1. Measure Your Diabetes Risk US.NMH.15.01.111 1

2. What Is Diabetes? S=sugar, I=insulin Diabetes affects the way your body uses food. When you eat, food is turned into sugar, or glucose. Glucose, in turn, makes energy in your body. Insulin (produced by your pancreas) opens your cells to allow the glucose to enter. If your body does not make enough insulin or if the insulin doesn’t work the way it should, glucose can’t get into your cells. It stays in your blood instead. Your blood glucose level then rises too high, causing prediabetes or diabetes. Blood sugar and insulin are normally in balance 2

3. US.NMH.15.01.111 The 2 Types of Diabetes Type 1 diabetes – The body no longer produces insulin, so the sugar cannot move into the cells to become energy Type 2 diabetes – The body doesn’t produce enough insulin and/or cannot use it well enough to get the blood sugar into the body’s cells for energy In both situations, blood glucose builds up in the body and can lead to: –Nerve damage and pain (neuropathy) –Kidney disease (nephropathy) –Eye disease that can lead to blindness (retinopathy) S=sugar, I=insulin 3

4. US.NMH.15.01.111 The Importance of Controlling Blood Sugar It is important for people with diabetes to get their blood sugar under control and keep it that way to reduce the risk of serious health problems (neuropathy, nephropathy, retinopathy). Things that affect blood sugar levels: –Food raises blood sugar –Exercise lowers blood sugar –Diabetes medicine (pills or insulin) lowers blood sugar 4

5. US.NMH.15.01.111 How Blood Sugar Is Measured 1. Blood sugar monitoring Finger stick test −Done 1 or more times a day −Shows the blood sugar level at that moment Blood sugar goals for people who have diabetes 2. A1C test −Your blood is drawn and sent to a lab (at least 2 times a year) −Shows average blood sugar level over the past 2 to 3 months −Goal: Less than 7% for most patients. However, your individual goal may be more or less, depending on your age and/or health history −1% reduction in your A1C level can lower your risk of many diabetes complications by 40% Before meals80 to 130 mg/dL (milligrams per deciliter) 2 hours after the start of a mealLess than 180 mg/dL 5

6. US.NMH.15.01.111 Be Aware of Hypoglycemia (Low Blood Sugar) Low blood sugar (less than 70 mg/dL) occurs when the blood sugar level drops too low to provide enough energy for the body’s activities. Symptoms can include: –Nervousness− Dizziness –Drowsiness− Feeling anxious –Confusion− Sweating Causes: –Taking your insulin or diabetes medication at the wrong time or taking too much –Side effects to some medications –Meals or snacks that are too small, delayed, or skipped –Waiting too long after taking medicine to eat your meal –Increased physical activity (not adjusting the insulin dose) –Alcoholic beverages 6

7. US.NMH.15.01.111 How to Treat Hypoglycemia Raise your blood glucose level quickly by eating or drinking something in the form of a sugar or simple carbohydrate 3 to 4 glucose tablets ½ cup (4 oz) of regular soda (not diet) 2 tablespoons of raisins 4 teaspoons of sugar If you experience hypoglycemia, check your blood glucose every 15 minutes until it is above 70 mg/dL. ½ cup (4 oz) of juice 4 or 5 saltine crackers 1 tablespoon of honey or corn syrup 7

8. US.NMH.15.01.111 Be Aware of Hyperglycemia (High Blood Sugar) High blood sugar occurs when a patient’s body has too little insulin or when the body cannot use insulin properly. The signs of hyperglycemia are often difficult to detect but include: −Frequent hunger– Weight loss −Frequent thirst– Frequent need to urinate −Fatigue– Blurred vision Causes: –Type 1 Diabetes – Not enough insulin –Type 2 Diabetes – Low insulin level or the body is not using insulin properly –Improper dosing of prescribed medication –Too much food –Too little exercise –Stress from an illness, such as cold or flu 8

9. US.NMH.15.01.111 Eating With Diabetes “Choose My Plate” helps you to eat a variety of nutritious foods and understand portion sizes at each meal. This will help you balance your blood sugar level and better manage your diabetes. 9

10. US.NMH.15.01.111 Beverages You Should Drink What do you drink when you are thirsty? Beverages can make a difference in your blood glucose level and weight. Drink Water Unsweetened teas Diet soda Coffee Other low-calorie drinks and drink mixes Don’t Drink Energy drinks Sweet tea Regular soda Fruit drinks Other sugary drinks 10

11. US.NMH.15.01.111 Benefits of Exercise for People With Diabetes The potential benefits include: –Weight control –Controlling blood sugar –Improving strength, balance, and flexibility (which reduces the risk of falling) Check with your health care provider before starting or changing an exercise regimen 11

12. US.NMH.15.01.111 Protect Your Skin Keep skin clean and dry Use moisturizing soaps when bathing Moisturize your skin to prevent chapping, especially in cold or windy weather Treat cuts right away 12

13. US.NMH.15.01.111 Protect Your Feet Check your feet every day Wear shoes and socks. Do not walk barefoot. Protect your feet from hot pavement or the sand on the beach Make sure your shoes fit correctly Wash your feet regularly Rub lotion over the tops and bottoms of your feet but not between toes Trim toenails when needed Do not use hot water bottles, heating pads, or electric blankets on your feet Try to put your feet up when sitting 13

14. US.NMH.15.01.111 Medication for Type 1 Diabetes – Insulin There are several ways you may take insulin: By injection –Using a vial and syringe or an insulin pen Using an insulin pump –Small machine worn outside of the body Using an insulin jet injector –Looks like a large pen 14

15. US.NMH.15.01.111 Medication for Type 2 Diabetes People with type 2 diabetes may take medication in the following ways: Pills Insulin 15

16. US.NMH.15.01.111 Thank you for your participation. Questions? 16