DIABETES. Type 2 PATIENT GUIDE

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1 DIABETES Type 2 PATIENT GUIDE

What is diabetes Diabetes is a lifetime condition. It is characterised by the fact that the pancreas does not produce enough insulin for the body, or the body is resistant to the insulin produced.

2 What is diabetes Diabetes is a lifetime condition. It is characterised by the fact that the pancreas does not produce enough insulin for the body, or the body is resistant to the insulin produced. Diabetes, therefore, can occur due to a scarce production of insulin, the resistance of the cells of the body to the insulin, or both causes at the same time.? Refers to a group of endocrine metabolic disorders or anomalies which alter: The role of different organs or bodily tissues. The process whereby energy from food is obtained. Blood vessels (arteries, veins, and capillaries) The circulatory system of the blood. The heart. The kidneys. The general nervous system with the different organs and functions that depend on it, etc. 2

3 Risk factors Obesity High blood pressure Lack of exercise Stress Family history of diabetes Unhealthy diet Age over 40 3

4 Symptoms of diabetes Excessive thirst. Weight loss for no apparently justified reason. Tiredness. Frequent urination. 4

5 Blurred vision. Constant hunger. Diabetes... Is related to a relative deficit of insulin production by the pancreas. Sudden weight loss. When there is not enough insulin in the body, glucose remains in the blood, which leads to many alterations. Overweight persons are much more prone to contracting diabetes. 5

How is diabetes There are several tests which diagnosed?

One of the conditions that can lead to suspicion is when random blood glucose is over 11.7 mmol/l.

NORMAL PRE-DIABETES DIABETES 6 6.0 mmol/l 7.

6 How is diabetes There are several tests which diagnosed? enable the presence of diabetes to be discovered. One of the conditions that can lead to suspicion is when random blood glucose is over 11.7 mmol/l. Blood glucose during fasting Glucose tolerance test during fasting. NORMAL PRE-DIABETES DIABETES mmol/l 7.0 mmol/l A test during fasting is a simple and quick way of blood measurement and diabetes diagnosis. The person must not eat or drink anything (except for water) during the previous 8-12 hours. PRE-DIABETES 7.8 mmol/l 11.1 mmol/l Glycaemia measurement. Random blood glucose test 2 hours after meal test NORMAL DIABETES A glucose alteration or pre-diabetes is diagnosed if the fasting levels are between 5.6 and 7.0 mmol/l. These are type 2 diabetes risk factors.

Glycosylated haemoglobin test (HbA1c) Haemoglobin is a protein which is found in red blood cells and which transports oxygen

In patients with diabetes mellitus, HbA1c level is normal or slightly elevated after six weeks when the blood glucose level is

3 8 % 10 9 % 11.7 10 % 13.3 11 % 15 Glycosylated haemoglobin test.

7 Glycosylated haemoglobin test (HbA1c) Haemoglobin is a protein which is found in red blood cells and which transports oxygen from the lungs to the rest of the body in order to keep cells alive. In patients with diabetes mellitus, HbA1c level is normal or slightly elevated after six weeks when the blood glucose level is regulated carefully and with maximum precision. haemoglobin A1c blood sugar level mmol/l 4 % % % % % 10 9 % % % 15 Glycosylated haemoglobin test. It is very useful in the diagnosis of diabetes which has not shown symptoms, and it is also very useful to detect a tolerance of altered glucose. Haemoglobin A1c test Less than 5.7 %: normal Between 5.7 % and 6.4 %: pre-diabetes. 6.5 % or greater: diabetes. 7

8 ? How to monitor blood sugar at home Obtain a blood glucose monitor from your pharmacy. You will also need strips, needles and a lancing device. Read the manual and ensure you are comfortable on how to use your specific meter. 1 Always wash your hands with soap and water and dry with a clean cloth before testing. DO not put cream on hands or touch food as this may influence your reading. 2 Insert the test strip into the meter. 3 Prick your finger with the lancing device. Always use a new needle. Prick the sides of the finger to minimize pain during pricking. Let the strip suck up the drop of blood. 8 4 Wait 5 seconds the meter will show your result.

? Normal blood glucose values are: What does the result mean In the morning after 8-12 hours of fasting the result should be between 4.

0 mmol/l you may experience the following symptoms: Hunger. Sweating. Palpitations. Anxiety. Irritability. Faintness. Headache.

0 mmol/l take the following steps: Consume 2-4 teaspoons of sugar with a little water. Test again after 5-10 minutes.

9 ? Normal blood glucose values are: What does the result mean In the morning after 8-12 hours of fasting the result should be between 4.0 and 7.0 mmol/l. Two hours after a meal blood sugar levels should be between 5.0 and 10.0 mmol/l. With a blood sugar lower than 4.0 mmol/l you may experience the following symptoms: Hunger. Sweating. Palpitations. Anxiety. Irritability. Faintness. Headache. What do i do? when blood sugar is too low If you are aware of the symptoms and a blood sugar test shows a value below 4.0 mmol/l take the following steps: Consume 2-4 teaspoons of sugar with a little water. Test again after 5-10 minutes. Repeat if blood sugar level is not above 4.0. Then consume a small meal like a sandwich with some protein (e.g. peanut butter/meat). Re-test again after minutes. 9

eyes. There are many small blood vessels in

These can be damaged by high blood glucose.

10 Complications of diabetes Diabetic retinopathy Retinopathy is damage to the eyes. There are many small blood vessels in the eye. These can be damaged by high blood glucose. If the damage is severe enough, it can lead to blindness. Renal complications 10 Diabetic nephropathy is kidney disease. It is the gradual mobility for the kidneys to perform its function. The body cannot survive without a functioning filtering system. If the kidneys fail completely, dialysis is needed for toxins to be filtered out of the blood.

Neuropathy Autonomous nervous system: Urine incontinence.

Peripheral nervous system: Arthropathies. Diabetic foot.

Nerve disease is damage to nerve cells throughout the body.

(hands, feet), nerves that are needed for digestion and

Initially a burning or tingling sensation can be felt.

Macrovascular complications Damage can also be done to the

11 Neuropathy Autonomous nervous system: Urine incontinence. Impotence. Faecal incontinence. Peripheral nervous system: Arthropathies. Diabetic foot. Alterations of proprioception. Nerve disease is damage to nerve cells throughout the body. Nerves that are affected include nerves used for sensation (hands, feet), nerves that are needed for digestion and other functions. Initially a burning or tingling sensation can be felt. Eventually the nerve can be destroyed. Macrovascular complications Damage can also be done to the larger vessels in the body if blood glucose is not controlled, the long term effect can be: Stroke. Heart disease. Atherosclerosis. Peripheral vascular disease. Macroangiopathy. Increase of glycaemia. 11

12 ? How to manage diabetes through lifestyle Glycaemic control Avoid excessive alcohol Stop smoking Regular medical check-ups and take medication as prescribed by your doctor Maintain a healthy weight Physical exercise Very well!!! Balanced diet 12

A healthy diet Making healthy food choices Some basic principles have wheathered the fad diets and here they are: Eat plenty of and a variety of fruit and vegetables.

Choose whole grain foods such as brown rice, wholewheat pasta, oats and whole grain bread and cereals over processed grain products.

Choose non-fat or low-fat dairy such as skim milk, low-fat yoghurt and cheeses.

13 A healthy diet Making healthy food choices Some basic principles have wheathered the fad diets and here they are: Eat plenty of and a variety of fruit and vegetables. Eat non-starchy vegetables with meals, such as broccoli, cabbage, carrots, cauliflower, green beans, cucumber, lettuce, tomatoes, peppers, beets and spinach. Choose whole grain foods such as brown rice, wholewheat pasta, oats and whole grain bread and cereals over processed grain products. Include legumes such as beans and lentils in your meals. Include fish in your meals 2 to 3 times per week. Choose lean cuts of meat and remove the skin from chicken. Choose non-fat or low-fat dairy such as skim milk, low-fat yoghurt and cheeses. Drink water, unsweetened tea, coffee and calorie-free beverages instead of sugarsweetened drinks or fruit juices. Choose liquid oils for cooking instead of solid fats. Cut back on calorie-rich foods such as puddings, crisps, biscuits, cakes, full-cream, icecream. Avoid processed meats such as sausages, polony, viennas and boerewors which are high in fat and salt. 13

? How much to eat Use a 22 cm plate and fill half the plate with non-starchy

decreasing the portion sizes of starches.

of dairy per day. Vegetables 22 cm plate. Fruit 2-3 servings per day.

portions: Hold out your hand, palm up and fingers stretched out: one serving of

14 ? How much to eat Use a 22 cm plate and fill half the plate with non-starchy vegetables, a quarter of the plate with starchy foods and a quarter of the plate with protein. The focus is on increasing the portion sizes of nonstarchy vegetables and decreasing the portion sizes of starches. Add 2 to 3 servings of fruit per day and at least 2 servings 2 servings per day. of dairy per day. Vegetables 22 cm plate. Fruit 2-3 servings per day. 14 Another simple way to measure portion sizes is by using palm and fist portions: Hold out your hand, palm up and fingers stretched out: one serving of protein such as fish, chicken or steak is about the size of your palm; not the whole hand, just the palm. Make a fist: your fist size is about the size of a portion of cooked rice, pasta, cereal and whole fruits.

Physical exercise Physical exercise reduces the risk of a heart attack and

Its effect seems to be positive on other risk factors: Increases peripheral

Reduces the concentration of triglycerides (bad fats). Reduces blood pressure.

15 Physical exercise Physical exercise reduces the risk of a heart attack and favors survival if a heart attack occurred. Its effect seems to be positive on other risk factors: Increases peripheral sensitivity to insulin. Increases HDL cholesterol values (good cholesterol). Reduces the concentration of triglycerides (bad fats). Reduces blood pressure. Favours weight loss. It is important that the patient talks to his/her doctor about the most convenient type of exercise. 15

Remember: What diabetes is. Regular check-ups by your doctor. Control glucose. Even though diabetes is not curable, a lifestyle to control diabetes can be adopted. Weight control. Healthy diet.

This booklet is for educational purposes and does not replace your doctor s professional opinion. AstraZeneca Pharmaceuticals (Pty) Ltd. Reg. No. 1992/005854/07.

16 Remember: What diabetes is. Regular check-ups by your doctor. Control glucose. Even though diabetes is not curable, a lifestyle to control diabetes can be adopted. Weight control. Healthy diet. Physical exercise. Normal glucose values: 4-6 mmol/l We hope that these contributions will help you fight diabetes. THANK YOU VERY MUCH FOR YOUR ATTENTION ASKLEPIOS MEDICAL ATLAS. All rights reserved. This booklet is for educational purposes and does not replace your doctor s professional opinion. AstraZeneca Pharmaceuticals (Pty) Ltd. Reg. No. 1992/005854/07. Building 2 Northdowns Office Park, 17 Georgian Crescent West, Bryanston Tel: (011) Fax (011) Log no Expiry Date: April 2016 ASKLEPIOS MEDICAL ATLAS. All rights reserved. S.A. Agent: Infodoc Health cc. Tel: /4659 Fax: nanette@infodoc.co.za Website:

Preventing Diabetes. prevent or delay type 2 diabetes from

Preventing Diabetes. prevent or delay type 2 diabetes from Preventing Diabetes Introduction Diabetes is a common condition. If not controlled, diabetes can lead to serious complications such as blindness, amputations, and even death. Before people develop diabetes,