Whatare the ComplicationsCaused byDiabetes?

Uncontrolled diabetes cangiverisetomany complications. Theseareeitheracuteor short-term; and chronic or long-term.

• Acuteproblemsaredue toeitherlow bloodsugar causinghypoglycemia orhighbloodsugar causing

hyperglycemia or diabetesketoacidosis.

• Chronic late complicationsassociatedwithdiabetesare:

• Highbloodpressureandheartproblems leadingtoheartattacksandheart failure;

• Difficulty invisionandeyeproblems leadingtoblindness;

• Kidneyproblems,leadingto kidney failure;

• Nervedamageprimarily leading toproblems ofthe foot; and

• Problemssuchasdiarrhea,constipation,nausea,vomiting,etc.,arisingfromdamage tonerves in other

parts ofthe body.

Bodymass index

BMIisanindicatoroftotalbodyfat,butitmayoverestimatebodyfatinathletesandotherswhohavea muscularbuild.BMIandwaistmeasurementarecheckedregularlytounderstandyourriskforhealth problems.Beingoverweight canleadtoheart

disease,stroke,diabetes,highcholesterol,highblood pressure,gallstones,osteoarthritis, cancerand sleep

problems.Theremayalsobealinkbetweenexcess weightanderectiledysfunctionordepression.

Yourriskfordisease related toyourweightis: (Provider checkone;riskcategorydefinitionsbelow)

rLowRisk rIncreasedRisk rHigh Risk rVery HighRisk

Weight riskchart foradultmenandwomen

ShowsriskbasedonBMIandwaistmeasurment.1

BMICategoryWaistcircumference

40inchesorlessformen,

35inchesorlessforwomen

WaistcircumferenceMorethan 40inchesfor men,morethan35inchesforwomen

NormalBMI(18.5–23)

Increased risk (23.1-24.9)

------Increasedrisk2

OverweightBMI(25-29.9)IncreasedriskHighrisk

ObesityIBMI(30 -34.9)HighriskVeryhighrisk

ObesityIIBMI (35-39.9)VeryhighriskVeryhighrisk

ObesityIIIBMI ( 40)ExtremelyhighriskExtremelyhighrisk

1 Diseaseriskfortype2 diabetes,hypertensionandcardiovasculardisease.

2 Increasedwaist circumferencecanalsobeamarker forincreasedrisk,eveninpersonsofnormalweight.

Source:NationalHeart,Lung,BloodInstitute,ClinicalGuidelines ontheIdentification, Evaluation,andTreatmentofOverweightandObesityinAdults.Availableat .

Health Calculators

BMI=wt (kg)/ height (m2)

Know HOW HEALTHY areyour kidneys?

GFR (mL/min/1.73m2)=175 × (Scr)-1.154× (Age)-0.203× (0.742 if female)× (1.212 ifAfricanAmerican) (conventionalunits)

References

1.LeveyAS, Coresh J,GreeneT, StevensLA,Zhang YL, HendriksenS,Kusek JW,VanLenteF; ChronicKidney DiseaseEpidemiologyCollaboration.Usingstandardizedserumcreatininevalues in themodificationof diet in renaldiseasestudyequationfor estimating glomerular filtration rate.AnnIntern Med. 2006 Aug

15;145(4):247-54.

Serumcreatinine(mg/dL) Age*

AfricanAmericanYesNo

GenderMaleFemale

Reset

GFR value:mL/min/1.73m2**

*This equationshould onlybeusedforpatients18 and older.

**The NKDEPpresently recommends reportingestimated GFR valuesgreaterthan orequal to60 mL/min/1.73 m2simplyas"≥60 mL/min/1.73m2",notan exactnumber.

What canIdoforamore healthylifestyle?

Loseweight. Ifyouareoverweight, startbylosing

10 pounds.Asmallweightlosswillreduceyourriskforhealthproblems.Weightlossof1 to2 poundsa

week isa healthypace.

Becomemorephysicallyactive.Forgeneralhealth,aimforatleast30 minutesofmoderateactivityonmost days. Toloseweight,youmayneedtodoubletheamountofmoderateactivityorincreasetheintensity.You don’thavetoexerciseallatonce–10 minutesatatimeaddsup.

Makeyourcaloriescount.Start byeatingatleastfiveservingsoffruitsandvegetablesperday. For

weightloss,reducetheamountyoueatby500 -

1,000 caloriesaday.

Myactionplan

Start bysettingaspecificandattainablegoal.Basedonhowreadyyouaretochange yourhealthhabits, checkoneortwoofthefollowinggoalsinthechartbelow.Give yourselfanonfoodrewardlikealikeanew bookorCDwhen youaccomplishyourgoal.Smallchangesmakeabigdifferencetowardreachingyour healthgoals.

Usethechartbelowtosetgoalsanddiscussthemwithyour doctor.

Ifyou’re notyetreadytomake

changesinyourhealthhabitsIfyou’rethinkingaboutmakingchangesinyour

healthhabits

Ifyou’re already makingchangesinyour healthhabits

rLearnmoreaboutthehealth risks ofbeingoverweightandsedentaryor ofeatinganunhealthy diet.

rImagineyourlife3to5 years from now. Areyourcurrent behaviors consistentwithyourhopesfor the future?

rReadaboutortalktoothers who havesuccessfullymade changesthat ledtobetter health.

rContact yourhealthcareproviderwhen

youaremorereadytomakechanges in yourhealth habits.

rMakealistofhowyourlifewillbebetter ifyou makehealthychanges. Thenlistwhatyou will havetogiveup.Dothereasons tochange outweighthereasons notto?

rTalkwitha familymemberor friendabout becomingmorephysicallyactivetogether.Share yourgoalswitheachother.

rBecomemoreawareofyourcurrent behaviors. Keepafooddiaryfortwoweeksand see patternsinyoureatingandphysicalactivity.

rTakesmallsteps, likewalking10minutesone dayforaweekoreatingonemoreservingof vegetables a week.

rAskafriendorfamilymember tosupport

you ortosuggest others whowillsupport your efforts.

rJoinasupport group,programorlocal exercisefacility.

rTrackyour progress andreward yourself alongtheway.

rMakealistofallofyourreasons for changing. Readitoften.

Other:

Other:

Other:

NUTRITION

Mealplanning isatoolthatcanhelpyoumanageyourdiabetes,weight,blood pressureandbloodcholesterol,andensure thatyougetthenutrientsthatyou needforoverallgood health.Usethishandoutasaguidetohelpyougetstarted, then work witha dietitianordiabetes educator todevelopa mealplan thatis right foryou.

Buildinga Better Plate

Whether you’renew todiabetesor havehadit formanyyearsandneedtoget back ontrack,the PlateMethod isaneasyway togetstartedwithmeal planning andensurethatyouandyourfamily eatavariety offoodsandisatool thatyou andyourfamily canusetoplanhealthy meals.Thinkofyourplatedividedinto THREEsections–nonstarchyvegetables,protein, andcarbohydrate foods (grains andstarchyvegetables)

•FillTWOsectionwithnonstarchy vegetables:lettuce,broccoli,greenbeans, spinach,carrotsorpeppers.– GREEN partofyourplate

•Fillonesectionwithprotein:chicken,turkey,fish,lean meat,eggsortofu,pulses and legumes– Yellowpartofyourplate

•Fillonesectionwithanutritiouscarbohydratefood:brownrice,wholewheat pasta,whole-wheatbread,peasorcorn.Controlling carbs helpsyou controlyour blood glucose-BLUE partofyourplate

•Include lowfatmilkor yogurt.

FOOD

R I S E S

B L O O D S U G A R

UsualHealthy

EveningSnack

WRONG RIGHT

FRUITS-

1/2

10-15

2 small

HealthyEating Tips:

•Eatmealsataboutthesametimeseachday.Trynottoskipmeals,especiallyif you take diabetesmedicine thatputsyou atriskforlowblood glucose.

•Eatabout thesame amountofcarbohydratefoods (potatoes,pasta,cereal,bread, fruit,milk)atyourmealseach day.

•Choose more often foods thatcontain fiber,likewhole-grainbread,beans, vegetablesand fruit.

•Useunsaturatedfats likeoliveandcanolaoilandcutbackonsaturatedandTransfats.

•Comparefoodlabelsforsodiuminfoodslikesoup,breadandfrozenmeals, andchoosefoods with less sodium.

WeightMatters

Losingasmallamountofweight,ifyouneed to,can leadtobighealthbenefits, suchasloweringyour riskofgettingtype2diabetesorheartdisease.Andifyou havediabetes, losingweightcanhelpyoubettermanageyourbloodglucose.

Tipsfor Getting StartedwithWeight Loss

•Beready tostart.Successislinkedwithyour feelingconfidentandhavingaclear plan.Setrealisticgoals.

• Getsupport.Meetwithadietitian;joinasupportgrouporsignupfor alocalweight- lossprogramin yourcommunity.

•Focusonforming healthyeating habits.Eatregularmealsand snacks.

•Findways to fit activityinto yourday.

•Checkyourprogressby keepingfoodrecords,wearingapedometerandweighing yourselfregularly.

•Ifyoudrinkalcohol,checkwithadietitianordiabeteseducatortolearnhow to fit alcohol safelyinto youreating plan.

Fiberis good foryouinmoreways than one.Higherfiberfoods take longer to chew, givingyourbodytime to realize it’sfull.Also,higherfiberfoods tend tobe morefilling

– so thatyou mightendupeating less!Ifyou’re awoman,aim foratleast25grams perday;ifyou’rea man,aim foratleast38gramsperday.Here are tips to increase fiber:

  1. Kickoff yourdaybyeatingabowlof high-fibercerealforbreakfastoradd vegetables to upma/dosa/sambharetc.

2.Stirfresh orfrozen berriesinto lowfatyogurtfora tastysnack.

3.Choosebreads,cerealsandcrackerswithawholegrainlistedasthefirst ingredient,preferbrownrice over white rice.

4 Include a salad and/orvegetablewith each ofyourmeals.

YourNextSteps

Often,thehardestpartabouteatinghealthfullyisgettingstarted.Tokeepthings easy,try notto maketoo manychangesatonce.Usethe checklistbelow togetyou started on yourwayto healthyeatingwith diabetes!

•Tryplanning yourmealsahead oftime.

•Shopfromalisttomakeiteasiertoremembertobuyhealthierfoodsandinvolve your

FOLLOwyOUrhEALthyEAtiNgPLAN.

Areyouproudofthewayyouatetoday?

kEEPACtivE

Whatisyourfavoriteoutdooractivity?

tAkEMEdiCAtiONS

Didyoutakeyourmedstoday?

MONitOryOUrbLOOdSUgAr

Whatwasyourbloodsugarnumberlasttimeyouchecked?

ChECkyOUrFEEt

Anypainorsoresonyourfeet?

brUShANdFLOSSyOUrtEEth

Whenwasyourlastdentistvisit?

ChECkyOUrbLOOdPrESSUrE

Doyouknowwhatyourbloodpressureis?

dON’tSMOkE

Whatcanhelpyouquit?

gEtANEyEExAM(whiChiNCLUdESdiLAtiNgyOUrEyES)AtLEAStONCEAyEAr

Haveyouhadaneyeexamthisyear?

A1C / Lessthan7% / Every3to6months
BloodPressure / Lessthan130/80 / Everyvisit
Lipids
HDL(goodcholesterol) LDL(badcholesterol) Triglycerides / Over40(formen);Over50(forwomen)
Lessthan100(lessthan70if youhaveheartdisease) Lessthan150 / Atleasteveryyear
EyeExam / Everyyear
FootExam(visual)
FootExam(withsensorytesting) / Everyvisittoyour healthcareprovider Everyyear