1. Looking after your diabetes Dr Gill Hood North Thames Clinical Research Network 18.7.14

2. 1. Healthy Eating Healthy eating is good for everyone – with and without diabetes! Have your weight checked and your waist measured to see if you need to lose weight See a dietician Setting realistic goals for healthy eating/ weight loss/agreed by the patient Diabetes control can improve with health eating Measuring food/plate size Food labelling information Preventing high (hyperglycaemia) and low blood sugar (hypoglycaemia)

3. 2. Being active can improve diabetes control 1. Recommendations are for 30 minutes of exercise 5 times a week which makes you feel warm and slightly out of breath Perhaps 3 X 10 minute sessions per day will be more achievable and acceptable Any amount of exercise is better than none Good Examples: Take the stairs when possible Get off the bus one stop early Gardening and housework A walk in the park Improvements include better circulation, feeling more agile, better mood, better diabetes control

4. 3. Monitoring Reduces Risk of diabetes complications Monitoring gives good information about diabetes control but only if you understand the levels Blood glucose should be 4-6mmols before eating 5-9 mmols two hours after eating Goals need to be personal Not everyone has a glucometer Monitoring also includes HbA1c (at least once a year) 48-58 mmols BP, weight, cholesterol, urine for protein, eye test and feet inspection Monitoring hypos Regular monitoring can prevent complications %mmol 6.042 6.548 7.053 7.558 8.064 HbA1c levels

5. 4. Taking Medication People with diabetes are on lots of medication! e.g. glucose lowering drugs, aspirin, BP, perhaps insulin, and cholesterol lowering therapy People should be familiar with what drug does what and also report possible side effects It is important to take your medicine regularly Adequate preparation of medication if going on holiday etc

6. 5. Problem Solving & Healthy Coping Everyone has problems with diabetes now and again – no matter how careful they are Many problems can be anticipated – hypoglycaemia, hyperglycaemia. Know what low and high blood glucose is and how to treat it. Seek help if needed Diabetes affects patients both physically and mentally. Depression is higher in people with diabetes Some ways of coping with stress /depression are not good e.g. smoking, over eating, less self care Some coping can be good and positive e.g. getting support, talking to family and friends, group educational sessions, talking to your health advisor, participating in research

7. Conclusion Diabetes is a growing health problem and people are required to look after themselves most of the timeDiabetes is a growing health problem and people are required to look after themselves most of the time People with diabetes need good support and education to self manage their condition well and this should include facts about healthy eating, exercise, diabetes monitoring, taking diabetes medication, problem solving with diabetes and health copingPeople with diabetes need good support and education to self manage their condition well and this should include facts about healthy eating, exercise, diabetes monitoring, taking diabetes medication, problem solving with diabetes and health coping Government continues to invest heavily in research for new diabetes treatments, weight loss programmes, and preventing diabetesGovernment continues to invest heavily in research for new diabetes treatments, weight loss programmes, and preventing diabetes We also need to continue to engage with patients and carers and work in partnership about the support you need locally and your ideas of how to raise further awareness about diabetesWe also need to continue to engage with patients and carers and work in partnership about the support you need locally and your ideas of how to raise further awareness about diabetes Thank you