1. Sue North Practice Nurse, Scarborough Medical Group February 2019
Diabetes did you know diabetes could do this to you? What happens when the door closes?
This session is in 2 parts
1) What diabetes is, focusing on type 2 and how it can affect the body
2) What happens at at typical annual review
Sue North
Practice Nurse, Scarborough Medical Group
February 2019

2. Did you know diabetes could do this to you?
- What is diabetes?
- What are the symptoms?
- How can diabetes affect the body?
- How is diabetes treated?

3. What is diabetes?
“A condition that occurs when the hormone insulin fails to adequately control the blood glucose (sugar) level”
When I say diabetes, whats the first thing you think of?
To understand this a bit better, need to ask a couple of questions –
Do we all have sugar in blood? (?Vote yes/no)
What do we need it for? energy
Where does it come from? food
Which types of food? Carbs e.g.
So we eat it, gets digested/broken down and from gut gets absorbed into blood stream as glucose … for the body to be able to use the glucose for energy, it needs to be able to get into the cells …

4. Insulin acts as a key
Explain

5. Type 2 diabetes – insulin doesn’t work properly
What causes keys/insulin not to work in type 2?
Overweight, getting older, ethnicity (Asian), inactivity, genetics, (bad luck – 20% normal wt)
Of all people with diabetes, 90% type 2

6. type 1 – no insulin Cause – autoimmune (hereditary). 10% type 1
Only treatment?

7. Explain – extra glucose in blood filtered by
Explain – extra glucose in blood filtered by? … kidneys, goes out in urine – 1, leads to 2/3. Glucose not getting to where it should, leads to 5, temp effect on nerves 4 and exra glucose in blood 6
MOST PEOPLE DON’T GET SYMPTOMS – that’s why we check for diabetes CVD check, BP checks or overweight, strong FH etc

8. complications How can diabetes affect the body in the long-term?
so what parts of the body can be affected by diabetes in the long-term i.e. over yrs? (draw on flipchart)

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Vector - Complications of Diabetes Mellitus in people. Illustration in Infographic style about medical and health.
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dementia

10. management - Lifestyle – diet & exercise
- Medication – many options, all work differently to lower glucose level in blood (usually increases over time)
- Regular check-ups to detect/prevent complications
Management all about preventing the complications

11. summary
- Most people with type 2 diabetes have no symptoms - Diabetes increases risk of heart attacks, strokes, blindness, kidney failure and amputation - Complications are preventable – regular check-ups play a large part in this

12. What happens when the door closes?
Initial visit:
Urine sample:
- dip & ACR
Blood sample:
- HbA1c, Cholesterol, U & E’s, (LFTs)
Blood pressure
Smoking
What urine test – ACR
What blood test LFTs if taking some meds (statin, Metformin)
Relate back to body flip-chart – urine – kidneys, chol & BP for heart/strokes, HbA1c also for eyes, kidneys, feet; smoking for all

13. Review results – HbA1c, cholesterol, kidney function,
2nd visit
Review results – HbA1c, cholesterol, kidney function,
Advice re lifestyle and/or medication
Check feet – pulses and sensation
Check had eye photograph done
Any further support/education
Agree plan
Group education, pregnancy
Help with wt loss; meds for BP/chol/kidney protection as well as glucose

14. summary - What diabetes is - How it can affect the body
- Importance of regular reviews in preventing complications