Part 3: Preventing Complications from Diabetes

Preventing Complications

• Having pre-diabetes and diabetes puts you at a higher risk for developing other health problems

HOWEVER…

• If you understand the risks, you can take steps now to lower your chance of diabetes related complications

Managing Diabetes

• What percentage of diabetes is managed by you vs. your healthcare provider?

• 20% of your diabetes control is managed by your healthcare provider

• 80% is managed by you

Preventing progression of DM

• Healthy eating• Exercise• Monitoring BG • Taking medications • Stop smoking

• Heart Disease and Stroke• Kidney Disease• Eye Complications• Nerve Damage• Foot Complications• Skin Complications• Depression • Sexual Dysfunction• Gum Disease

Long Term Complications of Poorly Controlled Diabetes

The good news is:

Better control = Less complications

Heart Disease and Stroke

• People with diabetes are 2x more likely to have heart disease or stroke than people without diabetes

• How can we prevent long term complications? – Cut out sugary and fattening foods– Daily exercise – Get your lipid panel done 2x/year

http://www.diabetes.org/living-with-diabetes/complications/mens-health/serious-health-implications/heart-disease-and-stroke.html

Kidney Disease

• The kidneys clean our blood • High blood sugar can put too much stress on the

kidneys and can cause damage over time

• How is the long term complication prevented?– Get your kidney function tests 2x/year

http://www.diabetes.org/living-with-diabetes/complications/kidney-disease-nephropathy.html

Eye Complications

• Diabetes can damage the blood vessels of the eyes, potentially leading to blindness

• Diabetes can also cause glaucoma or cataracts

• How is the long term complication prevented?– Get a comprehensive eye exam by an optometrist

or ophthalmologist 1x/year

http://www.diabetes.org/living-with-diabetes/complications/mens-health/serious-health-implications/blindness-or-vision-problems.html

Nerve Damage (Neuropathy)

• High sugar can harm the walls of the tiny blood vessels that connect to your nerves

• Described as a tingling, numbness, burning or pain in legs or fingers

• How is the long term complication prevented?– Get a foot exam by a physician 1x/year– Use proper foot care

http://www.diabetes.org/living-with-diabetes/complications/mens-health/serious-health-implications/nerve-damage.html

Foot Care • Check your feet every day

– Look at your bare feet for red spots, cuts, swelling, and blisters• Wash your feet, dry, and moisturize every day

– Rub lotion over the tops and bottoms but not between your toes• If you can see and reach your toenails, trim them

– File the edges with a nail file• Protect your feet from hot and cold

– Never use hot water bottles, heating pads, or electric blankets• Never walk barefoot

– Wear comfortable shoes that protect your feet– Check inside your shoes before wearing them

• Keep the blood flowing to your feet– Don't cross your legs for long periods of time

Depression • Studies show that people with diabetes have

an increased risk of depression• How is the long term complication prevented?

– Exercise and see your physician at least 1x/year, or as often as the two of you feel is appropriate

• Don’t be afraid to reach out for help– Employee Assistance Program (EAP)

1-800-822-4847 (24 hours a day)– 5 free sessions/year

Gum Disease

• There is an increased risk for gum disease because diabetes decreases your ability to

fight bacteria that invade the gums• How is the long term complication prevented?

– Brush and floss regularly– Have a dental exam at least 2x/year

http://www.diabetes.org/living-with-diabetes/treatment-and-care/oral-health-and-hygiene/diabetes-and-oral.html

Reducing Risk & Sick Day Management

• This is 1 risk factor YOU can control• IT IS NEVER TOO LATE TO QUIT• Smoking and diabetes have a lot of the same

complications• Talk to a health care professional if you are

interested in quitting• 1-800-Quit-Now

Reduce Risk: Quit Smoking

Reduce Risk: Get Vaccinated

• Flu vaccine 1x/year – Free to all employees and dependents in Employee

Health! • Pneumonia vaccine 1x before 65, 1x after age 65• Hepatitis B vaccine 1 time series between age 19-59

Target: Less than 7%

Target: Less than 140/90

Target: LDL “bad cholesterol” Less than 100

Know your ABC’s

• A1C – your doctor will likely tell you how often to have this lab drawn

• For the DHP: 2x/year at Employee Health

As a general rule: A1C < 7% A1C > 7%

2x/year 4x/year

A1C

• Blood pressure will be checked at every doctor visit and Employee Health & Clinic visit

Systolic (top number)

Diastolic(bottom number)

140 or less 90 or less

Blood Pressure

• Cholesterol will be drawn at least 2x/year at Employee Health & Clinic

Sex TotalCholesterol

HDL LDL TG

Male < 200 > 40 < 100 < 150

Female < 200 > 50 < 100 < 150

Cholesterol

Helps you see how food, physical activity and

medications affect your blood glucose level

Goal fasting BG before meals:

80-130 mg/dL

Goal 2 hours after the start of a meal:

Less than 180 mg/dL

Daily Monitoring

• Discuss your sick day plan with your physician • Make sure you get an annual flu vaccine

www.jimchines.com

Sick Day Management

S Is for Sugar testing more often

I Is for continue to take your Insulin or oral medications

C Is for Carbohydrate - keep intake as normal as possible

K Is for Keep well hydrated - drink at least 8 oz of calorie free fluids every hour

http://www.health.gov.sk.ca/Type-2-diabetes-on-insulin-sick-day-mgmt

S.I.C.K.

Things To Do on a Daily Basis

• Eat healthy • Keep active• Check your sugar• Reduce risky behaviors – smoking, drinking alcohol • Practice proper foot care habits• Wear proper footwear • Brush your teeth and floss regularly• Manage daily stressors• Ask for help when necessary

AADE7 Self Care Behaviors – Reducing Risk

http://diabeteshealth.com/

For appointments with Dietitian or PharmacistContact Dee Freeman at 667-5183 or

Diabetes.Pharmacy@nhrmc.org

For other questions related to the Diabetes Health Plan, contact the DHP

Administrator at 667-5959 orwellness@nhrmc.org

DHP Hotline 667-7777

Contact Information

• American Diabetes Association http://www.diabetes.org/

• Novo Nordisk http://www.cornerstones4care.com/

References

Other Resources

• http://www.health.gov.sk.ca/Type-2-diabetes-on-insulin-sick-day-mgmt

• http://www.diabetes.org

• 1 -800-QUIT NOW- for smoking cessation