What are the Complications Caused by Diabetes?
Uncontrolled diabetes can give rise to many complications. These are either acute or short-term; and chronic
or long-term.
• Acute problems are due to either low blood sugar causing hypoglycemia or high blood sugar causing
hyperglycemia or diabetes ketoacidosis.
• Chronic late complications associated with diabetes are:
• High blood pressure and heart problems leading to heart attacks and heart failure;
• Difficulty in vision and eye problems leading to blindness;
• Kidney problems, leading to kidney failure;
• Nerve damage primarily leading to problems of the foot; and
• Problems such as diarrhea, constipation, nausea, vomiting, etc., arising from damage to nerves in other
parts of the body.
Body mass index
BMI is an indicator of total body fat, but it may overestimate body fat in athletes and others who have a
muscular build. BMI and waist measurement are checked regularly to understand your risk for health
problems. Being overweight can lead to heart
disease, stroke, diabetes, high cholesterol, high blood pressure, gallstones, osteoarthritis, cancer and sleep
problems. There may also be a link between excess weight and erectile dysfunction or depression.
Your risk for disease related to your weight is:
(Provider check one; risk category definitions below)
rLow Risk
rIncreased Risk
rHigh Risk
rVery High Risk
Weight risk chart foradult men and women
Shows risk based on BMI and waist measurment.1
BMI Category
Normal BMI (18.5 – 23)
Waist circumference
40 inches or less for men,
35 inches or less for women
------
Increased risk (23.1-24.9)
Overweight BMI (25 - 29.9)
Obesity I BMI (30 - 34.9)
Obesity II BMI (35 - 39.9)
Obesity III BMI ( 40)
Increased risk
High risk
Very high risk
Extremely high risk
Waist circumference More than 40 inches for
men, more than 35 inches for women
Increased risk 2
High risk
Very high risk
Very high risk
Extremely high risk
1 Disease risk for type 2 diabetes, hypertension and cardiovascular disease.
2 Increased waist circumference can also be a marker for increased risk, even in persons of normal weight.
Source: National Heart, Lung, Blood Institute, Clinical Guidelines on the Identification,
Evaluation, and Treatment of Overweight and Obesity in Adults. Available at
www.nhlbi.nih.gov/guidelines/obesity/ob_home.htm.
Health Calculators
BMI= wt (kg)/ height (m2)
Know HOW HEALTHY are your kidneys?
2
-1.154
GFR (mL/min/1.73 m ) = 175 × (S cr )
(conventional units)
-0.203
× (Age)
× (0.742 if female) × (1.212 if African American)
References
1.Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S, Kusek JW, Van Lente F; Chronic Kidney
Disease Epidemiology Collaboration. Using standardized serum creatinine values in the modification of diet in
renal disease study equation for estimating glomerular filtration rate.Ann Intern Med. 2006 Aug
15;145(4):247-54.
Serum creatinine
(mg/dL)
Age*
African American
Gender
Male
Yes
No
Female
Reset
GFR value:
mL/min/1.73 m2**
*This equation should only be used for patients 18 and older.
**The NKDEP presently recommends reporting estimated GFR values greater than or equal to 60
mL/min/1.73 m2 simply as "≥ 60 mL/min/1.73 m2", not an exact number.
http://nkdep.nih.gov/lab-evaluation/gfr-calculators/adults-conventional-unit.shtml
What can I do for a more healthy lifestyle?
Lose weight. If you are overweight, start by losing
10 pounds. A small weight loss will reduce your risk for health problems. Weight loss of 1 to 2 pounds a
week is a healthy pace.
Become more physically active. For general health, aim for at least 30 minutes of moderate activity on most
days. To lose weight, you may need to double the amount of moderate activity or increase the intensity. You
don’t have to exercise all at once – 10 minutes at a time adds up.
Make your calories count. Start by eating at least five servings of fruits and vegetables per day. For
weight loss, reduce the amount you eat by 500 1,000 calories a day.
My action plan
Start by setting a specific and attainable goal. Based on how ready you are to change your health habits,
check one or two of the following goals in the chart below. Give yourself a nonfood reward like a like a new
book or CD when you accomplish your goal. Small changes make a big difference toward reaching your health
goals.
Use the chart below to set goals and discuss them with your doctor.
If you’re not yet ready to make
changes in your health habits
r Learn more about the health risks
of being overweight and sedentary or
of eating an unhealthy diet.
r Imagine your life 3 to 5 years from
now. Are your current behaviors
consistent with your hopes for the
future?
r Read about or talk to others who
have successfully made changes that
led to better health.
If you’re thinking about making changes in your
health habits
r Make a list of how your life will be better if you
make healthy changes. Then list what you will
have to give up. Do the reasons to change
outweigh the reasons not to?
r Talk with a family member or friend about
becoming more physically active together. Share
your goals with each other.
r Become more aware of your current behaviors.
Keep a food diary for two weeks and see
patterns in your eating and physical activity.
r Contact your health care provider when
you are more ready to make changes in
your health habits.
r Take small steps, like walking 10 minutes one
day for a week or eating one more serving of
vegetables a week.
Other:
Other:
If you’re already making changes in your
health habits
r Ask a friend or family member to support
you or to suggest others who will support your
efforts.
r Join a support group, program or local
exercise facility.
r Track your progress and reward yourself
along the way.
r Make a list of all of your reasons for
changing. Read it often.
Other:
NUTRITION
Meal planning is a tool that can help you manage your diabetes, weight, blood pressure
and blood cholesterol, and ensure that you get the nutrients that you need for overall good
health. Use this handout as a guide to help you get started, then work with a dietitian or
diabetes educator to develop a meal plan that is right for you.
Building a Better Plate
Whether you’re new to diabetes or have had it for many years and need to get
back on track, the Plate Method is an easy way to get started with meal planning
and ensure that you and your family eat a variety of foods and is a tool that you
and your family can use to plan healthy meals. Think of your plate divided into
THREE sections – nons tarchy vegetables, protein, and carbohydrate foods
(grains and starchy vegetables)
• Fill TWO section with nonstarchy vegetables: lettuce, broccoli, green beans,
spinach, carrots or peppers. – GREEN part of your plate
• Fill one section with protein: chicken, turkey, fish, lean meat, eggs or tofu, pulses
and legumes – Yellow part of your plate
• Fill one section with a nutritious carbohydrate food: brown rice, whole wheat
pasta, whole-wheat bread, peas or corn. Controlling carbs helps you control your
blood glucose- BLUE part of your plate
• Include low fat milk or yogurt.
FOOD
R
I
S
E
S
B
L
O
O
D
S
U
G
A
R
Usual
Healthy
Evening Snack
WRONG
RIGHT
FRUITS-
1/2
10-15
2 small
Healthy Eating Tips:
•
•
•
•
•
Eat meals at about the same times each day. Try not to skip meals, especially
if you take diabetes medicine that puts you at risk for low blood glucose.
Eat about the same amount of carbohydrate foods (potatoes, pasta, cereal,
bread, fruit, milk) at your meals each day.
Choose more often foods that contain fiber, like whole-grain bread, beans,
vegetables and fruit.
Use unsaturated fats like olive and canola oil and cut back on saturated and
Trans fats.
Compare food labels for sodium in foods like soup, bread and frozen
meals, and choose foods with less sodium.
Weight Matters
Losing a small amount of weight, if you need to, can lead to big health benefits, such as
lowering your risk of getting type 2 diabetes or heart disease. And if you have diabetes,
losing weight can help you better manage your blood glucose.
Tips for Getting Started with Weight Loss
• Be ready to start. Success is linked with your feeling confident and having a clear
plan. Set realistic goals.
• Get support. Meet with a dietitian; join a support group or sign up for a local weightloss program in your community.
• Focus on forming healthy eating habits. Eat regular meals and snacks.
• Find ways to fit activity into your day.
• Check your progress by keeping food records, wearing a pedometer and weighing
yourself regularly.
• If you drink alcohol, check with a dietitian or diabetes educator to learn how to fit
alcohol safely into your eating plan.
Fiber is good for you in more ways than one. Higher fiber foods take longer to chew,
giving your body time to realize it’s full. Also, higher fiber foods tend to be more filling
– so that you might end up eating less! If you’re a woman, aim for at least 25 grams
per day; if you’re a man, aim for at least 38 grams per day. Here are tips to increase
fiber:
1. Kick off your day by eating a bowl of high-fiber cereal for breakfast or add
vegetables to upma/ dosa/ sambhar etc.
2. Stir fresh or frozen berries into low fat yogurt for a tasty snack.
3. Choose breads, cereals and crackers with a whole grain listed as the first
ingredient, prefer brown rice over white rice.
4 Include a salad and/or vegetable with each of your meals.
Your Next Steps
Often, the hardest part about eating healthfully is getting started. To keep things
easy, try not to make too many changes at once. Use the checklist below to get you
started on your way to healthy eating with diabetes!
• Try planning your meals ahead of time.
• Shop from a list to make it easier to remember to buy healthier foods and involve
your
FOLLOw yOUr hEALthy EAtiNg PLAN.
Are you proud of the way you ate today?
kEEP ACtivE
What is your favorite outdoor activity?
tAkE MEdiCAtiONS
Did you take your meds today?
MONitOr yOUr bLOOd SUgAr
What was your blood sugar number last time you checked?
ChECk yOUr FEEt
Any pain or sores on your feet?
brUSh ANd FLOSS yOUr tEEth
When was your last dentist visit?
ChECk yOUr bLOOd PrESSUrE
Do you know what your blood pressure is?
dON’t SMOkE
What can help you quit?
gEt AN EyE ExAM (whiCh iNCLUdES diLAtiNg yOUr EyES) At LEASt ONCE A yEAr
Have you had an eye exam this year?
A1C
Less than 7%
Every 3 to 6 months
Blood Pressure
Less than 130/80
Every visit
Lipids
HDL (good cholesterol)
LDL (bad cholesterol)
Triglycerides
Over 40 (for men); Over 50 (for women)
Less than 100 (less than 70 if you have heart disease)
Less than 150
At least every year
Eye Exam
Every year
Foot Exam (visual)
Every visit to your
healthcare provider
Every year
Foot Exam (with sensory testing)