Post on 30-May-2018
8/9/2019 Diabetes SM Ppt5
1/32
DiabetesDiabetes
Making ChangesMaking Changes
forfor
SelfSelf--ManagementManagement
DebDeb BurlageBurlage,RN, CDE,RN, CDE
8/9/2019 Diabetes SM Ppt5
2/32
ObjectivesObjectives
Participants will be able to..Participants will be able to..
Discuss Basics of DiabetesDiscuss Basics of DiabetesHow to Impact ChangeHow to Impact Change
Apply Concepts to ExerciseApply Concepts to Exercise
8/9/2019 Diabetes SM Ppt5
3/32
EpidemicEpidemic
Approximately 17Approximately 17
million people in themillion people in theUS have diabetesUS have diabetes
Another 16 millionAnother 16 millionhave a condition nowhave a condition now
known as preknown as pre--
diabetesdiabetes
8/9/2019 Diabetes SM Ppt5
4/32
PrevalencePrevalence
The incidence ofThe incidence of
diagnosed diabetes hasdiagnosed diabetes has
increased by 61% sinceincreased by 61% since
1990.1990.
0
2
4
6
8
10
12
1990 1998
3-DColumn 1
DX_DM
UnDx-DM
8/9/2019 Diabetes SM Ppt5
5/32
Basic Diabetes InformationBasic Diabetes Information
DiabetesDiabetes is a disease in which the bodyis a disease in which the body
doesdoes NotNot produce or properly use insulinproduce or properly use insulin
InsulinInsulin is a hormone that is needed tois a hormone that is needed toconvert sugar, starches and other foodconvert sugar, starches and other foodinto energy needed for daily lifeinto energy needed for daily life
Cause:Cause: Genetics/EnvironmentGenetics/Environment
Sings and SymptomsSings and Symptoms
8/9/2019 Diabetes SM Ppt5
6/32
Classification of DiabetesClassification of Diabetes
Type 1 diabetes: failure to produce insulinType 1 diabetes: failure to produce insulin
Type 2: results from insulin resistanceType 2: results from insulin resistance
PrePre--diabetes: BS in between normal anddiabetes: BS in between normal andhighhigh
Gestational Diabetes: affects 4 % ofGestational Diabetes: affects 4 % of
pregnant women per yearpregnant women per year
8/9/2019 Diabetes SM Ppt5
7/32
FPGFPG
126 mg/dl**126 mg/dl**
Symptoms of diabetes and a casualSymptoms of diabetes and a casual
plasma glucoseplasma glucose 200 mg/dl*200 mg/dl*
Current Criteria forDiagnosis of Diabetes
8/9/2019 Diabetes SM Ppt5
8/32
IFG: 110 mg/IFG: 110 mg/dLdL and < 126and < 126
IGTIGT
Fasting:Fasting:
8/9/2019 Diabetes SM Ppt5
9/32
ComplicationsComplications
Heart DiseaseHeart Disease
StrokeStrokeHigh Blood PressureHigh Blood Pressure
BlindnessBlindness
Kidney DiseaseKidney Disease
Nervous SystemNervous System
AmputationsAmputations
Dental DiseaseDental Disease
8/9/2019 Diabetes SM Ppt5
10/32
Cost $$$$$$$$$Cost $$$$$$$$$
2002: 132 Billion2002: 132 Billion
Per Person:Per Person:
IndividualsIndividuals withwithdiabetes: $13,243diabetes: $13,243per yearper year
IndividualsIndividualswithoutwithout diabetesdiabetes::$2,560 per year$2,560 per year
8/9/2019 Diabetes SM Ppt5
11/32
ABCs of DiabetesABCs of Diabetes
Good NewsGood News
Studies have proven:Studies have proven:DCCT/UKSDCCT/UKS
You Can Make AYou Can Make A
DifferenceDifference
8/9/2019 Diabetes SM Ppt5
12/32
Standards of CareStandards of Care
ABCsABCsA A1CA A1CB Blood PressureB Blood Pressure
C CholesterolC CholesterolD Diabetes Ed/DentalD Diabetes Ed/Dental
Exam/DietExam/Diet
E Eye Exam/ExerciseE Eye Exam/ExerciseF Foot ExamF Foot ExamG Glucose monitoringG Glucose monitoring
H Heart HealthH Heart HealthI Indications forI Indications forspecialtiesspecialties
K KidneyK Kidney
8/9/2019 Diabetes SM Ppt5
13/32
Recommended GoalsRecommended Goals
Glycemic controlGlycemic control
A1C
8/9/2019 Diabetes SM Ppt5
14/32
Change Is HARDChange Is HARDKISSKISS
Knowledge: get theKnowledge: get the
facts!!!facts!!!Individual: set goalsIndividual: set goalsthat arethat are
yours/understandyours/understandBenefits and BarriersBenefits and Barriers
Start with whatStart with what
motivates YOUmotivates YOUSupport: Health careSupport: Health careteam/family/friendsteam/family/friends
8/9/2019 Diabetes SM Ppt5
15/32
ExampleExample
ExerciseExercise K:K: what do you need to know before youwhat do you need to know before youexerciseexercise
I:I: what works for you (schedules,what works for you (schedules,limitations)limitations)
S:S: start with what motivates you (family,start with what motivates you (family,
friends, hobby, travel..)friends, hobby, travel..) S:S: Find a friend or colleague that willFind a friend or colleague that will
motivate you!!!motivate you!!!
8/9/2019 Diabetes SM Ppt5
16/32
ExerciseExercise
Exercise can control blood sugars and lower
you risk of heart disease!
8/9/2019 Diabetes SM Ppt5
17/32
Examples of ExerciseExamples of Exercise
Examples of exercise:Examples of exercise:
Aerobic: Walking, Swimming, Bicycling,Aerobic: Walking, Swimming, Bicycling,Jogging, and SkatingJogging, and Skating
Strength: Weight/ResistanceStrength: Weight/Resistance Flexibility: Yoga, Tai ChiFlexibility: Yoga, Tai Chi
8/9/2019 Diabetes SM Ppt5
18/32
Three Key Parts To AnyThree Key Parts To Any
Exercise ProgramExercise Program Frequency:Frequency: Exercise at least 3Exercise at least 3--5 days per5 days per
weekweek Intensity:Intensity: This means how hard you workThis means how hard you work
during exercise. You should feel like you areduring exercise. You should feel like you are
working harder than usual but still be able toworking harder than usual but still be able tocarry on a conversationcarry on a conversation
Time:Time: Exercise for at least 20Exercise for at least 20--30 minutes at a30 minutes at a
time (Start out gradual).time (Start out gradual).
8/9/2019 Diabetes SM Ppt5
19/32
Exercise TipsExercise Tips
Type 1: do not exercise if sugars 300 or ifketonesketones are presentare presentType 2: do not exercise if sugars < 70 orType 2: do not exercise if sugars < 70 or>350>350
Exercise at peak insulin times may causeExercise at peak insulin times may causelow blood sugarslow blood sugars
Exercise can cause low blood sugarsExercise can cause low blood sugarsseveral hours after exerciseseveral hours after exercise
Schedule exercise 45Schedule exercise 45--60 minutes after60 minutes aftereatingeating
8/9/2019 Diabetes SM Ppt5
20/32
GuidelinesGuidelines
Always check with your physician beforeAlways check with your physician before
beginning any exercise program or if youbeginning any exercise program or if youhave any complications during exercisehave any complications during exercise
Check Blood Sugars before and after exerciseCheck Blood Sugars before and after exercise
Warm up and cool downWarm up and cool down
Wear good shoes and check feet afterWear good shoes and check feet after
exercise for any blisters or signs or irritationexercise for any blisters or signs or irritation
8/9/2019 Diabetes SM Ppt5
21/32
Further GuidelinesFurther Guidelines
Keep a daily logKeep a daily log
Wear Medical IDWear Medical IDDrink plenty of fluidsDrink plenty of fluids
Exercise with aExercise with a
partnerpartnerModify Caloric IntakeModify Caloric Intake
Carry fast actingCarry fast acting
sugarsugar
Do NOT inject intoDo NOT inject into
area where exercisearea where exerciseis involvedis involved
( )
8/9/2019 Diabetes SM Ppt5
22/32
Knowledge (continued)Knowledge (continued)BS Type of Exercise Extra Food NeeBS Type of Exercise Extra Food Neededded
No extra foodNo extra foodNo ExerciseNo Exercise> 300 mg/dl> 300 mg/dl
No extra foodNo extra foodNo extra foodNo extra food
15 gms Carb15 gms Carb
LowLowModerateModerate
StrenuousStrenuous
171171--300 mg/dl300 mg/dl
No extra foodNo extra food
15 gms Carb15 gms Carb30 gms Carb30 gms Carb
LowLow
ModerateModerateStrenuousStrenuous
101101--170 mg/dl170 mg/dl
15 gms Carb15 gms Carb
30 gms Carb30 gms Carb
60 gms Carb60 gms Carb
LowLow
ModerateModerate
StrenuousStrenuous
< 100 mg/dl< 100 mg/dl
8/9/2019 Diabetes SM Ppt5
23/32
Individualize ExerciseIndividualize Exercise
Benefits and Barriers to ExerciseBenefits and Barriers to Exercise
Maybe You are not ready to changeMaybe You are not ready to change
Maybe you are thinking about changeMaybe you are thinking about change This is a good time to think about the benefits,This is a good time to think about the benefits,
the barriers, and becoming more physicallythe barriers, and becoming more physically
active!active!
8/9/2019 Diabetes SM Ppt5
24/32
Individualize: ProsIndividualize: Pros--Why do youWhy do you
want to changewant to changePhysical ReasonsPhysical Reasons
Emotional ReasonsEmotional Reasons
8/9/2019 Diabetes SM Ppt5
25/32
Individual Barriers: What isIndividual Barriers: What is
Stopping You???Stopping You???
Physical BarriersPhysical Barriers
Emotional BarriersEmotional Barriers
8/9/2019 Diabetes SM Ppt5
26/32
Next StepNext Step
Summarize your findingsSummarize your findings
ID benefits you are most excited aboutID benefits you are most excited about ID barriers you feel strongest aboutID barriers you feel strongest about
Ask yourself if you are confident and ready toAsk yourself if you are confident and ready tocommit to changecommit to change
Ask yourself if you are satisfied with statusAsk yourself if you are satisfied with status
quoquo Are you open to learning more?Are you open to learning more?
8/9/2019 Diabetes SM Ppt5
27/32
Start With What Motivates YouStart With What Motivates You
What is meaningful in your lifeWhat is meaningful in your life
What do you enjoy doingWhat do you enjoy doingWhat are you passionate aboutWhat are you passionate about
What have you always wanted to do?What have you always wanted to do?
So Lets Get startedSo Lets Get started
8/9/2019 Diabetes SM Ppt5
28/32
SupportSupport
MultiMulti--disciplinary Teamdisciplinary Team
FamilyFamilyFriendsFriends
8/9/2019 Diabetes SM Ppt5
29/32
Summary for SuccessSummary for Success
KnowledgeKnowledge
IndividualizeIndividualize
StartStart
SupportSupport
8/9/2019 Diabetes SM Ppt5
30/32
ConclusionConclusion
Life is not simply holding a good handLife is not simply holding a good hand
Life is playing poor hand well.Life is playing poor hand well.--Danish SayingDanish Saying
8/9/2019 Diabetes SM Ppt5
31/32
Resources/ReferencesResources/References
American Diabetes Association:American Diabetes Association:
www.diabetes.orgwww.diabetes.org
Center for Disease Control:Center for Disease Control:www.cdc.gov/diabeteswww.cdc.gov/diabetes
Clinical Diabetes:Clinical Diabetes:http://clinical.diabetesjournals.http://clinical.diabetesjournals.orgorg
Diabetes is South Dakota:Diabetes is South Dakota:www.www.sddiabetessddiabetes.net.net
8/9/2019 Diabetes SM Ppt5
32/32
The Gift..The Gift..