The document discusses lifestyle factors that can predispose individuals to developing diabetes mellitus type 2. It notes that obesity and an unhealthy diet increase the risk of diabetes and its complications. The document recommends lifestyle modifications like regular exercise, maintaining a healthy weight through diet, reducing saturated fat intake, and quitting smoking to prevent and manage diabetes.
2. Diabetes mellitus is a chronic condition, with obese and fatty
people at high risk of developing diabetes mellitus type 2.
Lifestyle modifications (changes in day-to-day habits) are an
essential component of preventing diabetes .
Improved blood sugar control can slow the progression to
diabetes and prevent long-term complications.
Introduction
4.
Overweight and obesity are complex health problems
that affect more than two-thirds of adults globally.
Many health conditions are associated with overweight
and obesity including hypertension, CAD and type 2
diabetes.
Health care practitioners are advising overweight or
obese individuals to manage weight by lifestyle changes.
Fortunately, lifestyle changes including healthy eating
patterns, increased physical activity, and weight
management often improve the risk factors associated
with obesity.
Current factors and life style choices
predisposing to DM
6. Prevalence of type 2 diabetes is 3–7 times higher in obese (BMI
>35 are 20 times more likely to develop diabetes).
Obesity complicates the management of type 2 diabetes by
increasing insulin resistance and blood glucose concentrations
It further increases the risk of cardiovascular complications
and mortality in patients with type 2 diabetes.
Facts
8. You cannot catch diabetes.
But you can control the risk factors that lead to type 2 diabetes.
Eating sweets and sugar does not cause diabetes.
But eating a lot of sugary and fatty foods can lead to being overweight.
Stress does not cause diabetes.
Although it may make the symptoms worse in people who already have the
condition.
An accident or an illness will not cause diabetes.
But it may reveal diabetes if it is already there.
Busting the myths about diabetes
10.
Exercise goal:
Moderate intensity exercise : 2½ hrs each wk
High intensity exercise : 1¼ hrs each wk
Losing weight gradually to achieve a healthy BMI
Replace refined carbohydrates with wholegrain foods
Increase intake of vegetables and other foods high in
dietary fiber.
Reducing the amount of saturated fat in the diet
The recommended lifestyle interventions
include:
12.
Exercise is beneficial for all
individuals, with or without
diabetes.
Even people with
longstanding diabetes or
diabetic complications can
benefit from exercise.
EXERCISE AND TYPE 2 DIABETES
13.
Promotes cardiovascular fitness and weight loss
Lowers high blood pressure
Improves lipid profiles
Improves blood sugar control
Insulin sensitivity of both skeletal and adipose tissue
Exercise appears to decrease insulin resistance by activating
glucose transporters. (This effect is transient and deteriorates
within 72 hours).
leads to an overall sense of well-being
When combined with dietary lifestyle intervention, helps
prevent type 2 diabetes
Effects of Exercise
14. Moderate intensity : 2½ hrs each wk for 3-4 times a wk for 30-40 min a day
Brisk walking
Cycling on plains
Hiking
Gardening
Weight lifting
Vigorous intensity: 1¼ hrs each wk for 3-4 times a wk for 30-40 min a day
Jogging
Swimming
Cycling rapidly
Football
Skipping
Type Of Exercise
15. Intensity — increase exercise intensity gradually, and stop if
symptoms of chest discomfort or nausea arise.
Duration — 10 min stretching and warm-up,
20 min gentle aerobic exercise.
>30 min exercise (increase time gradually)
Timing — Try to exercise at the same time of the day to
maintain predictable blood sugar levels.
Frequency — regular, long-term exercise program, commit to
exercising 30 minutes a day most days of the week.
19.
Over 25% of people newly diagnosed with diabetes are
smokers.
Diabetics who quit smoking can decrease their risks.
Most people who smoke find it difficult to quit
Prescribe nicotine replacement treatment, if needed.
Smoking & diabetes
20.
Smokers with diabetes have an increased risk of the following:
Death (heart attacks and strokes)
High LDL, cholesterol levels
Worsened blood sugar controlled as compared to non-smokers
Nerve damage from diabetes
Kidney disease leading to dialysis
Foot ulcer and amputation of toes, feet or legs caused by
peripheral vascular disease
Increases abdominal fat accumulation and insulin resistance.
Increased blood pressure
Smoking & diabetes
21. If diabetes and smoke co-exist
To manage diabetes and stay healthier longer
23. There is no need for people to give up alcohol but needs
to be extra careful if pre-diabetic .
Alcohol intake significantly increases the risk
of hypoglycemia
If blood sugar is under control, a moderate amount of
alcohol may be fine.
Alcohol and diabetes
24. Do not drink more than
(Example: one alcoholic drink = 5-ounce glass of wine)
Guidelines
Male – 2 drinks/day
Female – 1 drink/day
25.
Moderate amounts cause hyperglycemia
Excess alcohol hypoglycemia
Beer and wine contain CHO and cause hyperglycemia.
Alcohol stimulates appetite, which can cause overeating
Alcohol interacts with the oral diabetes medicines
or insulin
Alcohol may increase triglyceride levels
Alcohol may increase blood pressure.
Effects of Alcohol on Diabetes
26.
Drink alcohol only with food.
Drink slowly.
Avoid "sugary" mixed drinks, sweet wines.
Mix liquor with water, club soda, or diet soft drinks.
Avoid drinking on an empty stomach
Also avoid binge-drinking or sustained drinking,
Never substitute alcohol for your meals.
Do not mix alcohol with exercise.
Diabetes and Alcohol Consumption
Dos and Don'ts
28.
Low levels of alcohol could potentially provide some level
of protection against developing diabetes.
According to a review of 15 previous studies (in 2005) into the link
between diabetes and alcohol, ‘moderate drinkers’ were a third less
likely to develop type 2 diabetes than either people who didn’t drink
alcohol or those who drank heavily.
Rationale : low to moderate levels of alcohol actually
make the body more sensitive to insulin.
Answer : True
30.
Foot infections
Chronic skin infections
Gum disease and tooth loss
Vision problems
Heart disease and blood circulation problems
Concerns for diabetics
31.
Common foot problems can cause many complications
and more critical for people with diabetes because:
If there is nerve damage, it can worsen
Poor blood flow can slow wound healing.
More prone to infection.
Damaged foot muscle nerves may prevent foot from
aligning properly, leading to foot sores.
1. Foot Care and Diabetes
32.
Wash your feet daily
Dry your feet well, especially between toes.
Keep the skin soft with a moisturizing
foot cream.
FOOT CARE
33.
Inspect your feet daily for cuts/blisters
Wear clean, soft, cotton socks
Keep your feet warm and dry.
contd..
34. Never walk barefoot.
Examine your shoes every day.
Cut nails in straight manner.
contd...
35.
Shop for shoes in the afternoon. Feet swell as the day
goes on.
37.
Routine medical care is important to long-term health
It helps in preventing, detecting, and slowing the
progression to diabetes.
A regular schedule for visits, screening, and monitoring
tests are advised.
Treatment & follow up
38.
Access health care facility.
Go for complete physical examination once a year.
Check blood glucose level every month.
Monitor HbA1c every 6 month.
Keep a check on blood pressure and weight.
Routine Treatment
39.
Strategies such as
Self-monitoring (daily records of food intake and physical
activity)
Stimulus control (avoiding triggers that prompt eating)
Problem solving (identifying barriers and ways to overcome
them)
Frequent patient-provider contact (e.g., weekly or biweekly)
Setting small and achievable goals
40. The necessary steps for high-quality care of diabetic
patients can be kept on tract:
A - Haemoglobin A1c to keep the HbA1c at <7.0%
B - Blood pressure (<140/90mm Hg)
C - Cholesterol to keep your LDL below 100 mg/dL
D - MDRD of assessing kidney function.
E - Eye check up every 2 years thereafter.
F - Foot assessment at least every 6 months.
6 simple steps
45.
Some research suggests that not getting enough sleep
may impair insulin use and increase the risk for obesity.
It is always wise to improve sleep habits
IMPROVING SLEEP
There is a direct mechanism between exercise and improved blood glucose control. Insulin sensitivity of both skeletal and adipose tissue can improve with or without a change in body composition. Exercise appears to decrease insulin resistance by activating glucose transporters (i.e., Glut 4). This effect is transient and deteriorates within 72 hours. As a result, regular physical activity is necessary to sustain improved insulin sensitivity. Improved lipids including decreased levels of serum triglycerides, VLD, total cholesterol, LDL, and potentially an increase in HDL. Lowers blood pressure in people with type 2 diabetes. Exercise by itself rarely leads to weight loss. However, 90% of weight maintainers exercise. In persons with type 2 diabetes, exercise is related to favorable changes in HbA1c and/or glucose tolerance. Exercise appears to be most beneficial in the early stages of diabetes and for individuals with blood glucose levels <200 mg/dL. For persons with type 1 diabetes, a long-term effect of exercise on improving blood glucose control has not been demonstrated. This lack of improvement has been attributed to the increased intake of ~300 to 400 kcal on exercising days. Therefore, the goal for persons with type 1 diabetes is to exercise safely so as to receive the same benefits of exercise that individuals who do not have diabetes receive.
Measure blood sugar before, during, and after exercise to determine their body's typical response to exercise. If the pre-exercise blood sugar reading is 250 mg/dL (13.9 mmol/L) or higher, exercise should be postponed until the level is under control.
Consider a decrease in insulin dose by about 30 percent during exercise.
Choose an insulin injection site away from exercising muscles (for example, avoid the legs if running).
Keep rapidly absorbed carbohydrates on hand (glucose tablets, hard candies, or juice).
Eat a snack 15 to 30 minutes before exercise, and again every 30 minutes during exercise.
Eat a source of slowly absorbed carbohydrates (dried fruit, fruit jerky, granola bars, or trail mix) immediately after exercise. This will counter a post-exercise drop in blood sugar levels.
People with diabetes already have an increased risk of heart disease, which is further elevated if they smoke. Diabetes acts in several ways to damage the heart. Smoking affects circulation by increasing heart rate and blood pressure and by making small blood vessels narrower. Smoking also makes blood cells and blood-vessel walls sticky, and allows dangerous fatty material to build up. This can lead to heart attack, stroke and other blood vessel disease.
Young adult smokers with diabetes are two to three times more likely to be sick than nonsmokers with diabetes.
