Diabetes Pamphlet

Definition of Diabetes:

Diabetes refers to a group of underlying diseases characterized by elevated blood glucose levels, which occur as a result of a defect in insulin production and secretion.

The prevalence of diabetes is increasing among both men and women of all ethnicities.

In the United States, diabetes is the leading cause of amputations, blindness, and end-stage kidney failure.

Additionally, diabetes is a major cause of death due to cardiovascular diseases such as heart attacks.

Risk Factors:

1. Family history
2. Obesity
3. Race and culture
4. Age over 45
5. History of glucose impairment
6. High blood pressure (140/90 or higher)
7. History of gestational diabetes or giving birth to a baby weighing more than 4kg
8. High cholesterol

Types of Diabetes:

1. Type 1 Diabetes: The most common cause is genetic history.
2. Type 2 Diabetes: Occurs in people over 30 and those who are obese.
3. Diabetic Ketoacidosis
4. Gestational Diabetes

Diagnostic Findings:

Symptoms that diagnose diabetes:

• Increased and decreased blood sugar levels
• Blood sugar control

Symptoms of Low Blood Sugar:

Sweating, trembling, increased heart rate, hunger, numbness in the lips and tongue, double vision, drowsiness, decreased consciousness.

Diabetes Diagnosis:

• Fasting blood sugar 126 mg/dL or higher, 2 hours after eating 200 mg/dL or higher.

Pre-diabetes:

• Fasting blood sugar between 100 and 125 mg/dL, 2 hours after eating between 140 and 199 mg/dL.

Normal:

• Fasting blood sugar lower than 99 mg/dL, 2 hours after eating lower than 139 mg/dL.

Physical Examinations:

• Blood pressure control while standing and sitting
• Detailed eye exam
• Body mass index (weight and height)
• Foot examination for wounds, infection signs, and pulses
• Oral examination
• Neurological examination
• Skin examination for wounds and insulin injection sites
• Sensory and vibration tests, including deep tendon reflexes

Laboratory Tests:

1. Hemoglobin A1C test: This test is performed by blood sample in a lab and is recommended at least twice a year.
2. Cholesterol measurement: LDL should be measured at least once a year.
3. Urinalysis
4. Electrocardiogram (ECG)
5. Serum creatinine level

Referrals:

• Ophthalmologist (once a year)
• Podiatrist
• Nutritionist
• Diabetes Association
• Visit to the primary care physician at least twice a year
• Dentist (twice a year)
• Cardiologist (at least twice a year)

Long-term Complications of Diabetes:

Heart attacks, strokes, eye and kidney problems, nerve damage, erectile dysfunction, amputation of one or both feet, gum disease, tooth loss.

Individuals with diabetes must regularly monitor their blood glucose, blood pressure, and cholesterol levels to prevent complications.

Control Methods:

1. Following a specific diet
2. Engaging in daily physical activity
3. Adhering to prescribed medical instructions
4. Consulting a doctor before using any medication, vitamins, or herbal products
5. Regular blood glucose monitoring according to a routine

Diabetes Treatment:

1. Medication: Taking medications as prescribed by a doctor.
2. Insulin Use: Easier-to-use insulin pens like Novorapid, Novomix, and Lantus. Alternatively, insulin vials like Regular and NPH can be used. Insulin treatment includes 3-4 doses per day or continuous subcutaneous insulin injection using an insulin pump, along with regular blood glucose monitoring. Insulin injection sites: abdomen, arm, thigh, and buttocks.
3. Exercise Recommendations: Diabetic individuals should exercise at specific times. Exercise advice should consider complications like retinopathy (damage to small blood vessels in the retina that can cause blindness) and sensory neuropathy (symptoms like itching, burning, numbness of feet, etc.), and cardiovascular diseases. For example, high blood pressure during exercise can worsen retinopathy and increase the risk of hemorrhage in the vitreous body and retina. Walking is the safest and most suitable exercise for these individuals.
4. Lifestyle Changes: Weight control, increased activity, healthy nutrition, balanced diet, and walking form the foundation of a diabetes management program.
   • Engage in physical activity every day.
   • Quit smoking.
   • Regularly check gums and teeth, and visit the dentist for any changes.
   • Check feet daily, wash, dry them, and visit a podiatrist if any issues arise.

Diabetes Symptoms:

Frequent urination, excessive thirst, increased hunger, and other symptoms like fatigue, dry skin, and recurrent infections.

Wishing you a speedy recovery.

Farvardin Surgery Center