Lesson 11: Preventing, Detecting & Treating Chronic Diabetes Complications

LEARNING OBJECTIVES Understand the following conditions: Diabetic Peripheral Neuropathy Diabetic Eye Disease Diabetic Kidney Complications Diabetic Cardiovascular Problems Signs & symptoms of each of conditions How to protect yourself against complications

DIABETIC PERIPHERAL NEUROPATHY Chronic high blood glucose levels damage the delicate coating of nerves. 60 to 70% of all people with diabetes will develop DPN. Damaged nerves cannot effectively carry messages between your brain and other parts of your body. Signs include: Pain Burning Tingling Loss of feeling in feet and hands Abnormal sweating Hard to tell when blood sugar is low Feeling light-headed when standing up Loss of balance, muscle weakness, and loss of coordination OTHER PROBLEMS INCLUDE: Problems swallowing & keeping food down Painful bowel problems Difficulty urinating Dribbling with urination Bladder and kidney infections Trouble having sex Erectile Dysfunction (for men

PROTECTING YOUR NERVES FROM DAMAGE KEEP YOUR BLOOD GLUCOSE UNDER CONTROL HAVE A PHYSICAL ACTIVITY PLAN Increases circulation in feet Exercise feet even when unable to walk...refer back to Lesson 3 Ask about activity that is healthy for you FOOT EXAMS Damage happens slowly, may not be aware you are losing feeling 4 x year need complete check feet & nerves Once per year test for how well you sense temperature, pinprick, vibration, & position in your feet If have signs of nerve damage…HCP might want more tests Keep track of your foot exams!

DIABETIC EYE DISEASE OR DIABETIC RETINOPATHY Can lead to loss of sight Study shows keeping blood glucose close to normal can prevent or delay onset Finding and treating eye problems early can help save sight Can develop even when sight is good SIGNS OF DIABETIC EYE DISEASE Vision changes Trouble reading Blurry vision Seeing rings around lights, dark spots, or flashing lights

PROTECTING YOUR SIGHT If you have lost your sight from diabetic eye disease, still need regular eye care; get an exam you if any of these apply to you… Have had type 1 more than 5 years Have type 2 diabetes Going through puberty and have diabetes Pregnant and have diabetes Planning on becoming pregnant and have diabetes > 65 YOA Medicare pay for eye exams KEEP YOUR BLOOD GLUCOSE UNDER CONTROL KEEP YOUR BLOOD PRESSURE UNDER CONTROL GET YEARLY DILATED EYE EXAM

TREATING DIABETIC EYE DISEASE Laser surgery may help those with advanced eye disease; Vitrectomy surgery clears bleeding within the eye. Physician who is expert in low vision may be able to give glasses or other devices to use limited vision more fully. Ask about job training or support groups for people with poor vision.

KIDNEY PROBLEMS MICROALBUMIN (protein) in the urine is an early sign of diabetic kidney disease; get this checked yearly. HCP can also perform yearly blood test to measure kidney function. If test shows Microalbumin in urine or if kidney function isn’t normal, will need to be checked more often. PROTECT YOUR KIDNEYS Keep blood glucose under control. Keep your blood pressure in balance.

STEPS TO LOWER BLOOD PRESSURE Maintain a healthy weight. Be active every day. Eat fewer foods high in salt/sodium. Eat more fruits and vegetables. Take your medicine the way doctor tells you. Have your blood pressure checked at least 4 x per year.

SIGNS OF A KIDNEY INFECTION Call your HCP right away if you have any signs of a kidney infection. Back pain Chills Fever Ketones in the urine Your HCP will test your urine; if you have a bladder or kidney infection, you’ll be given medicine to stop the infection. After you take all of the medicine, have your urine rechecked to make sure infection is gone.

HEART AND BLOOD VESSEL PROBLEMS MAIN CAUSE OF SICKNESS & DEATH among people with diabetes Can lead to HIGH BLOOD PRESSURE, HEART ATTACKS, STROKES AND POOR CIRCULATION (blood flow) in legs & feet You are more likely to have if… Smoke cigarettes Have high blood pressure Too much cholesterol/fats in blood Talk to Health care team about what you can do to lower risk for heart & blood pressure problems.

Any of these signs, go to emergency room or call 9-1-1. SLURRED SPEECH CHEST PAIN OR CHEST PRESSURE SWOLLEN ANKLES FEELING DIZZY NUMBNESS OR WEAKNESS ONE ARM / ONE LEG SHORTNESS OF BREATH IRREGULAR HEARTBEAT SUDDEN LOSS OF SIGHT

Preventing & Controlling Heart & Blood Vessel Problems EAT RIGHT & GET PHYSICAL ACTIVITY Follow dietary recommendations; eat plenty of fruits & vegetables, maintain low-fat diet. CHECK YOUR BLOOD PRESSURE CHECK YOUR CHOLESTEROL DON’T USE TOBACCO Risk of heart and blood pressure problems is even greater if you have diabetes and use tobacco.