><li>Wear comfortable shoes </li></ul><ul><li>Wear fresh socks every day </li></ul><ul><li>Avoid using sandals with toe grips </li></ul>Foot Care
  41. 43. Complications of Diabetes <ul><li>It is more common among those with type 1 insulin-dependent diabetes. It is considerably less common but still possible among those with type 2 non-insulin-dependent diabetes. </li></ul>Low Blood Glucose (Hypoglycemia)
  42. 44. Complications of Diabetes <ul><li>Too much insulin or diabetes medication. </li></ul><ul><li>Less or irregular food intake, particularly carbohydrates. </li></ul>Know what Causes Low Blood Glucose <ul><li>Too much exercise </li></ul><ul><li>Drinking alcohol </li></ul><ul><ul><li>Alcohol lowers blood glucose levels. </li></ul></ul><ul><ul><li>Be sure you don’t drink on an empty stomach. </li></ul></ul><ul><li>Pregnancy </li></ul>
  43. 46. Complications of Diabetes Hypoglycemia To minimize risk of night times hypoglycemia, test your blood sugar periodically around 2 a.m. to 3 a.m. and determine how your level relates to your food, exercise, and insulin or medication the previous day. Adjust accordingly.
  44. 47. Cholesterol Total less than 200 mg/dl LDL (bad)-below 130 mg/dl but below 100 is optimal, if known heart disease 70-100 (the higher the risk, the lower the LDL) HDL (good)–over 40 mg/dl but ideally over 60mg/dl as that greatly lowers heart disease risk 1% drop in blood cholesterol translates into 2% drop in risk for heart disease
  45. 48. Where does it come from ? <ul><li>Two sources of cholesterol: Food & made in your body </li></ul><ul><li>Food sources: All foods containing animal fat and meat products </li></ul>65% 35%
  46. 49. Know Your Numbers Triglycerides Less than 150 mg/dl is normal 150 to 500 mg/dl is considered high Over 500 mg/dl is very high
  47. 50. High Blood Pressure <ul><li>High Blood Pressure (HBP) also known as hypertension is a major risk factor for heart disease, kidney disease, stroke and congestive heart failure. </li></ul><ul><li>HBP is often called the “ silent killer” because it usually does not cause symptoms. </li></ul>
  48. 51. HBP: How High is High Category Systolic Diastolic Normal Less than 120 Less than 80 Prehypertension 120-139 80-89 Hypertension 140 or higher 90 or higher
  49. 52. <ul><li>Just monitor your blood glucose regularly </li></ul>
  50. 53. Blood Glucose Monitoring <ul><li>Check your blood glucose regularly </li></ul><ul><li>It is indeed very easy </li></ul>
  51. 54. Blood Glucose Testing - Basics <ul><li>No matter which type of diabetes you have-type 1 insulin dependent, type 2 non-insulin dependent or gestational the single best way to manage your condition is to monitor the amount of glucose in your blood. </li></ul><ul><li>Do it carefully and frequently </li></ul>
  52. 55. Blood Glucose Monitoring : Why ? <ul><li>Self-monitoring of blood glucose tells you when your blood glucose is too low or when your glucose is too high, which tells you about the need to change your dose of medication, diet & exercise. </li></ul><ul><li>And as your blood glucose control improves, self-testing gives you positive feedback about your progress toward the goal of diabetes self-management. </li></ul>
  53. 56. Blood Sugar Testing - Basics <ul><li>How often should you test ? </li></ul><ul><li>In people with type 1 diabetes you need to test four or five times a day - before each meal and before bedtime - and in the middle of the night (around 3 a.m.) once a week. </li></ul><ul><li>People with type 2 diabetes can also have high blood glucose levels and still feel fine so, when in doubt, test, When diet or activity levels change, or when you’re ill or under other stress, test more frequently. </li></ul>The more often you test, the higher your control becomes.
  54. 57. How to test blood for glucose?
  55. 58. How to test blood for glucose?
  56. 59. How to test blood for glucose?
  57. 60. How to test blood for glucose?
  58. 61. How to test blood for glucose?
  59. 62. How to test blood for glucose?
  60. 63. How to test blood for glucose?
  61. 64. Blood Glucose Testing - why? <ul><li>The amount of glucose in your blood changes throughout the day, if your blood glucose level rise too high or falls too low, you could develop some potentially serious complications. </li></ul>
  62. 65. Take Control Research shows that men and women can lower their heart disease risk & Diabetes by 82 percent by leading a healthy lifestyle.
  63. 66. Tight Control Really Works <ul><li>People with type 2 who aggressively reduced their blood glucose reduced their risk of blindness and kidney failure by 25%. </li></ul><ul><li>In addition, if they aggressively reduced their blood pressure, their risk of stroke was reduced by 44% and heart failure by 56%. </li></ul>
  64. 67. Blood Glucose Testing - Basics <ul><li>What to do with the results ? </li></ul><ul><li>Every time you take a reading. Write it down </li></ul><ul><li>Keeping a diabetes diary like this will help you fine-tune your glucose control and help you to figure out what’s wrong if your glucose levels go haywire. </li></ul><ul><li>Sometimes you might find an unexpected high or low reading. Try to figure out why. </li></ul><ul><li>Your reading may be surprisingly high or low for no apparent reason. Keep testing to make sense of your results. </li></ul>
  65. 68. Checklist for a Diabetic <ul><li>Blood Pressure - Whenever you visit Doctor </li></ul><ul><li>Blood Sugar, Urine sugar - Daily </li></ul><ul><li>Urine Ketones, proteins (Micral) - Every 6 mths. </li></ul><ul><li>HbA1c - Every 3 months </li></ul><ul><li>Lipids (Cholesterol, Triglycerides) - Every 3-6 mth. </li></ul><ul><li>Daily Foot Examination </li></ul><ul><li>Eye Examination - Every year </li></ul><ul><li>Body Weight </li></ul>
  66. 69. A blood sugar range that works for someone else may not work for you. Ask your doctor about your best range.