Shahida Perveen Registered nurse Cardiac Rehab. Deptt. Diploma in Diabetic education from BIDE
What is diabetes?
Diabetes
is a long term disorder characterized by a raised level of glucose or sugar in the blood.
What is diabetes?
What is diabetes?
(energy) Some foods provide glucose, very quickly e.g. Jams, sweets and fruit juices. Other foods provide glucose slowly e.g. potatoes, bread and rice.
What is diabetes?
What is diabetes?
Types of Diabetes: Type I Type 2 Type 2 Diabetes: Is the most common type of diabetes. Develops gradually. Is found mainly in people aged over 40 Risk factors include: - Age - Obesity - Having a blood relative with diabetes.
What is diabetes?
What is diabetes?
Dont worry Healthy living and taking your medicine will make you feel better
Acceptable Range
80-120 mg/dl
Hyperglycemia
Causes Of Hyperglycemia
Not taking your tablets Too much of the wrong kind of Food Not enough Exercise Sickness Stress Weight gain
Dont Panic. Its normal for your blood glucose level to go up and down in a day. Always take your tablets. If you have high blood glucose levels for a few days in a rows or you feel unwell, see your GP or Diabetes Specialist Nurse.
Hypoglycemia
Causes Of Hypoglycemia
Some tablets can make your glucose too low in certain situation for e.g
Examine your feet daily Wash your feet in warm water every day Sit less and walk around Keep your feet away from heater Do not treat you feet yourself consult your physician
Foot examination
Examine your feet daily and also after any trauma, no matter how minor, to your feet. Report any abnormalities to your physician.
Apply Moisturizer:
Use a water-based moisturizer every day (but not between your toes) to prevent dry skin and cracking. Wear cotton or wool socks. Avoid elastic socks and hosiery because they may impair circulation.
Toenail trimming:
Always cut your nails with a safety clipper, never a scissors. Cut them straight across and leave plenty of room out from the nailbed.
Footwear:
Wear comfortable shoes or slippers to protect your feet all the time. To be sure your shoes fit properly. Avoid pointed shoes and peshawari sleepers.
Smoking:
If you smoke any form of tobacco, quitting can be one of the best things you can do to prevent problems with your feet. Smoking accelerates damage to blood vessels, especially small blood vessels leading to poor circulation, which is a major risk factor for foot infections and ultimately amputations.
Exercise:
Regular exercise will improve bone and joint health in your feet and legs, improve circulation to your legs, and will also help to stabilize your blood sugar levels
Most of the time diabetic patients have no symptoms even his/her blood sugar level is very high/low, therefore regular self monitoring of glucose is the only way to inform you for the current level of glucose in you blood
Simple, cheap, fault proof and reliable Painless and non invasive Give immediate and reliable information which cant be faked by patients Understood and useful by both patients and doctor Warn of impending hypoglycemia Provide an index of long term control
Check List
Always take your tablets Test your blood glucose regularly See your doctor regularly to check your diabetes and general health Have your eyes tested Eat a healthy diet Dont smoke Keep to sensible amounts of alcohol Keep fit Watch your weight Check your feet daily Wear comfortable shoes
Better quality of life Control over own health rather than Dr. Feel better and healthier Cut down expenses Not loose time from work, better able to earn income and take care of family.
Objectives Of Management
Advice about potential risks of fasting. Providing guidelines for proper management of their diabetes.
Patient with moderate hyperglycemia. Patients with renal insufficiency People living alone, treated with insulin or sulphonylurea Old age with ill health Drugs that may affect mentation. Patients with co morbid conditions that may present additional risks.
Start by identifying patients with Very high risks, high risks and moderate risks.
Severe hypoglycemia during three months prior to Ramadan. DKA within three months prior to Ramadan. HONK within three months prior to Ramadan. Type 1 diabetics. Patient with a history of recurrent hypoglycemia. Poor glycemic control. Acute illness. Pregnancy. Chronic dialysis. Patient who perform intense physical labor.
Educate the patient that they should be prepared to break their fast in case of an acute complication. Educate the patient and their family about signs and symptoms of Hypoglycemia and its management. Educate regarding blood sugar monitoring. Educate regarding meal planning. Educate regarding physical activity.
Nutrition
Increase fluid intake. Avoid food rich in fat and simple carbohydrates. Advise food with complex carbohydrates at Sehar. Take Sehar as late as possible.
Monitoring Sugar
2 Hours After Sehar 150-200 mg/dl At Zuhur 120-150 mg/dl Just before Aftaar 80-120 mg/dl After Aftaar: 100-140 mg/dl