Negin Dorri, profile picture
Uploaded byNegin Dorri
182 views

Adaptation to Diabetes Mellitus

The document discusses diabetes mellitus, covering its physiological aspects, types, historical context, global prevalence, causes, symptoms, diagnoses, psychological impacts, and social considerations. It highlights the relationship between diabetes management and mental health, detailing emotional challenges faced by individuals with diabetes, such as diabetes distress and depression. Additionally, it emphasizes the importance of social support and effective self-care practices in managing diabetes.

Embed presentation

Adaptation to Diabetes Mellitus Department of Psychology Professor: Reza Pourhosein, Ph.D. By: Negin Dorri May 2020
Part One: Introduction • The Homan Body • The Endocrine System • The Pancreas • Pancreatic Endocrine Hormones
The Human Body The human body is the structure of a human being. It is composed of many different types of cells that together create tissues and subsequently organ systems. The main systems of the human body are: • Circulatory System • Digestive System • Immune System • Lymphatic System • Muscular System • Nervous System • Reproductive System • Respiratory System • Urinary System • Endocrine System• Integumentary System
The Endocrine System The endocrine system is a network of glands and organs located throughout the body. It’s similar to the nervous system in that it plays a vital role in controlling and regulating many of the body’s functions.
The Pancreas The pancreas has 2 main functions. The exocrine function and the endocrine function The Exocrine Function makes enzymes, which help digest proteins, fats, and carbohydrates before they can be absorbed in the intestine. When food enters the stomach, these pancreatic juices are released into a system of ducts that culminate in the main pancreatic duct. The Endocrine Function makes hormones, the most important of which is insulin, which control how the body uses and stores sugar glucose, its main source of energy.
The human body wants blood Glucose maintained in a very narrow range. Insulin and Glucagon are the hormones which make this happen. Both insulin and glucagon are secreted from the Pancreas, and thus are referred to as Pancreatic Endocrine Hormones. Pancreatic Endocrine Hormones
Part Two: Diabetes Mellitus • Diabetes Mellitus • The History of Diabetes • The Global Prevalence of Diabetes • Types of Diabetes • Gestational Diabetes Mellitus • Infographics of Diabetes Types • Causes and Risk Factors of Diabetes • Impaired Fetal Nutrition • Symptoms of Diabetes • Diagnoses of Diabetes • Possible Physical Effects of Diabetes
Diabetes Mellitus Diabetes Mellitus is a chronic disease that affects how your body turns food into energy. when someone is diabetic the body doesn’t or can’t use the Insulin it makes as well as it should. When there isn’t enough insulin or cells stop responding to insulin, too much blood sugar stays in the bloodstream. Insulin
Insulin The History of Diabetes Scientists and physicians have been documenting the condition now known as diabetes for thousands of years. • The first known mention of diabetes symptoms was in 1552 B.C., by Hesy-Ra, an Egyptian physician. • In 150 AD, the Greek physician Arateus described what we now call diabetes as "the melting down of flesh and limbs into urine.“ • Centuries later, people known as "water tasters" diagnosed diabetes by tasting the urine of people suspected to have it.
The Global Prevalence of Diabetes Estimates and projections of the global prevalence of diabetes in the 20–79 year age group Millions Estimates One in two adults with diabetes are undiagnosed 232 million people. One in eleven adults from 20 to 79 years old have diabetes 463 million people.
Types of Diabetes Insulin • Type 1 Diabetes Type 2 diabetes results from the body’s ineffective use of insulin. Type 2 diabetes comprises the majority of people with diabetes around the world, and is largely the result of excess body weight and physical inactivity. • Type 2 Diabetes Type 1 diabetes is characterized by deficient insulin production and requires daily administration of insulin. The cause of type 1 diabetes is not known and it is not preventable with current knowledge.
Gestational Diabetes Mellitus • Gestational diabetes mellitus is defined as carbohydrate intolerance resulting in hyperglycemia of variable severity with onset or first recognition during pregnancy. • Gestational diabetes affects 3–10% of pregnancies, depending on the population studied. • Some causes and Risk Factors of Gestational Diabetes Mellitus include: Obesity, Family History, Increasing Maternal Age, Multiple Pregnancy and Previous Gestational Diabetes Mellitus. Doi:10.1016/j.ogrm.2014.05.005
Insulin Gestational Diabeteswith Type 1 Diabetes: The Body doesn’t produce Insulin Infographics of Diabetes Types with Type 2 Diabetes: The Body produce Insulin but is not used efficiently ← Can be prevented →
Causes and Risk Factors of Diabetes Insulin • Type 1 Diabetes possible Causes: Genetics Viral or bacterial infection Chemical toxins within food Unidentified component causing autoimmune reaction • Type 2 Diabetes Causes: Obesity Living a sedentary lifestyle Increasing age Bad diet Other type 2 diabetes causes such as pregnancy or illness can be type 2 diabetes risk factor.
Impaired Fetal Nutrition • Low-birthweight babies, are more prone than those of normal weight to a range of clinical and metabolic abnormalities including : • A poor diet during pregnancy may increase the risk of a woman’s children and grandchildren developing type 2 diabetes in later life. Obesity Hypertension Dyslipidemia Insulin Resistance Doi:10.1002/14651858.CD006674.pub3 • Mothers who eat unhealthily could “programme” susceptibility into the cells of their unborn baby. This genetic vulnerability could then be passed down to future generations.
Insulin Symptoms of Diabetes Type 1 diabetes can develop at any age, though it often appears during childhood or adolescence. Type 2 diabetes, the more common type, can develop at any age, though it's more common in people older than 40. Some of the signs and symptoms of type 1 and type 2 diabetes are: Extreme Hunger Fatigue Frequent Urination Irritability Slow-healing Sores Blurred vision Unexplained Weight Loss Increased Thirst
Insulin Diagnoses of Diabetes There are several ways to diagnose diabetes: • The A1C test measures your average blood sugar for the past 2 to 3 months. The advantages of being diagnosed this way are that you don't have to fast or drink anything. • The Fasting Plasma Glucose test checks the fasting blood sugar levels. Fasting means after not having anything to eat or drink for at least 8 hours before the test. • The Oral Glucose Tolerance Test is a two-hour test that checks your blood sugar levels before and 2 hours after you drink a special sweet drink.
Insulin Possible Physical Effects of Diabetes Damage to the large blood vessels of the heart, brain and legs. Damage to the small blood vessels, causing problems in the eyes, kidneys, feet and nerves. Other parts of the body can also be affected by diabetes, including the digestive system, the skin, sexual organs, teeth and gums, and the immune system. The risk of most diabetes-related complications can be reduced by keeping blood pressure, blood glucose and cholesterol levels within recommended range. Also, being a healthy weight, eating healthily, and not smoking will help reduce your risk.
Part Three: Psychological Aspects of Diabetes Mellitus • Diabetes and Mental Health • Facing Life with Diabetes • Dealing with Diagnosis • Diabetes Distress • Diabetes-related Distress • Depression and Diabetes • Fear of Hypoglycemia • Psychological Barriers to Insulin Use • Identifying Patients
Diabetes and Mental Health Chronic illness usually leads to more symptoms. Many people assume that the symptoms they are experiencing are due to only one cause: the disease. While the disease can certainly cause certain symptoms., it is not the only cause. Symptoms Tense Muscles Disease Fatigue Pain Depression Stress Difficult Emotions Vicious Cycle The Vicious Symptom Cycle In no particular order ISBN-13: 978-1-933503-01-1
Insulin Facing Life with Diabetes “I was just shocked, thinking, because I’m so healthy. And I thought, “oh my God, it’s like the end of me”, kind of, you know, that shock.” (Person with Type 2 diabetes) “I was jumping around from shock to denial to grief to tears to… I certainly went through that… the reactions might go up and down for quite some time… for my first 12 months I went through lots of reactions.” (Person with Type 1 diabetes) “I don’t think it’s all that devastating. There are far worse incurable sorts of things.” (Person with diabetes)
Dealing with Diagnosis The diagnosis of diabetes is a life event that has been likened to the experience of grief. The diagnosis of diabetes can trigger a grieving for one’s “Lost Health”. Not everyone with diabetes will necessarily experience all of these emotional reactions, or in this particular order. The stages of grief: • Stage 1: Denial • Stage 2: Anger • Stage 3: Bargaining • Stage 4: Depression • Stage 5: Acceptance “I can take Control and Manage this”.
Insulin Diabetes Distress 1 in 4 people with Type 1 and 1 in 5 people with Type 2 diabetes have high levels of diabetes distress that is likely to be negatively effecting how they manage their diabetes Living with diabetes is challenging. ‘worrying about the future and the possibility of serious complications’ and ‘experiencing feelings of guilt and anxiety when diabetes management goes off track’.
Insulin • Diabetes-related distress is defined as a patient's concern about disease management, support, emotional burden and access to care. Diabetes‐related Distress The relationship between diabetes-related distress and glycaemia control does not assume the direct involvement of any physiological process, but instead, emphasizes the ongoing negative subjective experience of emotional distress around the management of diabetes that has implications for ongoing disease‐related behaviors, motivation, self‐efficacy, problem solving and even depressive symptoms. Doi: 10.1002/14651858.CD011469.pub2
Insulin Depression and Diabetes People with diabetes are more likely than the general population to be effected by symptoms of depression. Diabetes-specific contributors may include the chronic nature of the condition and complex management regimens. In people with diabetes, depression or depressive symptoms are associated with adverse medical and psychological outcomes. 1 in 5 people with Type 1 and 1 in 3 people with Type 2 diabetes using insulin and 1 in 4 people with Type 2 diabetes not depending on inulin a have high levels of depression.
Insulin Depression and Diabetes • Sub-optimal self-management such as: In people with diabetes, depression or depressive symptoms are associated with adverse medical and psychological outcomes, including: Reduced Physical Activity Less Healthy Eating Smoking • Elevated HbA1c, Hypoglycaemia and Hyperglycaemia. • Increased prevalence, and earlier onset, of complications and disability. • Increased risk of diabetes distress and elevated anxiety symptoms. • Impaired quality of life, and social role/ functioning. • Increased burden/costs to the individual and the healthcare system.
Insulin Fear of Hypoglycaemia Fear of hypos is a specific and intense feeling brought on by the risk and/or experiences of having low blood glucose. It is common to worry about: • Losing consciousness • Being judged by others • Relying on others for help • Having a hypo while asleep • Having an accident or injuring yourself
Insulin Fear of Hypoglycaemia is a common challenge for people managing their diabetes with insulin or other glucose-lowering medications. People with diabetes often worry or become fearful about hypos. “There’s nothing worse than having that fear at the back of your head that you’re going to be in a meeting or something and pass out from not treating a hypo quick enough— it’s never happened, touch wood.” Melissa, 31, person with diabetes. Hypoglycaemia
Insulin Psychological Barriers to Insulin Use 1. Painful Injection 2. Apprehension about self-injection. 3. Needle Phobia 4. Social Embarrassment Abu Hassan et al. BMC Family Practice 2013 In a qualitative exploration study of factors influencing insulin acceptance, Many participants had negative concerns related to insulin use. The main concerns vented by them were about injection of insulin: People with diabetes often have negative thoughts or feelings about starting, using, or intensifying insulin. This is also known as ‘Psychological Insulin Resistance’ or ‘Negative Appraisals of Insulin’.
Insulin Other Impacts of Using Insulin Inconvenience and Impractical “I see my daughter half an hour before dinner, she has to inject, so troublesome, very inconvenient” Lifestyle Restriction “When you are on insulin, it is more difficult to go out or eat out. You are more restricted. You have to plan your exercise as well” Social Stigma “Our society is quite ignorant of insulin therapy and they might associate insulin injection with drug addicts”
Insulin Identifying Patients Emotional problems are associated with poorer self-care behavior. Thus, addressing emotional problems is a key health care intervention even if diabetes self-care is adequate, and all clinicians should be able to: 1. Identify patients suffering from distress and depression. 2. Identify patients who are suffering from any other psychiatric disorders. 3. Apply effective treatments to relieve these issues. 4. Refer patients for specialized mental health care when appropriate.
Part Four: Social Aspects of Diabetes Mellitus • Social Aspects – Daily Life • Students with Diabetes • Employment and Diabetes Mellitus • Driving and Diabetes Mellitus • Diabetes and Social Support
Social Aspects – Daily Life Diabetes influences many aspects of daily life, principally through the effects of treatment and its potential side effects, particularly hypoglycemia. • Students with Diabetes • Employment • Driving The development of diabetic complications, such as neuropathy and retinopathy, can also affect everyday activities, particularly when these are severe with clinical manifestations, or require time-consuming treatment such as dialysis for chronic renal failure. Diabetes could effect ones daily routine such as:
Students with Diabetes There is a natural desire for students with diabetes not to appear different from their peers and this may lead them to assign a lower priority to diabetes management than they would normally and to undertake potentially high-risk activities. Some short and long terms problems can include high or low blood glucose levels that significantly effect the student's ability to concentrate and learn, and can cause serious immediate consequences such as brain damage or death if not treated. ISBN-13: 978-1118912027 ISBN-10: 9781118912027 Every Child with Diabetes May Experience Different Symptoms of Low Blood Sugar.
Employment and Diabetes Mellitus Diabetes is not a bar to most occupations, and people with diabetes are protected in many countries by legislation against discrimination on the grounds of disability. However People with insulin-treated diabetes are barred from certain occupations because of the risk of Hypoglycemia. These include: • The Armed Forces • Commercial Pilots • Emergency Services • Prison and Security Services • Jobs in Potentially Dangerous Areas
Insulin Driving and Diabetes Mellitus • Newly diagnosed people with diabetes, especially insulin-treated, should not drive until glycemic control and vision are stable • Potential hazards facing the driver with diabetes might include hypoglycemia, visual impairment and some other difficulties. • Hypoglycemia can severely disrupt driving skills by causing cognitive dysfunction and Mood Changes. • Motor skills and judgment can become impaired when blood glucose falls below 3.8 mmol/L, often without inducing hypoglycemic symptoms
Diabetes and Social Support Social support helps with diabetes control and provides support for the necessary physical and dietary changes. Social support is an important explanatory variable with prognostic significance for health outcomes and it plays a pivotal role in patients with diabetes and can contribute to the successful management of the disease.
Decision Support for Improving Adaptation and Self-management Emotional Support Information Support Tangible Support Healthy Food Physical Activity Medical Insurance Financial Support Engorgement Support Express Respect Empathetic Understanding Listening Support Analysis of the Condition Feedback Check Guidance “An integrated model to evaluate the impact of social support on improving self-management of type 2 diabetes mellitus”
Social Support Doi:10.1186/s12911-019-0914-9 Emotional support included providing empathy, care, love and trust. This kind of support could enhance the sense of self-worth and affirmation, and the coping efforts of patients with diabetes. Informational support referred to providing guidance, advice, and counseling to those under stress. Such support might help individuals benefit from advice on how to best respond to the challenges of diabetes Tangible support referred to offering material aid or behavioral assistance. Tangible support could be measured by Healthy Food, Physical Activity, Medicine and Medical Instruments, and Financial Support.
Insulin The mentioned study surveyed more than 1000 articles related to social support and diabetes in which the appearance of “Emotional Support” ,“Information Support” and “Tangible Support” accounted for 90, 88, and 83%, respectively, much higher than other social support dimensions.
Part Four: Adaptation and Self-Management • Adapting and Coping with Change • The Stages of Change • Self-Care in Adaptation and Management of Diabetes • Self-care Behaviors
Adopting and Coping with Change • A diabetes diagnosis can turn the patients life upside down and force them to re-examine how they live if they want to stay healthy and properly manage their diabetes. Sudden lifestyle changes are not without their challenges. • Change is defined as sustainable modification to a behavior or habit. Whatever needs to be modified, change generally follows the same route. Understanding the key stages can help the patients achieve their goals.
The Stages of Change • Precontemplation: At this stage, you are quite resistant to change. You don’t understand why you need to change and have no intention of doing so. This is the time to take responsibility and gradually consider the change. The more informed you are about the consequences of the disease and your current lifestyle, the more you will be prepared to make changes. • Contemplation: At this stage, you are less resistant to change. You embrace the idea of change over the medium term, but see more disadvantages than benefits in adopting new behaviors. For example, “If I take my blood glucose readings before bed, my husband will be less worried, but it hurts, it’s expensive and I won’t be able to sleep after I get the result.”
The Stages of Change At this stage, you are getting ready to take some concrete action. You buy your blood glucose meter, you register for an exercise program or you cut down to 3 cigarettes per day. You intend to adopt a new behavior in the near future 30 days. You adopt the desired attitude but you sometimes revert to old habits. For example, you take your blood glucose readings four times per day, but stop after a month and start again three weeks later. At this stage, encouragement and praise from your family and friends are very important. This is also the time to reward yourself for your successes. • Action: • Preparation:
The Stages of Change You have reached the maintenance stage when you have stuck to the desired behavior for at least 6 consecutive months. At this point, reverting to an earlier stage is less likely or of shorter duration. This can also be the time to contemplate making another change. • Maintenance:
Self-Care in Adaptation and Management of Diabetes • The World Health Organization defines self-care as: The ability of individuals, families and communities to promote health, prevent disease, maintain health, and to cope with illness and disability with or without the support of a healthcare provider. • There are many essential self-care behaviors in people with diabetes which predict good outcomes and helps them to adopt better with their diagnoses. DOI: 10.1186/2251-6581-12-14
Self-Care Behaviors The AADE Self-Care Behaviors are a series of seven skills determined by the American Association of Diabetes Educators to be essential to effective diabetes self-management and adaptation. The skills include: Healthy Eating Being Active Blood- Sugar Monitoring Problem Solving Taking Medication Healthy Coping Reducing Risks Aim for Diabetes Control
Nutrition and Diabetes Mellitus Nutrition is an important parts of a healthy lifestyle when someone has diabetes. Following a Healthy Meal Plan can help the patients keep their blood glucose level, in the targeted range. Eating well most days of the week can help:  Keep blood glucose level  Lose weight or stay at a Healthy weight*  Prevent or delay diabetes problem Healthy Weight often based on having a body mass index that falls in the normal, or healthy range. A healthy body weight may lower the chances of developing health problems such as type 2 diabetes and heart disease.
The Food Groups The key to eating with diabetes is to eat a variety of healthy foods from all food groups, in the amounts that the patients meal plan outlines. Vegetables Broccoli, Carrots, Greens, Peppers, and Tomatoes Fruits Oranges, Melon, Berries, Apples, Bananas, and Grapes Grains At least half of the grains for the day should be whole grains • Includes wheat, Rice, Oats, Cornmeal, Barley, and Quinoa • Examples: Bread, Pasta, Cereal Protein Chicken or Turkey without the skin, Fish, Egg, Nuts, Lean Meat Dairy Non-fat or low fat Milk, Yogurt, Cheese
The Balanced Plate Model The Balanced Plate Model is a simple tool designed to help patients prepare meals. It can help to allocate the carbohydrate intake, so that people feel full and nourished until the next meal or snack. Image from: Meal Planning for People with Diabetes at a Glance, © Government du Québec, 2014
Being Active Being active helps condition the heart, lungs, and muscles, and even improves weight-control, and energy. For people with diabetes, exercise may improve blood sugar levels by helping the body to better use insulin and food. Being physically active looks different for each person, depending on: • Age • Interests • Physical Ability
The Importance of Exercise in Treating Diabetes • Increased insulin sensitivity (insulin works better) • Lower blood sugar levels • Increased energy and endurance throughout the day • Weight loss with increased muscle tone • A healthier heart and lower blood pressure • Better sleep at night • Stronger bones and a lower risk of osteoporosis • Better resistance to illness • Improved cholesterol, heart rate, and blood pressure levels • Lower stress, anxiety, boredom, frustration and depression The effects of regular exercise:
Stop Exercising When Lightheadedness or dizziness Rapid heart beat Chest discomfort Jaw, arm, or upper back discomfort Nausea Unusual shortness of breath Sudden weakness Severe or unusual fatigue or sleepiness Severe discomfort of any kind
Home-based Exercise During COVID-19 In response to the current COVID-19 pandemic, governments in many countries have restricted the movement of their citizens confining them to the home environment. Below are a series of daily exercises that can be performed at home, provided by The Italian National Association of Athletes with Diabetes. The exercise intensity of each activity is comparable to one hour of brisk walking, resulting in an energy expenditure of 150-200 Kcal.  Treadmill  Stationary bicycle  Bodyweight exercises  joint mobility and stretching exercises, such as yoga and Pilates
Home-based Exercise During COVID-19  Two series of 20 Jumping Jacks  Two series of 15 crunches  Two series of 15 forward flexes  Two series of 10 rowing exercises  Two series of 8 push-ups  Two series of 8 sitting/standing  Three series x 15 squats  20 minutes treadmill training  Final stretching and relaxation
Blood-Sugar Monitoring • Blood sugar monitoring involves using a device to regularly check blood sugar levels, which can help keep track of blood sugar level fluctuations throughout the day and inform if action needs to be taken to maintain levels as close to normal-70- 120 mg/dl- as possible. • Recording blood sugar levels gives insight into how medicines, physical activity, stress, and other activities affect blood sugar daily.
Problem Solving Obstacles in diabetes self-management and adoptation are encountered every day, so it is very important to know how to find solutions for unexpected problems. Daily problems or stressors can put the body under stress and result in dramatic fluctuations in blood sugar levels. Problem solving involves 3 steps: • Step 1 Identify the Problem • Step 2 Find Solutions • Step 3 Take Action
Problem Solving • Take Action • Identify the Problem While on vacation, you don’t have easy access to a gym or time for exercise. How will you handle this? • Find Solutions You get the flu and notice your blood glucose levels are higher than normal. What do you do? You have a hard time finding healthy food choices within your family’s cultural or taste preferences. What steps can you take?
Taking Medication • People with type 2 diabetes may need to take pills or insulin to lower blood glucose levels and manage their diabetes. Diabetes medication works best when used regularly and in combination with healthy eating and physical activity. • With technology ever-evolving in the fight against diabetes, the quality of apps that assist in diabetes management and adopting to it is also improving. • Depending on whether you want your diabetes app to log blood glucose readings or monitor food intake, the options are increasing for those with single or multiple requirements.
Reducing Risks People with diabetes are at higher risk to develop some complications, such as circulatory problems and infections. Many activities can help reduce that risk, such as quitting smoking, controlling blood pressure and foot care. Poorly managed diabetes can lead to short term problems and long term complications. Reducing risks can help improve quality and quantity of life for people with diabetes.
Healthy Adaptation Living with diabetes can be emotionally challenging, so dealing positively with emotions can help overcome daily diabetes adaptation and management challenges. Healthy and positive coping with the emotions associated with diabetes can contribute to better control over one’s diabetes. Some of the skills that reflect healthy adaptation include: Doi: 10.1089/pop.2009.0065 • Expressing emotions • Having an adaptive coping style • Fulfilling health care obligations • Demonstrating basic problem-solving skills • Incorporating physical activity into one's life
Part Six: Conclusion
Setting Goals for Adapting to a Healthier Life To initiate lifestyle changes and measure the progress, it can be useful to set specific goals. the S.M.A.R.T Method can help diabetes to set their goals. People with diabetes have to make sure their goals have the following five characteristics:  Specific  Measurable  Achievable  Realistic  Time-based
The S.M.A.R.T Method Specific: The goal must be precise to be motivating and incorporated into your life. Measurable: You must be able to quantify and measure your progress, by specifying the frequency and duration, for example. Achievable: For a goal to be motivating, it must be attainable through concrete measures that match your abilities and tastes.
The S.M.A.R.T Method Realistic: Your goal must be consistent with your reality, your schedule and your limitations. You must feel able to achieve it in your current situation. A goal will not be effective or measurable if it is not defined by time. Set a precise time limit. You can even set the date you will be ready to begin. Timely:
Key Words May 2020 0 50000 100000 150000 200000 250000 300000 350000 400000 Diabetes Mellitus Nutrition Exercise Self-management Depression Mental Health Type 2 Anxiety Adaptation Distress Driving Students Emotional Support Gestational Diabetes Hypoglycaemia Travelling Coping Type 1 Stigma Neadle Fear
The Blue Circle is the Universal Symbol for Diabetes. November 14th is “World Diabetes Day.” “You Can be Both, a Masterpiece and a Work in Progress, at the Same Time” Thank You

More Related Content

PPTX
Nutrition in Ulcerative Colitis
byKritika Gupta
 
PPTX
DIABETIC KETOACIDOSIS (DKA).pptx
bySuvidhi4
 
PPTX
Myopathy undergraduate
byOsama Ragab
 
PPTX
Osteoporosis
bysaraayad4
 
PDF
Malnutrition in the hospital
byCorrie T
 
PPTX
Malabsorption syndromes
byShivshankar Badole
 
PPTX
Diabetes Powerpoint 6
byChocolate42
 
PPTX
Stress and Social Support Vs Diabetes Mellitus
byDr. Neeta Gupta
 
Nutrition in Ulcerative Colitis
byKritika Gupta
 
DIABETIC KETOACIDOSIS (DKA).pptx
bySuvidhi4
 
Myopathy undergraduate
byOsama Ragab
 
Osteoporosis
bysaraayad4
 
Malnutrition in the hospital
byCorrie T
 
Malabsorption syndromes
byShivshankar Badole
 
Diabetes Powerpoint 6
byChocolate42
 
Stress and Social Support Vs Diabetes Mellitus
byDr. Neeta Gupta
 

Similar to Adaptation to Diabetes Mellitus

PPTX
World Diabetes Day, 14th November 2014
bySai Sahet Healthcare Newspaper
 
PPTX
Diabetes
byabhiabhirami
 
PPTX
Diabetes
byabhiabhirami
 
PDF
Everything About Diabetes
byArbab Usmani
 
PPT
5 diabetes mellitus ishwar
byMahendra Poudel
 
PPT
Diabetes as presented by cheruiyot sambu in kapkatet county hospital.
bycheruiyot sambu
 
PPTX
Diabetes tech program_final
byKrystin Fields
 
PDF
Your guide diabetes
bytrailernow
 
PPT
diabetes food pyramid.ppt
bySHAUKATALI924321
 
PPTX
Diabetes Mellitus & Nurses Role
byProf Vijayraddi
 
PPTX
Diabetes Presentation
byrikama2007
 
DOCX
diabetes word document
bykavyayadav28
 
PPTX
Diabetes Presentation
byrikama2007
 
PDF
Understanding Diabetes: Diabetes Facts
byLiberty Medical
 
PDF
Diabetes --what, why and how tibb can help
byYounis I Munshi
 
PPTX
diabetes mellitus (one of the major type of diabetes)
bytahreemiftikhar879
 
PPT
1 introduction to dm.ppt
byasmabarhoom
 
PDF
You can live with diabetes if you learn how! diabetes treatment
byasucoms
 
PDF
DIABETES Artical.pdf
byBlogger
 
PDF
Diabetes control tips
bySaurabhBallal
 
World Diabetes Day, 14th November 2014
bySai Sahet Healthcare Newspaper
 
Diabetes
byabhiabhirami
 
Diabetes
byabhiabhirami
 
Everything About Diabetes
byArbab Usmani
 
5 diabetes mellitus ishwar
byMahendra Poudel
 
Diabetes as presented by cheruiyot sambu in kapkatet county hospital.
bycheruiyot sambu
 
Diabetes tech program_final
byKrystin Fields
 
Your guide diabetes
bytrailernow
 
diabetes food pyramid.ppt
bySHAUKATALI924321
 
Diabetes Mellitus & Nurses Role
byProf Vijayraddi
 
Diabetes Presentation
byrikama2007
 
diabetes word document
bykavyayadav28
 
Diabetes Presentation
byrikama2007
 
Understanding Diabetes: Diabetes Facts
byLiberty Medical
 
Diabetes --what, why and how tibb can help
byYounis I Munshi
 
diabetes mellitus (one of the major type of diabetes)
bytahreemiftikhar879
 
1 introduction to dm.ppt
byasmabarhoom
 
You can live with diabetes if you learn how! diabetes treatment
byasucoms
 
DIABETES Artical.pdf
byBlogger
 
Diabetes control tips
bySaurabhBallal
 

Recently uploaded

PPTX
50 Hrs - Yoga & Dialectical Behaviour Therapy (YDBT) Teacher Training Certifi...
byKaruna Yoga Vidya Peetham
 
PPTX
SONIC AND ULTRASONIC INSTRUMENTS PERIO.pptx
byjaishh987borkar
 
PPTX
Heart Block ppt made by 1sy year NH student
byAfifKhan7
 
PPTX
50 Hrs - Mindful Yoga - Based Acceptance and Commitment Therapy (MYACT) Teach...
byKaruna Yoga Vidya Peetham
 
PDF
Understanding Hair Loss: Causes, Solutions, and Healthy Hair Strategies
byaddictivemedia143
 
PDF
Pediatric ALD (pALD) HCW sensitization slides (1).pdf
byRuth640163
 
PDF
Erik Lannen - A Devoted Nurse, Christian Leader, And Adventurer
byErik Lannen
 
PPTX
Adolescent reproductive Health slide4.pptx
bynuramalicha
 
PPTX
Seniors Chair Yoga Teacher Training Certificate Course.pptx
byKaruna Yoga Vidya Peetham
 
PPTX
Pulmonary TB by Rakhi Rana.pptx for medical and nursing students
bypavitra8057
 
PPTX
Dhatu_dhatu_mala_Presentation_BAMS_1st_proff.pptx
bysoniakarali114
 
PPTX
DIABETIC RETINOPATHY DIABETIC RETINOPATHY
byMeghna Verma
 
PPTX
Vesico-vaginal fistula & Recto-vaginal fistula
byKeertis1
 
PDF
“Process and Importance of Hospital Planning”
bySutirthaMandal
 
PPTX
Nursing process.pptx nursing management.
bydeepams79
 
PPTX
Drug Administration.pptx.
bykristylBenitez
 
PPTX
DIPLOPIA in Oral and Maxillofacial trauma.pptx
byDrMeghnaChandrachood
 
PPTX
Unit-5 Introduction To Rational Drug Use
byDr Aman Suresh Tharayil
 
PPTX
Think and Grow Rich 2.0 How to future proof your career in the 4th industrial...
byArlen Meyers, MD, MBA
 
PDF
11.Biological Oxidation.pdf In Pharmacy In Science
bypjps6336
 
50 Hrs - Yoga & Dialectical Behaviour Therapy (YDBT) Teacher Training Certifi...
byKaruna Yoga Vidya Peetham
 
SONIC AND ULTRASONIC INSTRUMENTS PERIO.pptx
byjaishh987borkar
 
Heart Block ppt made by 1sy year NH student
byAfifKhan7
 
50 Hrs - Mindful Yoga - Based Acceptance and Commitment Therapy (MYACT) Teach...
byKaruna Yoga Vidya Peetham
 
Understanding Hair Loss: Causes, Solutions, and Healthy Hair Strategies
byaddictivemedia143
 
Pediatric ALD (pALD) HCW sensitization slides (1).pdf
byRuth640163
 
Erik Lannen - A Devoted Nurse, Christian Leader, And Adventurer
byErik Lannen
 
Adolescent reproductive Health slide4.pptx
bynuramalicha
 
Seniors Chair Yoga Teacher Training Certificate Course.pptx
byKaruna Yoga Vidya Peetham
 
Pulmonary TB by Rakhi Rana.pptx for medical and nursing students
bypavitra8057
 
Dhatu_dhatu_mala_Presentation_BAMS_1st_proff.pptx
bysoniakarali114
 
DIABETIC RETINOPATHY DIABETIC RETINOPATHY
byMeghna Verma
 
Vesico-vaginal fistula & Recto-vaginal fistula
byKeertis1
 
“Process and Importance of Hospital Planning”
bySutirthaMandal
 
Nursing process.pptx nursing management.
bydeepams79
 
Drug Administration.pptx.
bykristylBenitez
 
DIPLOPIA in Oral and Maxillofacial trauma.pptx
byDrMeghnaChandrachood
 
Unit-5 Introduction To Rational Drug Use
byDr Aman Suresh Tharayil
 
Think and Grow Rich 2.0 How to future proof your career in the 4th industrial...
byArlen Meyers, MD, MBA
 
11.Biological Oxidation.pdf In Pharmacy In Science
bypjps6336
 

Adaptation to Diabetes Mellitus

  • 1.
    Adaptation to DiabetesMellitus Department of Psychology Professor: Reza Pourhosein, Ph.D. By: Negin Dorri May 2020
  • 2.
    Part One: Introduction •The Homan Body • The Endocrine System • The Pancreas • Pancreatic Endocrine Hormones
  • 3.
    The Human Body Thehuman body is the structure of a human being. It is composed of many different types of cells that together create tissues and subsequently organ systems. The main systems of the human body are: • Circulatory System • Digestive System • Immune System • Lymphatic System • Muscular System • Nervous System • Reproductive System • Respiratory System • Urinary System • Endocrine System• Integumentary System
  • 4.
    The Endocrine System Theendocrine system is a network of glands and organs located throughout the body. It’s similar to the nervous system in that it plays a vital role in controlling and regulating many of the body’s functions.
  • 5.
    The Pancreas The pancreashas 2 main functions. The exocrine function and the endocrine function The Exocrine Function makes enzymes, which help digest proteins, fats, and carbohydrates before they can be absorbed in the intestine. When food enters the stomach, these pancreatic juices are released into a system of ducts that culminate in the main pancreatic duct. The Endocrine Function makes hormones, the most important of which is insulin, which control how the body uses and stores sugar glucose, its main source of energy.
  • 6.
    The human bodywants blood Glucose maintained in a very narrow range. Insulin and Glucagon are the hormones which make this happen. Both insulin and glucagon are secreted from the Pancreas, and thus are referred to as Pancreatic Endocrine Hormones. Pancreatic Endocrine Hormones
  • 7.
    Part Two: DiabetesMellitus • Diabetes Mellitus • The History of Diabetes • The Global Prevalence of Diabetes • Types of Diabetes • Gestational Diabetes Mellitus • Infographics of Diabetes Types • Causes and Risk Factors of Diabetes • Impaired Fetal Nutrition • Symptoms of Diabetes • Diagnoses of Diabetes • Possible Physical Effects of Diabetes
  • 8.
    Diabetes Mellitus Diabetes Mellitusis a chronic disease that affects how your body turns food into energy. when someone is diabetic the body doesn’t or can’t use the Insulin it makes as well as it should. When there isn’t enough insulin or cells stop responding to insulin, too much blood sugar stays in the bloodstream. Insulin
  • 9.
    Insulin The History ofDiabetes Scientists and physicians have been documenting the condition now known as diabetes for thousands of years. • The first known mention of diabetes symptoms was in 1552 B.C., by Hesy-Ra, an Egyptian physician. • In 150 AD, the Greek physician Arateus described what we now call diabetes as "the melting down of flesh and limbs into urine.“ • Centuries later, people known as "water tasters" diagnosed diabetes by tasting the urine of people suspected to have it.
  • 10.
    The Global Prevalenceof Diabetes Estimates and projections of the global prevalence of diabetes in the 20–79 year age group Millions Estimates One in two adults with diabetes are undiagnosed 232 million people. One in eleven adults from 20 to 79 years old have diabetes 463 million people.
  • 11.
    Types of Diabetes Insulin •Type 1 Diabetes Type 2 diabetes results from the body’s ineffective use of insulin. Type 2 diabetes comprises the majority of people with diabetes around the world, and is largely the result of excess body weight and physical inactivity. • Type 2 Diabetes Type 1 diabetes is characterized by deficient insulin production and requires daily administration of insulin. The cause of type 1 diabetes is not known and it is not preventable with current knowledge.
  • 12.
    Gestational Diabetes Mellitus •Gestational diabetes mellitus is defined as carbohydrate intolerance resulting in hyperglycemia of variable severity with onset or first recognition during pregnancy. • Gestational diabetes affects 3–10% of pregnancies, depending on the population studied. • Some causes and Risk Factors of Gestational Diabetes Mellitus include: Obesity, Family History, Increasing Maternal Age, Multiple Pregnancy and Previous Gestational Diabetes Mellitus. Doi:10.1016/j.ogrm.2014.05.005
  • 13.
    Insulin Gestational Diabeteswith Type1 Diabetes: The Body doesn’t produce Insulin Infographics of Diabetes Types with Type 2 Diabetes: The Body produce Insulin but is not used efficiently ← Can be prevented →
  • 14.
    Causes and RiskFactors of Diabetes Insulin • Type 1 Diabetes possible Causes: Genetics Viral or bacterial infection Chemical toxins within food Unidentified component causing autoimmune reaction • Type 2 Diabetes Causes: Obesity Living a sedentary lifestyle Increasing age Bad diet Other type 2 diabetes causes such as pregnancy or illness can be type 2 diabetes risk factor.
  • 15.
    Impaired Fetal Nutrition •Low-birthweight babies, are more prone than those of normal weight to a range of clinical and metabolic abnormalities including : • A poor diet during pregnancy may increase the risk of a woman’s children and grandchildren developing type 2 diabetes in later life. Obesity Hypertension Dyslipidemia Insulin Resistance Doi:10.1002/14651858.CD006674.pub3 • Mothers who eat unhealthily could “programme” susceptibility into the cells of their unborn baby. This genetic vulnerability could then be passed down to future generations.
  • 16.
    Insulin Symptoms of Diabetes Type1 diabetes can develop at any age, though it often appears during childhood or adolescence. Type 2 diabetes, the more common type, can develop at any age, though it's more common in people older than 40. Some of the signs and symptoms of type 1 and type 2 diabetes are: Extreme Hunger Fatigue Frequent Urination Irritability Slow-healing Sores Blurred vision Unexplained Weight Loss Increased Thirst
  • 17.
    Insulin Diagnoses of Diabetes Thereare several ways to diagnose diabetes: • The A1C test measures your average blood sugar for the past 2 to 3 months. The advantages of being diagnosed this way are that you don't have to fast or drink anything. • The Fasting Plasma Glucose test checks the fasting blood sugar levels. Fasting means after not having anything to eat or drink for at least 8 hours before the test. • The Oral Glucose Tolerance Test is a two-hour test that checks your blood sugar levels before and 2 hours after you drink a special sweet drink.
  • 18.
    Insulin Possible Physical Effectsof Diabetes Damage to the large blood vessels of the heart, brain and legs. Damage to the small blood vessels, causing problems in the eyes, kidneys, feet and nerves. Other parts of the body can also be affected by diabetes, including the digestive system, the skin, sexual organs, teeth and gums, and the immune system. The risk of most diabetes-related complications can be reduced by keeping blood pressure, blood glucose and cholesterol levels within recommended range. Also, being a healthy weight, eating healthily, and not smoking will help reduce your risk.
  • 19.
    Part Three: PsychologicalAspects of Diabetes Mellitus • Diabetes and Mental Health • Facing Life with Diabetes • Dealing with Diagnosis • Diabetes Distress • Diabetes-related Distress • Depression and Diabetes • Fear of Hypoglycemia • Psychological Barriers to Insulin Use • Identifying Patients
  • 20.
    Diabetes and MentalHealth Chronic illness usually leads to more symptoms. Many people assume that the symptoms they are experiencing are due to only one cause: the disease. While the disease can certainly cause certain symptoms., it is not the only cause. Symptoms Tense Muscles Disease Fatigue Pain Depression Stress Difficult Emotions Vicious Cycle The Vicious Symptom Cycle In no particular order ISBN-13: 978-1-933503-01-1
  • 21.
    Insulin Facing Life withDiabetes “I was just shocked, thinking, because I’m so healthy. And I thought, “oh my God, it’s like the end of me”, kind of, you know, that shock.” (Person with Type 2 diabetes) “I was jumping around from shock to denial to grief to tears to… I certainly went through that… the reactions might go up and down for quite some time… for my first 12 months I went through lots of reactions.” (Person with Type 1 diabetes) “I don’t think it’s all that devastating. There are far worse incurable sorts of things.” (Person with diabetes)
  • 22.
    Dealing with Diagnosis Thediagnosis of diabetes is a life event that has been likened to the experience of grief. The diagnosis of diabetes can trigger a grieving for one’s “Lost Health”. Not everyone with diabetes will necessarily experience all of these emotional reactions, or in this particular order. The stages of grief: • Stage 1: Denial • Stage 2: Anger • Stage 3: Bargaining • Stage 4: Depression • Stage 5: Acceptance “I can take Control and Manage this”.
  • 23.
    Insulin Diabetes Distress 1 in4 people with Type 1 and 1 in 5 people with Type 2 diabetes have high levels of diabetes distress that is likely to be negatively effecting how they manage their diabetes Living with diabetes is challenging. ‘worrying about the future and the possibility of serious complications’ and ‘experiencing feelings of guilt and anxiety when diabetes management goes off track’.
  • 24.
    Insulin • Diabetes-related distressis defined as a patient's concern about disease management, support, emotional burden and access to care. Diabetes‐related Distress The relationship between diabetes-related distress and glycaemia control does not assume the direct involvement of any physiological process, but instead, emphasizes the ongoing negative subjective experience of emotional distress around the management of diabetes that has implications for ongoing disease‐related behaviors, motivation, self‐efficacy, problem solving and even depressive symptoms. Doi: 10.1002/14651858.CD011469.pub2
  • 25.
    Insulin Depression and Diabetes Peoplewith diabetes are more likely than the general population to be effected by symptoms of depression. Diabetes-specific contributors may include the chronic nature of the condition and complex management regimens. In people with diabetes, depression or depressive symptoms are associated with adverse medical and psychological outcomes. 1 in 5 people with Type 1 and 1 in 3 people with Type 2 diabetes using insulin and 1 in 4 people with Type 2 diabetes not depending on inulin a have high levels of depression.
  • 26.
    Insulin Depression and Diabetes •Sub-optimal self-management such as: In people with diabetes, depression or depressive symptoms are associated with adverse medical and psychological outcomes, including: Reduced Physical Activity Less Healthy Eating Smoking • Elevated HbA1c, Hypoglycaemia and Hyperglycaemia. • Increased prevalence, and earlier onset, of complications and disability. • Increased risk of diabetes distress and elevated anxiety symptoms. • Impaired quality of life, and social role/ functioning. • Increased burden/costs to the individual and the healthcare system.
  • 27.
    Insulin Fear of Hypoglycaemia Fearof hypos is a specific and intense feeling brought on by the risk and/or experiences of having low blood glucose. It is common to worry about: • Losing consciousness • Being judged by others • Relying on others for help • Having a hypo while asleep • Having an accident or injuring yourself
  • 28.
    Insulin Fear of Hypoglycaemia isa common challenge for people managing their diabetes with insulin or other glucose-lowering medications. People with diabetes often worry or become fearful about hypos. “There’s nothing worse than having that fear at the back of your head that you’re going to be in a meeting or something and pass out from not treating a hypo quick enough— it’s never happened, touch wood.” Melissa, 31, person with diabetes. Hypoglycaemia
  • 29.
    Insulin Psychological Barriers toInsulin Use 1. Painful Injection 2. Apprehension about self-injection. 3. Needle Phobia 4. Social Embarrassment Abu Hassan et al. BMC Family Practice 2013 In a qualitative exploration study of factors influencing insulin acceptance, Many participants had negative concerns related to insulin use. The main concerns vented by them were about injection of insulin: People with diabetes often have negative thoughts or feelings about starting, using, or intensifying insulin. This is also known as ‘Psychological Insulin Resistance’ or ‘Negative Appraisals of Insulin’.
  • 30.
    Insulin Other Impacts ofUsing Insulin Inconvenience and Impractical “I see my daughter half an hour before dinner, she has to inject, so troublesome, very inconvenient” Lifestyle Restriction “When you are on insulin, it is more difficult to go out or eat out. You are more restricted. You have to plan your exercise as well” Social Stigma “Our society is quite ignorant of insulin therapy and they might associate insulin injection with drug addicts”
  • 31.
    Insulin Identifying Patients Emotional problemsare associated with poorer self-care behavior. Thus, addressing emotional problems is a key health care intervention even if diabetes self-care is adequate, and all clinicians should be able to: 1. Identify patients suffering from distress and depression. 2. Identify patients who are suffering from any other psychiatric disorders. 3. Apply effective treatments to relieve these issues. 4. Refer patients for specialized mental health care when appropriate.
  • 32.
    Part Four: SocialAspects of Diabetes Mellitus • Social Aspects – Daily Life • Students with Diabetes • Employment and Diabetes Mellitus • Driving and Diabetes Mellitus • Diabetes and Social Support
  • 33.
    Social Aspects –Daily Life Diabetes influences many aspects of daily life, principally through the effects of treatment and its potential side effects, particularly hypoglycemia. • Students with Diabetes • Employment • Driving The development of diabetic complications, such as neuropathy and retinopathy, can also affect everyday activities, particularly when these are severe with clinical manifestations, or require time-consuming treatment such as dialysis for chronic renal failure. Diabetes could effect ones daily routine such as:
  • 34.
    Students with Diabetes Thereis a natural desire for students with diabetes not to appear different from their peers and this may lead them to assign a lower priority to diabetes management than they would normally and to undertake potentially high-risk activities. Some short and long terms problems can include high or low blood glucose levels that significantly effect the student's ability to concentrate and learn, and can cause serious immediate consequences such as brain damage or death if not treated. ISBN-13: 978-1118912027 ISBN-10: 9781118912027 Every Child with Diabetes May Experience Different Symptoms of Low Blood Sugar.
  • 35.
    Employment and DiabetesMellitus Diabetes is not a bar to most occupations, and people with diabetes are protected in many countries by legislation against discrimination on the grounds of disability. However People with insulin-treated diabetes are barred from certain occupations because of the risk of Hypoglycemia. These include: • The Armed Forces • Commercial Pilots • Emergency Services • Prison and Security Services • Jobs in Potentially Dangerous Areas
  • 36.
    Insulin Driving and DiabetesMellitus • Newly diagnosed people with diabetes, especially insulin-treated, should not drive until glycemic control and vision are stable • Potential hazards facing the driver with diabetes might include hypoglycemia, visual impairment and some other difficulties. • Hypoglycemia can severely disrupt driving skills by causing cognitive dysfunction and Mood Changes. • Motor skills and judgment can become impaired when blood glucose falls below 3.8 mmol/L, often without inducing hypoglycemic symptoms
  • 37.
    Diabetes and SocialSupport Social support helps with diabetes control and provides support for the necessary physical and dietary changes. Social support is an important explanatory variable with prognostic significance for health outcomes and it plays a pivotal role in patients with diabetes and can contribute to the successful management of the disease.
  • 38.
    Decision Support forImproving Adaptation and Self-management Emotional Support Information Support Tangible Support Healthy Food Physical Activity Medical Insurance Financial Support Engorgement Support Express Respect Empathetic Understanding Listening Support Analysis of the Condition Feedback Check Guidance “An integrated model to evaluate the impact of social support on improving self-management of type 2 diabetes mellitus”
  • 39.
    Social Support Doi:10.1186/s12911-019-0914-9 Emotional supportincluded providing empathy, care, love and trust. This kind of support could enhance the sense of self-worth and affirmation, and the coping efforts of patients with diabetes. Informational support referred to providing guidance, advice, and counseling to those under stress. Such support might help individuals benefit from advice on how to best respond to the challenges of diabetes Tangible support referred to offering material aid or behavioral assistance. Tangible support could be measured by Healthy Food, Physical Activity, Medicine and Medical Instruments, and Financial Support.
  • 40.
    Insulin The mentioned studysurveyed more than 1000 articles related to social support and diabetes in which the appearance of “Emotional Support” ,“Information Support” and “Tangible Support” accounted for 90, 88, and 83%, respectively, much higher than other social support dimensions.
  • 41.
    Part Four: Adaptationand Self-Management • Adapting and Coping with Change • The Stages of Change • Self-Care in Adaptation and Management of Diabetes • Self-care Behaviors
  • 42.
    Adopting and Copingwith Change • A diabetes diagnosis can turn the patients life upside down and force them to re-examine how they live if they want to stay healthy and properly manage their diabetes. Sudden lifestyle changes are not without their challenges. • Change is defined as sustainable modification to a behavior or habit. Whatever needs to be modified, change generally follows the same route. Understanding the key stages can help the patients achieve their goals.
  • 43.
    The Stages ofChange • Precontemplation: At this stage, you are quite resistant to change. You don’t understand why you need to change and have no intention of doing so. This is the time to take responsibility and gradually consider the change. The more informed you are about the consequences of the disease and your current lifestyle, the more you will be prepared to make changes. • Contemplation: At this stage, you are less resistant to change. You embrace the idea of change over the medium term, but see more disadvantages than benefits in adopting new behaviors. For example, “If I take my blood glucose readings before bed, my husband will be less worried, but it hurts, it’s expensive and I won’t be able to sleep after I get the result.”
  • 44.
    The Stages ofChange At this stage, you are getting ready to take some concrete action. You buy your blood glucose meter, you register for an exercise program or you cut down to 3 cigarettes per day. You intend to adopt a new behavior in the near future 30 days. You adopt the desired attitude but you sometimes revert to old habits. For example, you take your blood glucose readings four times per day, but stop after a month and start again three weeks later. At this stage, encouragement and praise from your family and friends are very important. This is also the time to reward yourself for your successes. • Action: • Preparation:
  • 45.
    The Stages ofChange You have reached the maintenance stage when you have stuck to the desired behavior for at least 6 consecutive months. At this point, reverting to an earlier stage is less likely or of shorter duration. This can also be the time to contemplate making another change. • Maintenance:
  • 46.
    Self-Care in Adaptationand Management of Diabetes • The World Health Organization defines self-care as: The ability of individuals, families and communities to promote health, prevent disease, maintain health, and to cope with illness and disability with or without the support of a healthcare provider. • There are many essential self-care behaviors in people with diabetes which predict good outcomes and helps them to adopt better with their diagnoses. DOI: 10.1186/2251-6581-12-14
  • 47.
    Self-Care Behaviors The AADESelf-Care Behaviors are a series of seven skills determined by the American Association of Diabetes Educators to be essential to effective diabetes self-management and adaptation. The skills include: Healthy Eating Being Active Blood- Sugar Monitoring Problem Solving Taking Medication Healthy Coping Reducing Risks Aim for Diabetes Control
  • 48.
    Nutrition and DiabetesMellitus Nutrition is an important parts of a healthy lifestyle when someone has diabetes. Following a Healthy Meal Plan can help the patients keep their blood glucose level, in the targeted range. Eating well most days of the week can help:  Keep blood glucose level  Lose weight or stay at a Healthy weight*  Prevent or delay diabetes problem Healthy Weight often based on having a body mass index that falls in the normal, or healthy range. A healthy body weight may lower the chances of developing health problems such as type 2 diabetes and heart disease.
  • 49.
    The Food Groups Thekey to eating with diabetes is to eat a variety of healthy foods from all food groups, in the amounts that the patients meal plan outlines. Vegetables Broccoli, Carrots, Greens, Peppers, and Tomatoes Fruits Oranges, Melon, Berries, Apples, Bananas, and Grapes Grains At least half of the grains for the day should be whole grains • Includes wheat, Rice, Oats, Cornmeal, Barley, and Quinoa • Examples: Bread, Pasta, Cereal Protein Chicken or Turkey without the skin, Fish, Egg, Nuts, Lean Meat Dairy Non-fat or low fat Milk, Yogurt, Cheese
  • 50.
    The Balanced PlateModel The Balanced Plate Model is a simple tool designed to help patients prepare meals. It can help to allocate the carbohydrate intake, so that people feel full and nourished until the next meal or snack. Image from: Meal Planning for People with Diabetes at a Glance, © Government du Québec, 2014
  • 51.
    Being Active Being activehelps condition the heart, lungs, and muscles, and even improves weight-control, and energy. For people with diabetes, exercise may improve blood sugar levels by helping the body to better use insulin and food. Being physically active looks different for each person, depending on: • Age • Interests • Physical Ability
  • 52.
    The Importance ofExercise in Treating Diabetes • Increased insulin sensitivity (insulin works better) • Lower blood sugar levels • Increased energy and endurance throughout the day • Weight loss with increased muscle tone • A healthier heart and lower blood pressure • Better sleep at night • Stronger bones and a lower risk of osteoporosis • Better resistance to illness • Improved cholesterol, heart rate, and blood pressure levels • Lower stress, anxiety, boredom, frustration and depression The effects of regular exercise:
  • 53.
    Stop Exercising When Lightheadednessor dizziness Rapid heart beat Chest discomfort Jaw, arm, or upper back discomfort Nausea Unusual shortness of breath Sudden weakness Severe or unusual fatigue or sleepiness Severe discomfort of any kind
  • 54.
    Home-based Exercise DuringCOVID-19 In response to the current COVID-19 pandemic, governments in many countries have restricted the movement of their citizens confining them to the home environment. Below are a series of daily exercises that can be performed at home, provided by The Italian National Association of Athletes with Diabetes. The exercise intensity of each activity is comparable to one hour of brisk walking, resulting in an energy expenditure of 150-200 Kcal.  Treadmill  Stationary bicycle  Bodyweight exercises  joint mobility and stretching exercises, such as yoga and Pilates
  • 55.
    Home-based Exercise DuringCOVID-19  Two series of 20 Jumping Jacks  Two series of 15 crunches  Two series of 15 forward flexes  Two series of 10 rowing exercises  Two series of 8 push-ups  Two series of 8 sitting/standing  Three series x 15 squats  20 minutes treadmill training  Final stretching and relaxation
  • 56.
    Blood-Sugar Monitoring • Bloodsugar monitoring involves using a device to regularly check blood sugar levels, which can help keep track of blood sugar level fluctuations throughout the day and inform if action needs to be taken to maintain levels as close to normal-70- 120 mg/dl- as possible. • Recording blood sugar levels gives insight into how medicines, physical activity, stress, and other activities affect blood sugar daily.
  • 57.
    Problem Solving Obstacles indiabetes self-management and adoptation are encountered every day, so it is very important to know how to find solutions for unexpected problems. Daily problems or stressors can put the body under stress and result in dramatic fluctuations in blood sugar levels. Problem solving involves 3 steps: • Step 1 Identify the Problem • Step 2 Find Solutions • Step 3 Take Action
  • 58.
    Problem Solving • TakeAction • Identify the Problem While on vacation, you don’t have easy access to a gym or time for exercise. How will you handle this? • Find Solutions You get the flu and notice your blood glucose levels are higher than normal. What do you do? You have a hard time finding healthy food choices within your family’s cultural or taste preferences. What steps can you take?
  • 59.
    Taking Medication • Peoplewith type 2 diabetes may need to take pills or insulin to lower blood glucose levels and manage their diabetes. Diabetes medication works best when used regularly and in combination with healthy eating and physical activity. • With technology ever-evolving in the fight against diabetes, the quality of apps that assist in diabetes management and adopting to it is also improving. • Depending on whether you want your diabetes app to log blood glucose readings or monitor food intake, the options are increasing for those with single or multiple requirements.
  • 60.
    Reducing Risks People withdiabetes are at higher risk to develop some complications, such as circulatory problems and infections. Many activities can help reduce that risk, such as quitting smoking, controlling blood pressure and foot care. Poorly managed diabetes can lead to short term problems and long term complications. Reducing risks can help improve quality and quantity of life for people with diabetes.
  • 61.
    Healthy Adaptation Living withdiabetes can be emotionally challenging, so dealing positively with emotions can help overcome daily diabetes adaptation and management challenges. Healthy and positive coping with the emotions associated with diabetes can contribute to better control over one’s diabetes. Some of the skills that reflect healthy adaptation include: Doi: 10.1089/pop.2009.0065 • Expressing emotions • Having an adaptive coping style • Fulfilling health care obligations • Demonstrating basic problem-solving skills • Incorporating physical activity into one's life
  • 62.
  • 63.
    Setting Goals forAdapting to a Healthier Life To initiate lifestyle changes and measure the progress, it can be useful to set specific goals. the S.M.A.R.T Method can help diabetes to set their goals. People with diabetes have to make sure their goals have the following five characteristics:  Specific  Measurable  Achievable  Realistic  Time-based
  • 64.
    The S.M.A.R.T Method Specific: Thegoal must be precise to be motivating and incorporated into your life. Measurable: You must be able to quantify and measure your progress, by specifying the frequency and duration, for example. Achievable: For a goal to be motivating, it must be attainable through concrete measures that match your abilities and tastes.
  • 65.
    The S.M.A.R.T Method Realistic: Yourgoal must be consistent with your reality, your schedule and your limitations. You must feel able to achieve it in your current situation. A goal will not be effective or measurable if it is not defined by time. Set a precise time limit. You can even set the date you will be ready to begin. Timely:
  • 66.
    Key Words May 2020 050000 100000 150000 200000 250000 300000 350000 400000 Diabetes Mellitus Nutrition Exercise Self-management Depression Mental Health Type 2 Anxiety Adaptation Distress Driving Students Emotional Support Gestational Diabetes Hypoglycaemia Travelling Coping Type 1 Stigma Neadle Fear
  • 67.
    The Blue Circleis the Universal Symbol for Diabetes. November 14th is “World Diabetes Day.” “You Can be Both, a Masterpiece and a Work in Progress, at the Same Time” Thank You