1. Diabetes What Employers Need to Know Rhonda K. Carr, RD, LD, CDE Midland Memorial Hospital Diabetes and Nutrition Learning Center

2. What is Diabetes? What is diabetes? Insulin – shortage or inability to use insulin Three types of diabetes: Type 1 Type 2 Gestational Diabetes

3. What are the numbers? 25.8 million Americans have diabetes (8.3%). Of these, 7.0 million are undiagnosed. In Texas the rate is 9.7%. In Midland County ~13,000-14,000 people If current trends continue, 1 in 3 U.S. adults will have diabetes by 2050 CDC: Diabetes at a Glance 2011

4. What are the costs? Annual economic cost of diabetes in 2007 was $174 billion Direct medical costs in 2007: $116 billion Indirect costs (related to disability, work loss, premature death) in 2007: $58 billion CDC: Diabetes at a Glance 2011

5. Why so costly? Among adults, diabetes is the leading cause of new cases of Blindness Kidney failure Amputations – not related to accidents or injury On average, medical expenses for a person with diagnosed diabetes are more than double the expenses of a person without diabetes.

6. Who is at risk for Type 2 DM? Age - Over 30 years of age and overweight or over 45 Obesity and physical inactivity Family history of Type 2 DM Personal history of gestational diabetes Hispanic/Latino, African American, American Indian or Asian American heritage CDC: Diabetes at a Glance 2011

7. What are the warning signs? Excessive thirst or hunger Frequent urination Extreme weakness or fatigue Texas Diabetes Council

8. Warning signs? Cuts or sores that are slow to heal Blurred vision Tingling or numbness in the hands or feet Frequent infections (skin, dental, or urinary tract infections) Texas Diabetes Council

9. How can the Diabetes Center at MMH help you and your employees? Education

10. 7 Healthcare Behaviors Being Active Healthy Eating Medication Taking Monitoring Blood Glucose Problem Solving Reducing Risk Living with Diabetes American Association of Diabetes Educators

11. Being Active Improves cholesterol Reduces stress Prevents osteoporosis Lowers blood glucose Helps with sleep Boosts the immune system Weight management

12. Healthy Eating Change habits Learn to read labels/carb count Eat less fat and choose better fat Lose weight if needed Consider vending options

13. Taking Medications Expensive medications Multiple medications Insulin or other injectable medications Side effects of medications

14. Monitoring Your Blood Glucose Meters & Supplies When What does it tell you? Keep a log and take to your doctor

15. Problem Solve Use BG numbers to problem solve Food/carbohydrate Exercise Medication Stress Illness

16. Reducing Risk Short Term Complications Low blood sugar High blood sugar

17. Long Term Complications Vision Kidneys Feet – pain, numbness, wounds Heart Emotional health – depression, anxiety, stress Sexual dysfunction

18. Check your feet daily Check for cuts, blisters, red spots, swelling ingrown toenails and foot ulcers.

19. Know your ABC’s A – A1C B – Blood Pressure C - Cholesterol

21. Diabetes and Nutrition Learning Center Medical Nutrition Therapy – 1 to 1 visit with a registered dietitian – Medicare covers 3 hours per year Diabetes Self Management Classes Series of 3 classes plus an individualized assessment of learning needs Offer instruction in Spanish Call 522-3045