Diabetes mellitus is a metabolic disorder characterized by high blood glucose levels resulting from defects in insulin production or insulin action. There are four main types of diabetes: type 1, type 2, gestational diabetes, and secondary diabetes. The main symptoms include increased thirst, frequent urination, and unexplained weight loss. Treatment involves managing diet, exercise, blood glucose monitoring, oral medications or insulin therapy, and diabetes self-management education. Lifestyle modifications like following a healthy diet, engaging in regular physical activity, weight control, and avoiding tobacco can help prevent and manage diabetes.
Diabetes mellitus -INTRODUCTION,TYPES OF DIABETES MELLITUSvarinder kumar
INTRODUCTION
TYPES OF DIABETES MELLITUS
DIAGNOSE TEST FOR DIABETES MELLITUS
MECHANISM OF ACTION OF INSULIN (IDDM)
HERBAL DRUG TREATMENT FOR DIABETES
LIFESTYLE FOR TYPE 1 AND TYPE 2 DM
NEW ANTI DIABETIC DRUGS
Diabetes mellitus (DM) has routinely been described as a metabolic disorder characterized by hyperglycemia that develops as a consequence of defects in insulin secretion, insulin action, or both.
Such a deficiency results in increased concentrations of glucose in the blood, which in turn damage many of the body's systems, in particular the blood vessels and nerves.
1. Microvascular (due to damage to small blood vessels).
2. Macrovascular (due to damage to larger blood vessels).
Heart failure (HF) is a common cardiovascular condition with increasing incidence and prevalence. Unlike western countries where heart failure is predominantly a disease of elderly, in India it affects younger age group. Heart failure is a chronic condition in which the heart cannot pump enough blood and oxygen to support other organs in your body.
Diabetes mellitus -INTRODUCTION,TYPES OF DIABETES MELLITUSvarinder kumar
INTRODUCTION
TYPES OF DIABETES MELLITUS
DIAGNOSE TEST FOR DIABETES MELLITUS
MECHANISM OF ACTION OF INSULIN (IDDM)
HERBAL DRUG TREATMENT FOR DIABETES
LIFESTYLE FOR TYPE 1 AND TYPE 2 DM
NEW ANTI DIABETIC DRUGS
Diabetes mellitus (DM) has routinely been described as a metabolic disorder characterized by hyperglycemia that develops as a consequence of defects in insulin secretion, insulin action, or both.
Such a deficiency results in increased concentrations of glucose in the blood, which in turn damage many of the body's systems, in particular the blood vessels and nerves.
1. Microvascular (due to damage to small blood vessels).
2. Macrovascular (due to damage to larger blood vessels).
Heart failure (HF) is a common cardiovascular condition with increasing incidence and prevalence. Unlike western countries where heart failure is predominantly a disease of elderly, in India it affects younger age group. Heart failure is a chronic condition in which the heart cannot pump enough blood and oxygen to support other organs in your body.
Definition of diabetes - introduction - classification of diabetes - etiology of diabetes type 1 and type 2- risk factors for diabetes - diagnosis of diabetes - clinical manifestations of diabetes type 1 and type 2- investigations for diabetes - treatment of diabetes - non-pharmacological treatment and pharmacological treatment - pharmacotherapy of type 1 and type 2 - acute complications of diabetes and treatment
Angina also known as angina pectoris is a medical condition characterized by chest pain usually left sided due to inadequate blood supply (ischemia) to the heart muscles due to obstruction (like presence of blood clot), narrowing or contraction (vasospasm) of the supplying coronary arteries.
Chronic obstructive pulmonary disorders COPD is a [preventable and treatable disease with some significant extra pulmonary effects that may contribute to the severity in individual clients.
It is characterized by airflow limitation that is not completely reversible.
Definition of diabetes - introduction - classification of diabetes - etiology of diabetes type 1 and type 2- risk factors for diabetes - diagnosis of diabetes - clinical manifestations of diabetes type 1 and type 2- investigations for diabetes - treatment of diabetes - non-pharmacological treatment and pharmacological treatment - pharmacotherapy of type 1 and type 2 - acute complications of diabetes and treatment
Angina also known as angina pectoris is a medical condition characterized by chest pain usually left sided due to inadequate blood supply (ischemia) to the heart muscles due to obstruction (like presence of blood clot), narrowing or contraction (vasospasm) of the supplying coronary arteries.
Chronic obstructive pulmonary disorders COPD is a [preventable and treatable disease with some significant extra pulmonary effects that may contribute to the severity in individual clients.
It is characterized by airflow limitation that is not completely reversible.
Diabetes mellitus (DM) is a syndrome of chronic hyperglycaemia is due to one of two mechanisms:
Inadequate production of insulin , or
Inadequate sensitivity of cells to the action of insulin.
It affects more than 220 million people worldwide, and it is estimated that it will affect 440 million by the year 2030
"Diabetes" comes from the Greek word for "siphon", and implies that a lot of urine is made.
The second term,"mellitus" comes from the Latin word, "mel" which means "honey", and was used because the urine was sweet.
• The onset of type 1 diabetes may also be associated with sudden weight loss or nausea, vomiting, or abdominal pains, if DKA has developed.
Nursing Management · Monitor blood sugar and use a sliding scale to treat high levels of glucose · Educate patient about diabetes · Examine feet .
Diagnosis involves measuring blood glucose levels. Ongoing specialized assessment and evaluation for complications are essential for diabetes management.
Express Clinics Diabetes Health Check Up (69 Parameters) @ Rs. 2,499ExpressClinicsIndia
Diabetes Check Up – Only @ Rs. 2,499 – Express Clinics
Diabetes is a ceaseless disease that triggers high blood sugar (glucose) levels in the body. Albeit diabetic patients can have an ordinary life existence with regular Diabetes Check-Up, uncontrolled diabetes can cause genuine long haul health hazards. Highlighting a wide scope of medical tests, The Diabetes Check-Up Package at Express Clinics is intended to analyze and treat such health hazards at the correct time.
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Diabetes mellitus refers to a group of diseases that affect how the body uses blood sugar (glucose). Glucose is an important source of energy for the cells that make up the muscles and tissues. It's also the brain's main source of fuel.
Basic Life Support, or BLS, generally refers to the type of care that first-responders, healthcare providers and public safety professionals provide to anyone who is experiencing cardiac arrest, respiratory distress or an obstructed airway.
The Advanced Cardiovascular Life Support (ACLS) algorithm is a systematic, evidence-based approach designed to guide healthcare providers in the urgent treatment of: Cardiac arrest. Arrhythmias. Stroke. Other life-threatening cardiovascular emergencies.
Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves. The most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn't make enough insulin. In the past 3 decades the prevalence of type 2 diabetes has risen dramatically in countries of all income levels. Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin by itself. For people living with diabetes, access to affordable treatment, including insulin, is critical to their survival. There is a globally agreed target to halt the rise in diabetes and obesity by 2025.
Levels of Organization
1
An Introduction to the Human Body
2
The Chemical Level of Organization
3
The Cellular Level of Organization
4
The Tissue Level of Organization
Support and Movement
Regulation, Integration, and Control
Fluids and Transport
Energy, Maintenance, and Environmental Exchange
Human Development and the Continuity of Life
Anatomy refers to the internal and external structures of the body and their physical relationships, whereas physiology refers to the study of the functions of those structures.
Communicable diseases, including HIV/AIDS, tuberculosis (TB), malaria, viral hepatitis, sexually transmitted infections and neglected tropical diseases (NTDs), are among the leading causes of death and disability in low-income countries and marginalized populations.
Nursing Mangement on occupational and industrial disorders [Autosaved].pptxDR .PALLAVI PATHANIA
What are the 5 types of occupational disease?
Occupational diseases in this registry system including Occupational lung diseases, occupational skin diseases, noise-induced hearing loss, diseases caused by chemical agents (poisoning), diseases caused by biological agents, occupational cancers and other occupational diseases
Acyanotic heart disease is where the blood contains enough oxygen but it's pumped abnormally around the body. Babies born with acyanotic heart disease may not have any apparent symptoms but, over time, the condition can cause health problems.
Congenital heart disease, also called a defect, refers to one or more problems with the heart structure that are present at birth. These abnormalities occur when the heart or blood vessels don't form correctly in utero. At least eight out of every 1000 infants born in the US each year have a heart defect.
Dialysis is a treatment for people whose kidneys are failing. When you have kidney failure, your kidneys don't filter blood the way they should. As a result, wastes and toxins build up in your bloodstream. Dialysis does the work of your kidneys, removing waste products and excess fluid from the blood
Urinary disorders with congenital anomalies of Kidney, ureter. UTIs are common infections that happen when bacteria, often from the skin or rectum, enter the urethra, and infect the urinary tract. The infections can affect several parts of the urinary tract, but the most common type is a bladder infection (cystitis).
Genitourinary disorders are conditions that affect the genitourinary system, which includes the urinary and reproductive systems. Some are congenital, and others are acquired later in life.
Large numbers of patients suffer from a variety of diseases in the genitourinary system, which is composed of kidneys, ureters, bladder, urethra, and genital organs. Genitourinary diseases include congenital abnormalities, iatrogenic injuries, and disorders such as cancer, trauma, infection, and inflammation.
The genitourinary system, or urogenital system, are the organs of the reproductive system and the urinary system. These are grouped together because of their proximity to each other, their common embryological origin and the use of common pathways, like the male urethra.
lymphatic system, a subsystem of the circulatory system in the vertebrate body that consists of a complex network of vessels, tissues, and organs. The lymphatic system helps maintain fluid balance in the body by collecting excess fluid and particulate matter from tissues and depositing them in the bloodstream
The musculoskeletal system is made up of bones, cartilage, ligaments, tendons and muscles, which form a framework for the body. Tendons, ligaments and fibrous tissue bind the structures together to create stability, with ligaments connecting bone to bone, and tendons connecting muscle to bone.
The skin is the largest organ of the body, with a total area of about 20 square feet. ... Skin has three layers: The epidermis, the outermost layer of skin, provides a waterproof barrier and creates our skin tone. The dermis, beneath the epidermis, contains tough connective tissue, hair follicles, and sweat glands.
Cancer cell metabolism: special Reference to Lactate PathwayAADYARAJPANDEY1
Normal Cell Metabolism:
Cellular respiration describes the series of steps that cells use to break down sugar and other chemicals to get the energy we need to function.
Energy is stored in the bonds of glucose and when glucose is broken down, much of that energy is released.
Cell utilize energy in the form of ATP.
The first step of respiration is called glycolysis. In a series of steps, glycolysis breaks glucose into two smaller molecules - a chemical called pyruvate. A small amount of ATP is formed during this process.
Most healthy cells continue the breakdown in a second process, called the Kreb's cycle. The Kreb's cycle allows cells to “burn” the pyruvates made in glycolysis to get more ATP.
The last step in the breakdown of glucose is called oxidative phosphorylation (Ox-Phos).
It takes place in specialized cell structures called mitochondria. This process produces a large amount of ATP. Importantly, cells need oxygen to complete oxidative phosphorylation.
If a cell completes only glycolysis, only 2 molecules of ATP are made per glucose. However, if the cell completes the entire respiration process (glycolysis - Kreb's - oxidative phosphorylation), about 36 molecules of ATP are created, giving it much more energy to use.
IN CANCER CELL:
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
introduction to WARBERG PHENOMENA:
WARBURG EFFECT Usually, cancer cells are highly glycolytic (glucose addiction) and take up more glucose than do normal cells from outside.
Otto Heinrich Warburg (; 8 October 1883 – 1 August 1970) In 1931 was awarded the Nobel Prize in Physiology for his "discovery of the nature and mode of action of the respiratory enzyme.
WARNBURG EFFECT : cancer cells under aerobic (well-oxygenated) conditions to metabolize glucose to lactate (aerobic glycolysis) is known as the Warburg effect. Warburg made the observation that tumor slices consume glucose and secrete lactate at a higher rate than normal tissues.
Nutraceutical market, scope and growth: Herbal drug technologyLokesh Patil
As consumer awareness of health and wellness rises, the nutraceutical market—which includes goods like functional meals, drinks, and dietary supplements that provide health advantages beyond basic nutrition—is growing significantly. As healthcare expenses rise, the population ages, and people want natural and preventative health solutions more and more, this industry is increasing quickly. Further driving market expansion are product formulation innovations and the use of cutting-edge technology for customized nutrition. With its worldwide reach, the nutraceutical industry is expected to keep growing and provide significant chances for research and investment in a number of categories, including vitamins, minerals, probiotics, and herbal supplements.
Richard's aventures in two entangled wonderlandsRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
(May 29th, 2024) Advancements in Intravital Microscopy- Insights for Preclini...Scintica Instrumentation
Intravital microscopy (IVM) is a powerful tool utilized to study cellular behavior over time and space in vivo. Much of our understanding of cell biology has been accomplished using various in vitro and ex vivo methods; however, these studies do not necessarily reflect the natural dynamics of biological processes. Unlike traditional cell culture or fixed tissue imaging, IVM allows for the ultra-fast high-resolution imaging of cellular processes over time and space and were studied in its natural environment. Real-time visualization of biological processes in the context of an intact organism helps maintain physiological relevance and provide insights into the progression of disease, response to treatments or developmental processes.
In this webinar we give an overview of advanced applications of the IVM system in preclinical research. IVIM technology is a provider of all-in-one intravital microscopy systems and solutions optimized for in vivo imaging of live animal models at sub-micron resolution. The system’s unique features and user-friendly software enables researchers to probe fast dynamic biological processes such as immune cell tracking, cell-cell interaction as well as vascularization and tumor metastasis with exceptional detail. This webinar will also give an overview of IVM being utilized in drug development, offering a view into the intricate interaction between drugs/nanoparticles and tissues in vivo and allows for the evaluation of therapeutic intervention in a variety of tissues and organs. This interdisciplinary collaboration continues to drive the advancements of novel therapeutic strategies.
What is greenhouse gasses and how many gasses are there to affect the Earth.moosaasad1975
What are greenhouse gasses how they affect the earth and its environment what is the future of the environment and earth how the weather and the climate effects.
Richard's entangled aventures in wonderlandRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
A brief information about the SCOP protein database used in bioinformatics.
The Structural Classification of Proteins (SCOP) database is a comprehensive and authoritative resource for the structural and evolutionary relationships of proteins. It provides a detailed and curated classification of protein structures, grouping them into families, superfamilies, and folds based on their structural and sequence similarities.
Slide 1: Title Slide
Extrachromosomal Inheritance
Slide 2: Introduction to Extrachromosomal Inheritance
Definition: Extrachromosomal inheritance refers to the transmission of genetic material that is not found within the nucleus.
Key Components: Involves genes located in mitochondria, chloroplasts, and plasmids.
Slide 3: Mitochondrial Inheritance
Mitochondria: Organelles responsible for energy production.
Mitochondrial DNA (mtDNA): Circular DNA molecule found in mitochondria.
Inheritance Pattern: Maternally inherited, meaning it is passed from mothers to all their offspring.
Diseases: Examples include Leber’s hereditary optic neuropathy (LHON) and mitochondrial myopathy.
Slide 4: Chloroplast Inheritance
Chloroplasts: Organelles responsible for photosynthesis in plants.
Chloroplast DNA (cpDNA): Circular DNA molecule found in chloroplasts.
Inheritance Pattern: Often maternally inherited in most plants, but can vary in some species.
Examples: Variegation in plants, where leaf color patterns are determined by chloroplast DNA.
Slide 5: Plasmid Inheritance
Plasmids: Small, circular DNA molecules found in bacteria and some eukaryotes.
Features: Can carry antibiotic resistance genes and can be transferred between cells through processes like conjugation.
Significance: Important in biotechnology for gene cloning and genetic engineering.
Slide 6: Mechanisms of Extrachromosomal Inheritance
Non-Mendelian Patterns: Do not follow Mendel’s laws of inheritance.
Cytoplasmic Segregation: During cell division, organelles like mitochondria and chloroplasts are randomly distributed to daughter cells.
Heteroplasmy: Presence of more than one type of organellar genome within a cell, leading to variation in expression.
Slide 7: Examples of Extrachromosomal Inheritance
Four O’clock Plant (Mirabilis jalapa): Shows variegated leaves due to different cpDNA in leaf cells.
Petite Mutants in Yeast: Result from mutations in mitochondrial DNA affecting respiration.
Slide 8: Importance of Extrachromosomal Inheritance
Evolution: Provides insight into the evolution of eukaryotic cells.
Medicine: Understanding mitochondrial inheritance helps in diagnosing and treating mitochondrial diseases.
Agriculture: Chloroplast inheritance can be used in plant breeding and genetic modification.
Slide 9: Recent Research and Advances
Gene Editing: Techniques like CRISPR-Cas9 are being used to edit mitochondrial and chloroplast DNA.
Therapies: Development of mitochondrial replacement therapy (MRT) for preventing mitochondrial diseases.
Slide 10: Conclusion
Summary: Extrachromosomal inheritance involves the transmission of genetic material outside the nucleus and plays a crucial role in genetics, medicine, and biotechnology.
Future Directions: Continued research and technological advancements hold promise for new treatments and applications.
Slide 11: Questions and Discussion
Invite Audience: Open the floor for any questions or further discussion on the topic.
3. What is diabetes Mellitus?
The term diabetes mellitus describes a metabolic disorder of multiple
aetiology characterized by chronic hyperglycaemia with disturbances
of carbohydrate, fat and protein metabolism resulting from defects in
insulin secretion, insulin action, or both.
Middle-aged and elderly age groups are most commonly affected by
diabetes. Diabetes is one of the four major types of non-communicable
diseases (cardiovascular disease, diabetes, cancer and chronic
respiratory diseases).
4.
5.
6.
7.
8. Definition
Diabetes mellitus (DM) is a group of diseases characterized by high
levels of blood glucose resulting from defects in insulin
production, insulin action, or both.
Or
A disease in which the body’s ability to produce or respond to the
hormone insulin is impaired, resulting in abnormal metabolism of
carbohydrates and elevated levels of glucose in the blood.
15. Classification / Etiology of diabetes mellitus
1. Type 1 diabetes
2. Type 2 diabetes
3. Secondary diabetes
4. Gestational diabetes
16. Type 1 diabetes
• Occur at any age, but usually <30 years
• Usually thin at diagnosis
• Can be due to genetic, immunologic or
environmental factors
• Can have islet cell antibodies
• No endogenous insulin , so require
exogenous insulin
• Diabetic ketoacidosis prone
17. Type 2 Diabetes
• Onset at age , usually >30 years
• Usually obese at diagnosis
• Can be due to hereditary or
environmental factors
• No islet cell antibodies
• Decreased insulin production or
decreased sensitivity to insulin
• Oral anti-diabetic agents may
improve blood glucose levels
• Diabetic keto-acidosis is rare
18.
19. Gestational Diabetes
• Onset usually in 2nd or 3rd trimester
•Placental hormones reduces action of
insulin
• Treated with diet or insulin
44. Management of DM
The major components of the treatment of diabetes are:
• Diet and ExerciseA
• Oral hypoglycaemic
therapy
B
• Insulin TherapyC
45. Dietary Considerations
• BMI
• Activity level
• Age / Sex
• Present food habits
• Economic status
• Complications in Diabetes
• Treatment of Diabetes
46. A. Diet
Diet is a basic part of management in every case.
Dietary treatment should aim at:
◦ Ensuring weight control
◦ Providing nutritional requirements
◦ Allowing good glycaemia control with blood glucose levels as
close to normal as possible
47.
48. A. Diet (cont.)
The following principles are recommended as dietary guidelines for
people with diabetes:
Dietary fat should provide 25-35% of total intake of calories but saturated
fat intake should not exceed 10% of total energy.
Cholesterol consumption should be restricted and limited to 300 mg or less
daily.
Protein intake can range between 10-15% total energy (0.8-1 g/kg of
desirable body weight).
Excessive salt intake is to be avoided. It should be particularly restricted in
people with hypertension and those with nephropathy.
51. Considerations during exercise
• Use proper footwear during
exercise
• Avoid exercise in extremes of
temperature
• Inspect feet daily
• Avoid exercise in periods of
poor metabolic control
• Do not exercise empty or full
stomach
52. Monitoring
A – A1C Levels {estimated average
BS level}
B – Blood pressure
C – Cholesterol
D – Diabetic education
E – Eye Examination
F – Foot Examination
G – Blood Glucose Examination
H – Health
I – Indications & Referral
54. B. Oral Anti-Diabetic Agents
There are currently four classes of oral anti-diabetic agents:
i. Biguanides
ii. Sulphonylureas
iii. Non-sulphonylureas
iv. α-glucosidase inhibitors
v. Thiazolidinediones (TZDs)
65. Nursing Diagnosis
1) Imbalanced Nutrition Less Than Body Requirements R/T reduction of carbohydrate
metabolism due to insulin deficiency, inadequate intake due to nausea and vomiting.
2) Fluid Volume Deficit related to osmotic diuresis from hyperglycemia, polyuria, decreased
fluid intake.
3) Impaired Skin Integrity related to decreased sensory sensation, impaired circulation,
decreased activity / mobilization, lack of knowledge of skin care.
4) Activity Intolerance related to weakness due to decreased energy production.
5) High risk of injury associated with decreased sensation sensory (visual), weakness, and
hypoglycemia.
6) Anxiety related to a lack of knowledge (diabetes management), the ability to remember the
less, diagnosis or treatment of a new way, cognitive limitations.
7) Risk for ineffective management of therapeutic rules at home due to a lack of knowledge
about the condition of the therapeutic management, inadequate support systems.
66. Nursing diagnosis ……(Contd.)
Altered nutrition : less than
body requirements
•Abnormal glucose
metabolism
•Depletion of fat stores,
cellular proteins
•Decreased oral intake –
dislike of prescribed diet,
anorexia gastric fullness
70. Self-Care
Patients should be educated to practice self-care. This allows the patient to assume
responsibility and control of his / her own diabetes management. Self-care should include:
◦ Blood glucose monitoring
◦ Body weight monitoring
◦ Foot-care
◦ Personal hygiene
◦ Healthy lifestyle/diet or physical activity
◦ Identify targets for control
◦ Stopping smoking