1. Part 1: Diabetes 101

2. Novo Nordisk: Changing Life with Diabetes  Food is broken down into glucose  Glucose = Sugar  Pancreas makes insulin and helps move glucose in the blood into cells  Glucose helps the cells produce energy What Happens When I Eat?

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4. Novo Nordisk: Changing Life with Diabetes What’s the Difference?

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6. A1C gives the you the average blood glucose over a 3 month period, but mostly in the past 30 days Since this is an AVERAGE, it only represents the middle ground You could be having really HIGH blood glucose and really LOW blood glucose What is A1C?

7. Pre Diabetes - A1C 5.7-6.4% - Fasting glucose 100-125 Normal - A1C < 5.7% - Fasting glucose < 100 Diabetes - A1C > 6.5% - Fasting glucose >126 - 2 hrs after meal >200 - Random glucose >200 with symptoms of high blood sugar How is Diabetes Diagnosed?

8. Frequent urination Increased thirst Hunger Blurred vision Fatigue Headache Novo Nordisk: Changing Life with Diabetes Signs of HIGH Blood Sugar

9. Heart palpitations Shakiness Anxiety Sweating Hunger Tingling sensation Weakness Sleepiness Dizziness Novo Nordisk: Changing Life with Diabetes Signs of LOW Blood Sugar

10. Check your blood sugar!!! If your blood glucose is LESS than 80: – Eat/drink 15 grams of sugar » 4 oz of Orange Juice » 4 oz of REGULAR Soda » Chew 3-4 Lifesaver Candies » 3 Glucose Tablets » 1 Tube of Glucose Gel Recheck your blood sugar in 15 minutes and repeat until blood glucose is greater than 80 Treating a LOW: Rule of 15

11. Damage to the body’s cells occur when blood sugars are ABOVE 180 constantly It gives you an idea of what happens on a daily basis with your blood sugar It helps YOU manage your diabetes Why Should I Monitor BG?

12. Goals & Treatments

13. Based on the 2015 Guidelines from the American Diabetes Association (ADA): – A1C: < 7% – Fasting Sugar: 80-130 – 2-hours after meal sugar: < 180 – LDL “Bad Cholesterol”: < 100 – Blood Pressure: < 140/90 Goals for Diabetes

14. Oral medications and injectable medications Sometimes you may need to take more than one medication because they work in different areas of the body Treatment Options

15. Examples: –G–Glucophage® (metformin) Take with FOOD! –A–Actos® (pioglitazone) –J–Januvia® (sitagliptin) –O–Onglyza® (saxagliptin) –T–Tradjenta® (linagliptin) Medications That Work in the Liver

16. Examples: –M–Micronase® (glyburide), Amaryl® (glimepiride), Glucotrol® (glipizide) –S–Starlix® (Nateglinide), Prandin® (repaglinide) Take 15-30 min before meals BUT you MUST eat to prevent low blood sugar Medications That Work in the Pancreas

17. Examples: – Glucophage® (metformin) – Actos® (pioglitazone) Medications That Work in the Muscle

18. Examples: –V–Victoza ®, Byetta ®, and Bydureon ® (Injectables) Take Byetta 30-60 minutes before meals –J–Januvia® (sitagliptin), Onglyza® (saxagliptin), and Tradjenta® (linagliptin) Medications That Work in the Stomach

19. Provides the body with insulin which helps bring glucose into the cell and decreases your blood sugar Examples: –L–Long Acting Lantus, Levemir –S–Short or Rapid Acting (Meal Time Insulin) Humalog, Novolog, Apidra Make sure you EAT!!!!! Insulin

20. Follow-up with your doctor at least 1x/year Attend regular check ups with your doctor Take medications properly Eat right and exercise Monitor blood sugar! Comprehensive eye exam and foot exam yearly Check feet daily Flu vaccine yearly What Can I Do To Manage My Diabetes?