Maintenance of Complications

of Diabetes

Mary Jo Wardle, Melissa Bruss,

Jessica Welsh, Josh DeSalvo,
and Kaitlyn Viglio
Testing Your Blood Sugar at Home

§
1.) Wash Hands
§
2.) Insert test strip into device
§
3.) Use the lancet to get your drop of blood
§
4.) Wait for the results to appear on the screen
What Are My Goals?

§
A1C: 7%
§ This is measured at the
doctors office and shows
how your blood sugar has
been over ~ 180 days
§
Before a meal: 80 – 130
§
1-2 hours after a meal:
less than 180
What if My Results Are Abnormal?
§
Hypoglycemia
§ Confusion
§ Heart palpitations
§ Shakiness
§ Excessive hunger
§ Excessive sweating
§ Lightheadedness
§ Can be life-threatening
§
Hyperglycemia
§ Increased thirst
§ Fruity-Smelling breath
§ Shortness of breath
§ Weakness
§ Fatigue
§ Blurred vision
§ Can cause coma (if
untreated)
Pancreas and Insulin
§
When food is digested most of it
breaks down into glucose
§
Once glucose gets into the
bloodstream it travels to our cells to
make energy
§
In order for it to get to our cells we
need insulin which is a hormone
that is produced from the pancreas
§
It is the pancreas’s job to decide
how much insulin our body actually
needs
Types of Diabetes and Insulin

§
In Type 1 Diabetes the pancreas does not
produce any Insulin
§
In Type 2 Diabetes the pancreas produces too
little insulin or the cells in the muscles do not
use the insulin in the right way
§ This
can then lead to the cells not receiving
any glucose to provide energy and the glucose
then accumulates in the bloodstream
 Diabetes and Stroke
§
All of these factors then lead
to increased fatty deposits
and clots in the blood vessels
§
These clots then contribute to
the blood vessels being
narrowed or blocked in the
neck or brain
§
The blockage and narrowing of
these blood vessels then leads
to the brain not receiving
enough oxygen and blood
which causes a stroke
Other Factors that Lead to Stroke
§
Smoking
§
Obesity
§
Being 55+ years old
§
Prior diagnosis of stroke or
heart disease
§
Family history
§
Being African American
§
Alcohol consumption
Pre-Diabetes and Stroke

§
Some factors that lead to diabetes also
contribute to having a stroke
§
Pre-diabetes is also called “metabolic
syndrome”, which comes from a cluster of
factors that lead to problems with metabolism
leading to stroke or diabetes
§
Having two of the four factors in the cluster can
increase your risk of diabetes and stroke
The Four Factors

§
1.)High Blood
Pressure
§
2.)High Cholesterol
§
3.)Obesity around
the waist
§
4.)High Blood
Glucose levels
How to Prevent Having These
Factors
§
Maintain a Heart Healthy Diet
§ Eat 14 grams of fiber to every 1000 calories taken in
§ Keep cholesterol at 300 mg or less
(continued…)

§
DO NOT
SMOKE!
§ Smoking
doubles the
risk of having
a stroke!
(continued…)

§
Maintain a healthy weight
§ For men – 40 inches or more increases
the risk for diabetes and stroke
§ For women – 35 to 40 inches or more
increases the risk for these as well
(continued…)

§
Limit alcohol consumption
§ For men do not consume more than 2 drinks a day and for
women do not consume more than 1 drink per day
(continued…)

§
EXERCISE!
§ 30 minutes of aerobic exercise, 5 times a week!
S/S of Having a Stroke

§
Numbness and weakness of the arm, face or leg
on one side
§
Confusion or having a hard time understanding
people
§
Trouble speaking
§
Having trouble walking or keeping balance
§
Dizziness
§
Severe headache for no reason
F. A. S. T.

§
F= Face Drooping
§
A= Arm Weakness
§
S= Speech Difficulty
§
T= Time to call 9-1-1
The Kidneys

§
Two fist-sized, bean-
shaped organs
§
Located just below the
rib cage and
retroperitoneal
§
Filter blood to produce
urine
Other Functions

§
Removal of waste
§
Electrolyte monitoring
§
Bone health
§
Hormone Production:
RBC creation and
blood pressure
control!
How does it work?

§
Nephron,
glomerulus, and
tubule
§
Urine production
and excretion
Diabetes vs. Kidneys

§
Blood sugar and
proteinuria
§
Other contributing factors
What to look for:

§
Late-stage symptoms
(damage already done)
§
Late-stage symptoms
(damage already done)
§
Loss of sleep
§
Poor appetite
§
Upset stomach
§
Weakness
§
Difficulty concentrating
Diabetic Neuropathy

§
Diabetes is the most common cause of neuropathy
worldwide
§
4-10% of diabetes patients are affected by this after 5
years
§
15% of patients are affected after 20 years
§
Risk factors:
§ Male
§ HTN
§ Duration of diabetes
§ Type 1 Diabetes
4 Types

§
Peripheral
§
Autonomic
§
Proximal
§
Focal
Peripheral Neuropathy

§
Usually affects legs and feet
§
Can also affect arms, abdomen, and back (less often)
§
Symptoms:
§ Numbness
§ Tingling
§ Burning
§ Pain
Autonomic Neuropathy
§
Affects the digestive system
(stomach) mostly
§
Can also affect urinary system,
blood vessels, and reproductive
organs
§
Symptoms:
§ Diarrhea
§ Bloating
§ Constipation
§ Heartburn
§ Nausea/Vomiting
Proximal Neuropathy
§
Causes pain (usually
only on one side) in the
hips, buttocks, or thighs
§
Can also lead to
weakness in the legs
§
Treatment:
§ Medication
§ Physical therapy for
weakness
Focal Neuropathy

§
Sudden
§
Affects specific
nerves
§
Most often in the
head, torso, or leg
§
Weakness or pain
occurs
Causes of Diabetic Neuropathy

§
Prolonged high blood sugar can damage
nerve fibers, causing diabetic neuropathy
§
High blood sugar affects the ability of
nerves to transmit signals to and from the
brain
§
High blood sugar also weakens the walls of
the capillaries (small blood vessels) that
supply the nerves with oxygen and
nutrients
Other factors:

§
Inflammation of nerves
§ Caused by autoimmune responses (mistaking
parts of body as foreign bodies)
§
Genetics
§
Smoking and Alcohol consumption
§ Damages nerves and increases risk of
infection
Possible Complications of Diabetic
Neuropathy:
§
Amputation:
§ Because of a lack of feeling in
the feet from poor circulation,
sores and cuts can form and go
unnoticed…
§ Can lead to ulcers and infection
§ Infection can possibly spread to
the bone and cause gangrene
(tissue death)
§ Amputation of toe, foot, or leg
can occur
(continued…)

§
Urinary Tract
Infection:
§ Nervedamage in the
bladder can prevent
complete emptying
§ Alsocan lose feeling
of when you need to
urinate
§ Bacteria multiplies in
(continued…)

§
Digestive Problems:
§ Can cause diarrhea or
constipation
§ Also nausea, vomiting,
bloating, and loss of
appetite
§ These can cause
malnutrition, electrolyte
imbalance, and
dehydration…
(continued…)

§
Sexual
dysfunction:
§ Damage of nerves
of sex organs
§ Erectile
dysfunction in
men
§ Arousal
difficulties
in women
Treatment of Diabetic Neuropathy

§
Monitor and
control blood
sugar levels
§ Diet

§ Exercise

§ Medications
(insulin/oral
meds)
(continued…)
§
Foot care:
§ Wearing shoes in
areas where you
can be cut
§ Monitoring
bottom of feet
for sores
§
Untreated sores
can lead to
(continued…)
§
Medical Treatment:
§ Pain relievers
§ Prescription medications
§
Depression meds
§
Anti-Seizure meds (Gabapentin)
§ Acupuncture/Biofeedback
§ Physical therapy (stretching and massage)
§ Transcutaneous electrical nerve stimulation (TENS)
§
Reduces pain by applying brief pulses of electricity to nerve
endings in the skin