1. Diabetes ABCs Diabetes Care Centers Henry Ford Health Systems

2. Sobering Statistics for Diabetes Every 24 hours another …. 4100 people are diagnosed with diabetes 230 diabetes-related amputations are performed 120 patients have kidney failure 55 cases of blindness are reported 810 die of complications associated with diabetes For newly diagnosed patients …. Over half receive no formal diabetes education Physician office visits average 10 minutes or less

3. Signs of Diabetes urination Frequent urination thirst Increased thirst tiredness Extreme tiredness Weight loss Weight loss ( in spite of increased appetite) Slow-healing Slow-healing infections or wounds tingling in the feet Pain, numbness or tingling in the feet

4. Risk Factors Contributing To Diabetes Heredity Overweight – causes insulin resistance Age Ethnic background Stresses – physical & emotional illness, surgery, pregnancy, medications (steroids) Injury to the pancreas (infections, injury, trauma, tumour and surgery)

6. Types of Diabetes Type 1 Diabetes Type 2 Diabetes Gestational Diabetes

8. Diabetes is Managed, But it Does Not Go Away GOAL: To maintain target blood glucose

9. Blood Glucose Goals for Most People Before meals 90-130 2 hours after meals Less than 180 A1C Less than 7%

10. What makes blood glucose go up or down? UP Too much food Skipped or not enough diabetes medicine Illness Less activity than usualDOWN Not enough food Too much diabetes medicine Alcohol More activity than usual

11. Low Blood Sugar (Glucose) What are the Warning Signs? Sweaty, shaky, or dizzy Irritable or confused Hungry Headache Changes in vision Low blood glucose (or “hypoglycemia”) is when your blood glucose goes below 70 mg/dl.

12. Treatment of Low Blood Sugar Check blood glucose, if possible, to be sure that it is low. Take 15 grams of carbohydrate. Recheck blood glucose after 10 – 15 min. Eat small snack, your next meal is more than one hour away.

13. High Blood Sugar (Glucose) High blood glucose or “hyperglycemia” is when your blood glucose is above your target goals. What are the Warning Signs? Increase urination Increase thirst Dry skin & mouth Blurry vision

14. Treatment of High Blood Sugar Treatment is based on cause Take medication as usual. Drink plenty of sugar-free fluids Test your blood sugar & ketones (if > 300 mg/dl) every 4 hours until back to usual range

15. A is for A1C Average blood glucose over past 2-3 months Best way to measure overall glucose control Have it checked 2-4 times a year Less than 7% Target level: Less than 7% Your goal may be different

16. B is for Blood Pressure Blood Pressure Goal <120/80 mmHg

17. C is for Cholesterol Total cholesterol HDL (good) LDL (bad) < 180 mg/ dl > 40 mg/dl < 100 mg/dl A 1 % reduction in blood cholesterol levels, reduces the risk of heart disease by 2%.

18. Basic Carbohydrate Counting Calories from:  carbohydrate  protein  fat Each nutrient type affects blood sugar differently. Carbohydrate has the biggest effect on blood sugar. TOTAL carbohydrate matters more than the source (sugar or starch.) D is for Diet

19. Sugar is NOT the Enemy There is no justification for complete restriction of sugar: However, timing matters a lot with diabetes, and sometimes sugar (or any carbohydrate) is not a good choice at all. Consider portion size.

20. What are carbohydrates? Fruits and juice (SUGARS) Milk and yogurt (SUGARS) Bread, rice, pasta (STARCH ) Starchy Vegetables (STARCH ) Sugars, honey and syrup (SUGARS)

21. “Develop an Eye for Portion Size”

22. Plate Method of Portion Control

23. 1 Carbohydrate Serving Equals 15 grams carbohydrate

24. 1 Carbohydrate Serving 1 slice bread or 1 cup milk or 1/3 cup rice or 1 small apple = = = All count the same, all raise blood sugar

25. Carbohydrate Target 3 to 4 servings of milk, fruit or starch at each meal or 45 - 60 grams carbohydrate at each meal

26. Reading Food Labels 1.Serving Size 2.Total Carbohydrate 3.Dietary Fiber 4.Total Fat 5.Saturated/Trans Fat 6.Sodium

27. No exercise is more harmful for your health than smoking a pack of cigarettes every day! E is for Exercise

28. Benefits of Exercise Blood sugar Weight Blood pressure HDL, good cholesterol Improves mood Muscle

29. ADA Recommendations for Exercise People with diabetes should be advised to perform at least 150 min/week of moderate-intensity aerobic physical activity. People with type 2 diabetes should be encouraged to perform resistance training three times per week. Evaluation by doctor is recommended before an exercise program is started.

30. YOU can control Diabetes 1. Take your medicine 2. Count carbohydrates 3. Exercise 4. Check blood sugar

31. For additional information, please contact the Diabetes Care Center at (800) 277-2740 or visit www.henryford.com/diabetes www.henryford.com/diabetes