1. Diabetes: What You Should Know.

2. Source: American Diabetes Association (www.ada.org), 04/08
Could You Be At Risk?
Could you have diabetes and not know it?
Take the following test to see if you are at risk for having diabetes. According to the American Diabetes Association (ADA), diabetes is more common in African Americans, Hispanic/Latinos, American Indians and Pacific Islanders.
If you are a member of one of these ethnic groups, you need to pay special attention to this test.
Source: American Diabetes Association ( 04/08

3. Source: American Diabetes Association (www.ada.org), 04/08
Know Your Score.
Write in the points next to each statement that is true for you. If a statement is not true, place a zero. Then add your total score.
Yes No
Score
I am a woman who has had a baby weighing more than nine (9) pounds at birth
1 pt
0 pt
I have a sister or brother with diabetes
I have a parent with diabetes
My weight is equal to or above that listed on the chart
5 pts
I am under age 65 and I get little or no exercise
I am between 45 and 64 years of age
I am 65 years old or older
9 pts
Total Points
Source: American Diabetes Association ( 04/08

4. Know Your Score…Scoring
10 or more Points
You are at high risk for having diabetes. Only your health care provider can determine if you have diabetes. See your provider soon and find out for sure.
3 – 9 points
You are probably at low risk for having diabetes now. But don’t just forget about it. Keep your risk low by losing weight if you are overweight, being active most days, and eating low fat meals that are high in fruits and vegetables, and whole grain foods.
Source: American Diabetes Association ( 04/08

5. Source: American Diabetes Association (www.ada.org), 04/08
Get the Facts.
What is Diabetes?
According to the American Diabetes Association (ADA), diabetes is a disease in which your body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although genetics and environmental factors such as obesity and lack of exercise appear to play major roles.
While there is no cure, diabetes is a manageable condition. In fact, most people can live as full a life as they did before developing diabetes.
Let’s take a look at the four (4) most prevalent type of diabetes:
Pre-diabetes
Type 1 Diabetes
Type 2 Diabetes
Gestational Diabetes
Source: American Diabetes Association ( 04/08

6. Are you one of the 5.4 million?
Pre-diabetes
This condition occurs when a person’s blood glucose levels are higher than normal, but not in the diabetic range.
Losing weight, eating a healthy diet and getting adequate exercise can help prevent you from developing diabetes.
There are 5.4 million Americans who have pre-diabetes in addition to the 20.8 million with diabetes.
Are you one of the 5.4 million?
Source: American Diabetes Association ( 04/08

7. Source: American Diabetes Association (www.ada.org), 04/08
Type 1 Diabetes
This disorder results from the body’s failure to produce enough insulin.
The pancreas (a gland behind the stomach) makes little or no insulin.
Insulin acts like the key to “unlock” the cells of the body, allowing glucose to enter and fuel them.
Daily insulin shots, along with proper diet and exercise is needed to stay healthy.
What are the warning signs?
Frequent urination
Excessive thirst, extreme hunger
Dramatic weight loss
Irritability, weakness and fatigue
Nausea and vomiting
Source: American Diabetes Association ( 04/08

8. Source: American Diabetes Association (www.ada.org), 04/08
Type 2 Diabetes
This illness results from insulin resistance (a condition in which the body fails to properly use insulin) combined with relative insulin deficiency.
The pancreas (a gland behind the stomach) makes some insulin, but either it is not enough or the cells do not use it properly.
For some, Type 2 diabetes is controlled with proper diet and exercise. While others will need insulin and/or diabetes pills, along with proper diet and exercise.
What are the warning signs?
Any of the Type 1 symptoms
Recurring or hard to heal skin, gum or bladder infections
Drowsiness
Blurred Vision
Tingling or numbness in hands or feet
Itching
Source: American Diabetes Association ( 04/08

9. Source: American Diabetes Association (www.ada.org), 04/08
Gestational Diabetes
Gestational diabetes is a temporary form (in most cases) of diabetes in which the body does not produce adequate amounts of insulin during pregnancy. It may also be called glucose intolerance or carbohydrate intolerance.
This condition affects about 4 percent of all pregnant women and usually disappears after the birth.
Women with gestational diabetes have a higher incidence of developing Type 2 diabetes later in life.
What are the warning signs?
Glucose in urine
Unusual thirst
Frequent urination
Fatigue
Blurred Vision
Nausea
Frequent infections of bladder, vagina and skin
Source: American Diabetes Association ( 04/08

10. Recommended Screenings*
Glycosylated Hemoglobin or Hemoglobin A1c
Blood test that measures the average blood glucose level over the past 2 – 3 months.
This test will tell if your diabetes is under control.
Goal is less than 7%
LDL Cholesterol Screening
Blood test that measures the level of low-density lipoprotein (LDL), also known as the “bad cholesterol” in the blood.
This test helps your doctor to watch your cholesterol level, and prescribe medication or lifestyle changes.
Goal is less than 100mg/dl.
*Goals and recommendations are based on the 2006 American Diabetes Association (ADA) Standards of Medical Care for Patients with Diabetes Mellitus.
*If you are not within goal or have positive test results, please talk to your primary care physician.

11. Recommended Screenings*
Urine Microalbumin
Screens for tiny amounts of albumin (protein) in the urine.
This test may indicate early signs of kidney disease.
Serum Creatinine
Blood test that tells how well your kidneys are functioning.
ADA recommends having this test once a year.
*Goals and recommendations are based on the 2006 American Diabetes Association (ADA) Standards of Medical Care for Patients with Diabetes Mellitus.
*If you are not within goal or have positive test results, please talk to your primary care physician.

12. Recommended Screenings*
Dilated Retinal Exam
Blindness is a leading cause of diabetes due to its effects on the retina (the back portion of the eye).
A dilated eye exam is different than a routine eye exam (for glasses).
Special equipment and medications are used to examine the blood vessels in your eyes.
An annual dilated eye examination promotes early detection and treatment.
Foot Exam
People with diabetes sometimes experience circulatory problems.
Minor cuts, scrapes or ulcers in the feet can develop into major medical problems
Frequent examinations (self and by your health care provider) can help prevent serious problems from developing.
Dental Checkup
Poor glucose control makes gum problems more likely.
People with diabetes have a much greater risk of developing gum disease and losing their teeth.
A regular dental checkup 2 times a year can help avoid serious problems.
*Goals and recommendations are based on the 2006 American Diabetes Association (ADA) Standards of Medical Care for Patients with Diabetes Mellitus.
*If you are not within goal or have positive test results, please talk to your primary care physician.

13. Know All Your Numbers Test Target/Goal Frequency HgA1c Less the 7%
2 – 4 times a year; every 3 months for most patients
Blood Pressure
Less than 130 (systolic); less than 80 (diastolic). Lower numbers for patients with renal disease.
Every office visit. If blood pressure is above target, recommend home monitoring as well.
Total Cholesterol
Less than 200 mg/dl
Yearly if meeting target; more frequently if not
LDL
Less than 100 mg/dl; less than 70 mg/dl if you have peripheral vascular disease
HDL
Greater than 40 mg/dl in men; greater than 50 mg/dl in women
Triglycerides
Less than 150 mg/dl
Microalbuminuria
Less than 30 mg creatinine
Once a year
Eye Exam
No proliferative retinopathy
Source: Joslin Diabetes Center: Joslin Clinical Guideline for Adults with Diabetes. Revised March 2008

14. Diabetes Care Checklist
Quarterly Visits and Tests (done 2 – 4 times a year)
Year 1
Year 2
Qtr1
Qtr2
Qtr 3
Qtr4
Hemoglobin A1c (Goal less than 7%)
Blood Pressure (Goal less than 130/80)
Review Medications
Weight (every visit)
Annual Visits and Tests (done once a year)
Date
Result
Dilated eye exam
Urine Proteins (Microalbumin)
Serum Creatinine
Source: Joslin Diabetes Center: Joslin Clinical Guideline for Adults with Diabetes. Revised March 2008

15. Diabetes Care Checklist
Annual Visits and Tests (done once a year)
Year 1
Year 2
Date
Result
LDL (Goal less than 100 mg/dl)
HDL (Men: goal less than 40 mg/dl; Women: goal greater than 50 mg/dl)
Triglycerides (Goal less than 150 mg/dl)
Other Annual Visits and Tests
Dental checkup (twice a year)
Foot exam
Flu immunization (annual)
Pneumonia immunization
Source: Joslin Diabetes Center: Joslin Clinical Guideline for Adults with Diabetes. Revised March 2008

16. Now You Know…