Living Well with Diabetes
Lesson 5
Living Well With Diabetes
The Bad News…
• People with diabetes are at risk for a variety of
problems
• Problems can develop years after initial
diagnosis
• More likely to have:
– Heart attack, stroke, eye problems, kidney
disease, foot or leg amputation, frequent
infections, sexual problems
And The Good News…
• Diabetes complications do not have to occur
• People with diabetes can live long, healthful
and productive lives
Three Keys To Living Well with Diabetes
• Education
• Early Detection
• Regular Doctor/Health Care Team Visits
EDUCATION
• Learn as much as you can about diabetes and
its complications
– How
– What
– Why
EARLY DETECTION
• Learn earliest signs and symptoms of potential
problems
• Know your lab test results
• Keep track of changes
REGULAR OFFICE VISITS
• Make regular office visits with your diabetes
care team
• Set up a 3-month schedule and STICK TO IT!
• Contact immediately if you are having
problems
• Working together = strong prevention team
Keep A Check
• Every Office Visit
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Blood glucose
Blood pressure
Weight
Review meal plan
Discuss concerns
• At least every 3-6
months
– A-1-C
• At least once a year
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Physical exam
Cholesterol
Triglycerides
Microalbumin
Feet exam
Dilated eye exam
Flu shot
• Every 5 years
– Pneumonia vaccine
Who Should Be On Your Team?
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Doctor
Diabetes educator
Dietitian
Pharmacist
Nurse
Foot doctor
• Eye doctor
• Mental health
counselor
• Nurse practitioner
• Dentist
• Social worker
• Family and friends
How Do Problems Start?
• Blood glucose levels consistently exceed 140
mg/dl
• Physiological changes occur and affect organs
and body functions
• Having high glucose levels for long term leads
to complications
– Nerve damage, eye damage, kidney disease,
dental problems, foot problems, etc.
Take Care of Your Heart
• Ask your doctor these questions:
– What are my blood glucose, blood pressure and
cholesterol numbers?
– What should they be?
– What actions should I take to reach these goals?
Take Action Now
To Reduce Heart Disease
• Eat the right amounts of foods for your meal
plan
• Eat foods prepared with less salt and less fat
• Get at least 30 minutes of physical activity
every day
• Maintain a healthy weight
Take Action Now
To Reduce Heart Disease
• Stop smoking – seek help
• Take medicines the way your doctor tells you
to take them
• Ask your family and friends to help
Seeing After Your Eyes
• Have eyes checked at least once a year
• Tell your eye doctor if you:
– See spots
– See poorly in dim light
– Have eye pain
– Or any other eye problem
Keeping Your Kidneys Fit
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Get yearly screening for microalbumin
Keep blood glucose tightly controlled
Keep blood pressure in check
Avoid medications that can damage kidneys
Say no to nicotine
Go easy on protein
Use preventive medications when needed
Taking Care of Your Tootsies
• Wear comfortable shoes and
clean, properly fitting thick socks
• Wash your feet daily with lukewarm soapy
water and dry well, especially between toes
• Keep feet soft by using lotion after a bath or
shower
• Inspect daily cuts, scratches, redness or
swelling
Taking Care of Your Tootsies
• Call health care provider if wound does not
heal
• Wear shoes with good support or diabetic
shoes, if possible
• Never go barefoot, even inside your home
• Never, ever, do bathroom surgery on your own
feet
• See a podiatrist for foot care (surgery, trimming
nails, medications)
Don’t Deny Your Dental Care
• Brush and floss your teeth daily
• Have your teeth cleaned every 3 to 6 months
• If you notice any problems, tell your dentist
Your Sick Day Plan
• When to call your physician:
– Fever
– Uncontrolled vomiting or diarrhea
– High ketone count
– Glucose levels above 240
– Do not know what to do
Things to Do…
• Take your medicines for diabetes
• Make sure to check blood sugar often
• Try to eat and drink according to your meal
plan as much as possible
• 50 grams carbohydrates every 3-4 hours
• Write down blood sugar levels, ketone levels,
what you eat and medicines taken!!!
Handy Sick Day Foods
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Gatorade
Milk
Soup
Fruit juice
Regular soft drinks
Crackers
Dry toast
Cooked cereal
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Frozen yogurt, sherbet
Sugar-free pudding
Mashed potatoes
Regular pudding
Custard
Peanut butter
Be Food Safe
4 Basic Steps . . .
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Clean
Separate
Cook
Chill
Clean
• Wash hands and surfaces often
Separate
• Don’t cross-contaminate
Cook
• Cook to proper temperatures
Chill
• Refrigerate promptly
Making Wise Food Choices
• Foods most likely to contain
pathogens include:
–Uncooked fresh fruits and
vegetables
–Animal products
Type of Food
Meat, Poultry &
Seafood
Milk
Eggs
Higher Risk
Raw or
undercooked
Unpasteurized
Raw or
undercooked
Sprouts
Raw
Vegetables/Fruits Unwashed
Cheese
Soft
Hot Dogs/Deli
Meats
Not reheated
Lower Risk
Cooked to safe
temperature
Pasteurized
Pasteurized
Cooked
Washed
Hard/processed/
pasteurized
Reheated
Tips for Safe Shopping
• Check the “sell by” date.
• Put raw meat, poultry or seafood in plastic
bags.
• Buy only pasteurized milk, cheese, dairy
products and juices.
• Keep it safe when buying eggs.
• Don’t buy food displayed in unsafe or unclean
conditions.
Transportation Issues
• Pick up perishable foods last.
• Follow the “2 hour rule.”
• Consider a cooler.
Dining Out
• Ask about uncooked ingredients.
• Request a safe minimum temperature.
• To minimize your risk of getting a foodborne
illness it is wise to avoid restaurant buffets.
• Keep the “doggy bag” safe.
Uh Oh . . .
• Know the symptoms:
– Nausea
– Vomiting
– Diarrhea
– Fever
I Don’t Think We’re in Kansas
Anymore . . .
• Preparing for
Emergencies
Before the Storm
• Prepare a waterproof insulated emergency kit
including standard emergency supplies plus:
– At least 3 days of diabetes supplies
– Carbohydrate source along with water and food
– A list of emergency contacts and medications
– Prescription bottles or numbers so you can
replace medications at a pharmacy, if needed
– Cooler with at least 4 re-freezable gel packs for
storing insulin (if you’re using insulin)
Play It Safe
• Consider wearing medical identification.
• Identify school personnel to help with
children.
• Wear sturdy shoes.
• Pack 2 to 3 days of extra clothing.
• Keep immunizations up to date.
• Keep your cell phone charged.
• Have a plan.
During the Storm
• Identify yourself as a person with diabetes.
• Drink plenty of water.
• Watch what you eat and carry a fast source of
sugar with you at all times.
• Stick with your testing and medication
schedule.
• Check your feet!
Have Diabetes. Will Travel.
Plan Ahead
• Have a medical exam
• Control your ABCs
• Ask for prescription and letter explaining
medications, supplies and allergies
• Acquire medical identification
• Learn to say: “I have diabetes” and “sugar or
orange juice, please” in the language of the
countries if traveling abroad
Plan Ahead
• Plan for time zone changes
• Find out flight times, and if meals will be
served, ask for special meal
• Always carry enough food to cover flight time
and delays
Travel Preparations
• Take twice the amount of medication and supplies you
need normally; pack at least half in carry-on bag
• Carry-on bag
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All the insulin and syringes you will need for trip
Blood and urine testing supplies
Extra batteries for glucose meter
All oral medications
Other medications or medical supplies
Your ID and medical identification
Emergency snacks
Travel Preparations
• Keep insulin cool by packing in insulated bag
with refrigerated gel packs.
• Pack a first-aid kit.
• Don’t forget a sharps container.
• Notify airport security that you have diabetes.
• Have all medications and delivery systems
clearly marked with prescription labels intact.
You Can Be Your Own Worst
Enemy . . .
or Your Own Best Friend
Acceptance of Diagnosis
Denial
Depression
Anger
Bargaining
Acceptance
Worst Enemies
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I’m tired and this is how I relax.
These foods taste good.
I eat more when I am stressed.
I don’t want to think about whether foods are
healthful or not.
I don’t want to face my diabetes.
Everyone is nagging me.
I don’t want to worry my family.
It’s too hard to make it to the doctor.
Best Friends
• I want to protect my family from losing me.
• I am ready to face reality and do something about
my diabetes.
• I am willing to try something new.
• I am willing to take charge and to take action.
• I am willing to ask for help.
• My family is important to me, and they can help.
• I should share what I am feeling with my family.
Are You Ready to Change???
• Precontemplation
• Contemplation
• Preparation
• Action
• Maintenance
How Can I Be My Best Friend?
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Tell yourself you can do it.
Pat yourself on the back for positive changes.
Ask for help when you need it and share your fears.
Seek out positive people.
Believe that you deserve to have a healthy body.
Don’t beat up on yourself.
Don’t let yourself get away with excuses.
How Can I Help My Family Member?
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Learn about diabetes.
Understand your loved one’s diabetes.
Find out what your loved one needs.
Talk about your feelings.
Offer practical help.
Try a new approach.
Get help.
Diabetes Does Not Control Me
I Control My Diabetes
References
• American Diabetes Association
• National Diabetes Education Program
• The Diabetic Bible by Dana Armstrong and Allen Bennett
King
• Diabetes Life Lines – The University of Georgia Cooperative
Extension
• U. S. Food and Drug Administration
• U. S. Department of Agriculture’s Food Safety and Inspection
Service
• Diabetes Prevention and Control Program
• Journey for Control…Advancing Diabetes Education by Merck
and Company
Living Well With Diabetes
Prepared By:
Terri Crawford, Extension Agent, Nutrition,
Northeast Region
Cathy Agan, Extension Agent, FNP
Ouachita Parish