Welcome to the Type 2 Diabetes - PowerPoint Presentation

Slide1

Welcome to the Type 2 DiabetesStructured Education Session

Nurse EducatorDietitian

Slide2

Overview of the session Part 1 Impact of diagnosis, what is diabetes, symptoms, treatment, complications and how to prevent themPart 2 Healthy eating for diabetes, carbohydrate awareness, food labelling

Break Part 3 Targets for treatment, metformin, foot care, what care to expect Part 4 Eating for a healthy heart, fats, salt, alcohol, healthy weight, physical activity

Slide3

Type 2 diabetes long term, progressive, complicated conditionCan lead to complications

Majority of the time self managedAim to improve knowledge, skills and confidence to take control of diabetes.Education programmes are proven to improve physical and psychological wellbeing

Gain a better understanding of diabetes

Assist with the practical tools to assist management of your condition

Opportunity to ask questions

Programme for those diagnosed with Type 2 diabetes

Slide4

Shock

Feelings about diagnosis

Anger

Fear

Guilt

Overwhelmed

Upset

Relieved that there is an explanation to your symptoms.

Disbelief

Important to find out more about diabetes

and how to manage it

Normal feelings/emotions

Confused

Slide5

Characterised by raised levels of blood sugar/glucosePancreas produces insulinInsulin is needed to get sugar/glucose into the cells of the body

Important to manage as it may lead to damage

What is Diabetes?

Slide6

If the glucose/sugar can’t get into the cells, high levels of it stay in the blood

Slide7

Type 1No insulin is producedUsually rapid onset of symptomsPeople of any age can develop it but often associated with children or young people

Type 2Not enough insulin is produced or it is ineffectively usedSymptoms are often slower to develop 90% of people with diabetes have type 2Family history, age and ethnic group can increase risk This programme is for people with Type 2 Diabetes

Type 1 or Type 2

Slide8

Symptoms

Slide9

Poor wound healing

Sexual problems

Important!

Sooner action is taken to reduce blood glucose/sugar, risk of complications is drastically reduced.

Diabetes can have a detrimental affect on all parts of the body

High levels of sugar/glucose in the blood stream for a long period can damage the arteries

Diabetic Complications

Slide10

Healthy eating

Increased activity

Stop smoking

Limit your alcohol

Healthy behaviours = risk reduction

All people, not just people with diabetes benefit from a healthy lifestyle both with their physical and mental health

Take Control of Diabetes through Lifestyle Changes

Slide11

Increased physical activity will be different for each individual (chair-based exercises, walking more, recommended 30 min x5 a week)

Be more active. Keep doing a bit more each day/week

Make being more active/doing more exercise a priority

Take Control of Diabetes through Lifestyle Changes

Slide12

Finger prick blood testingmeasurement of blood sugars at that moment (a snapshot)

self testing only recommended if on certain medications (insulin or gliclazide) normal reading 4-7mmol/l

HbA1c blood test

more meaningful test

measures long term blood sugar control

measures the amount of glucose that attach to the red blood cells

measures a 3 month average (lifespan of red blood cells)

therefore reflects control over the past 3 months

adequate control 48-53mmol/l

aim <48mmol/l

Measuring Blood Sugars

Slide13

Lowering HbA1c

Lowering BP

Reducing waist circumference

Lowering cholesterol levels

If necessary losing weight

Reducing Risk

Slide14

AimHbA1c 48-53mmol/l or lessBlood pressure 140/80mmhg or less

Cholesterol (blood fats) 4mmol/l or lessHow?Healthy eating (weight loss if necessary)ActivityMedication (statins, antihypertensives, metformin or other diabetic medication)

Preventing Complications, Keep in Target

Slide15

Access your results either on line or call your surgery (important to know results to gain control)Hba1cBlood PressureCholesterol

Positive message - sooner action is taken to reduce HbA1c the risk of complications is reduced

Know Your Numbers

Slide16

Slide17

Part 2

Eating Well with Type 2 Diabetes

Healthy Eating

Carb awareness

Food labelling

Slide18

What is Healthy Eating?

Wide variety of food

Less fat particularly saturated fat

Less

sugary food and drink

5 portions fruit and veg per day High fibre foods Include protein foods daily Include some dairy foods daily Alcohol in moderation Less salt

Slide19

Carbohydrates

Sugary Carbs

EAT LESS

Starchy Carbs

EAT REGULARLY

Sugar Sweets/chocolateSugary drinksHoney/syrup/jam

/ marmalade

Biscuits/Cakes

Puddings

Ice cream

Fruit juice

Bread RicePastaPotatoYamCouscousCereals

Higher Fibre BEST

Wholemeal/granary/seeded breadBrown riceSkins on potatoesOatsPulses Wholegrain cereals

Slide20

Fruit

I can eat as much fruit as I like if I have type 2 diabetesTrue or False?

Slide21

Fruit

Rich in vitamins, minerals and fibre BUT contain natural sugar (fructose) Limit to 2-3 portions per day spread through the dayBest to eat wholeLimit juice to 150ml per day with food

Limit dried fruit to 1tbsp portion

What is a portion?

80g or palm-size portion

1 tbsp dried fruit

Slide22

Fruit and Veg portions 80g

www.bhf.org.uk

Slide23

Dairy

What is a portion?

Rich in calcium and vitamins

Aim for 3 portions per day

Choose low fat versions

Milk and yogurt contain a natural sugar (lactose)So keep to portion sizes and spread them through the day

200 ml

milk

150g pot of

yogurt

Matchbox size piece of cheese (30g)

Slide24

Cutting down on sugar

Sugar in tea/coffee Artificial sweetener

Squash /fizzy drinks

Sugar

free squash/fizzy drinks

Fruit yogurt Natural yogurt with added fresh/tinned/frozen fruit Custard Custard made with sweetener Jam Reduced sugar jam, spread thinly Chocolate biscuit Wholemeal biscuitJam Doughnut Scone, teacake, malt loafIce cream 1 scoop plain ice cream

Healthy swaps

No benefit of having special ‘diabetic’ foods !

Slide25

Carbs – how much and how often?

How much depends on age, gender, weight, activity levels and goalsLow carb diets may be helpful in the short term for those who are overweight

Aim

to get most of your carbs from healthy foods – wholegrains, pulses, fruit, veg, nuts, unsweetened dairy rather than sugary or processed

carbs

Include SOME carbs at each meal

As a guide at your main meal:

Starchy Carbs

Protein

Veg

Slide26

Carbs – Food Labelling

Front of pack – choose foods with more green than red and amber

Back of pack – look for ‘of which sugars’

<5g sugar per 100g is low in sugar

>22.5g sugar per 100g is high in sugar

Diabetes UK ‘ Food Labels Made Easy’

Slide27

Sugar per 100g

35g

24g

4.4g

1g

Fibre per 100g

2.5g

6.6g

10g

8.3g

Slide28

Know your numbers and targets

MedicationFootcare

Getting the most out of annual diabetic review

Ongoing support

Content of Type 2 Diabetes Programme

Part 3

Slide29

AimHbA1c 48-53mmol/l or lessBlood pressure 140/80mmhg or less

Cholesterol (blood fats) 4mmol/l or lessHow?Healthy eating (weight loss if necessary)ActivityMedication (statins, antihypertensives, metformin or other diabetic medication)

Preventing Complications, Keep in Target

Slide30

1st line treatmentHealthy

eatingIncreased activityWeight loss (if appropriate)

Stopping smoking

Many medications to treat diabetes

Metformin

1st

line medication treatment

Effective medication to reduce blood sugar levels

Optimal dose 2g daily (4 x 500mg)

Dose can be increased slowly to ensure well tolerated

Many advantages to some alternatives (available in a slow release tablet)

Medication

Slide31

Patient A was diagnosed with type 2 diabetes 6 months ago and was advised to make healthy lifestyle changes, HbA1c was 49mmol/l. In addition he has been taking a statin for his cholesterol and ramipril to control his BP.Recent blood test results are below

HbA1c 59 mmol/lCholesterol 3.5 mmol/l

BP

130/65

mmhg

Are these results in target?Should any action be taken?

Results

from Patient A

Slide32

Diabetes Review

Your time

Slide33

Practice nurse will check feet annually. Assess circulation and sensation

Important to selfcare daily Check feet daily

Moisturise

Ensure good nailcare

Wear well fitting footwear

Any problems seek help early

Aim for good diabetic control

Seek help to stop smoking

Footcare

Slide34

Annual Diabetic Review and The 15 Healthcare Essentials Get the most out of health checks

COVIDFootcare Retinal screenings

If you experience poor healing of wounds it may be the result of poorly controlled blood sugar/glucose

Health Checks

Slide35

Ongoing support

Diabetes UK

(diabetes.org.uk)

Practice nurse (blood and urine tests, annual review, smoking cessation, advice)

Digital tools to assist healthy living

Important to access additional help from other services

eg

podiatry, chiropody, social prescribing, leisure centres.

Attend retinal screening

Diabetes UK Learning Zone

Self management Tool. Videos, quizzes, interactive tools, top tips and food swaps, assist day to day management

Podcasts on diabetes related subjects

Easier to become healthier

On Going Support

Slide36

Accepting that you have diabetes can take time and feelings about can be varied

Proven that with knowledge your confidence will increase resulting to improved diabetic control and reduced risk of complications

The sooner healthy lifestyles are adopted, the better outcome

Self management is essential but it is also important to access help including screening and tests

Any questions

Conclusion

Slide37

Part 4

Eating for a healthy heart Fats

Salt

Alcohol

Healthy weight

Physical activity

Slide38

Fats

Fats are important for healthBUT needed in very small amounts High in calories – twice as many as carbs per g AND

Some fats (SATURATED) increase blood cholesterol

Increased risk of heart disease and stroke

Slide39

Choose healthier fats

SATURATED

Butter / lard/ghee

Whole milk

Cheese

Cream

Fatty meat

Pies/pastries

Biscuits/cakes

MONOUNSATURATED

Olive oil/spreads

Rapeseed oilAvocadoNuts

POLYUNSATURATEDSunflower oil/spread SeedsNuts

OMEGA 3 Oily fish

Mackerel, sardines, herrings, trout, pilchards

Slide40

Lower fat cheeses

Cut visible fat from meat

Choose lean cuts

Smaller portions of high fat foods or have them less often

Sunflower/olive spread, low fat spreads, use more thinly

Low fat/0% fat yogurts

Healthy Fat Swaps

Swap some meat for pulses in stews and casseroles

Skim fat from meat juices and mince

Baking, grilling, dry frying, air frying, poaching, boiling

Skimmed/semi skimmed/1% fat milks

Slide41

Salt

Is sea salt healthier than table salt?

Slide42

Salt

Too much salt is linked with high blood pressure

¾ of our salt comes from salt already in food - crisps, soups, sausages, bacon, processed foods, sauces

etc

Use pepper, herbs, spices, lemon, garlic instead Avoid special salt substitutes

No advantage in using sea/rock/Himalayan salt!

Slide43

Foods for a Healthy Heart

Oily fish Fruit and VegOats and barleyPulses, beans, lentils, wholegrainsNutsPlant sterol/stanols

Slide44

Alcohol

How many units of alcohol is safe to drink each week if you have Type 2 Diabetes?None?Up to 5 units?Up to 14 units?

Up to 21 units?

Slide45

Alcohol

Government guidelines – no more than 14 units per week spread over at least 3 days Too much alcohol can increase your blood pressure and damage your liver

Alcohol is high in calories and can be very high in carbs (sweet sherries and wines, liqueurs, low alcohol wines)

Can cause a rise in blood sugars

Can cause low blood sugar later if you are

on gliclazide or insulin www.drinkaware.co.uk

Slide46

Healthy Weight

Benefits of weight loss :reduced insulin resistanceBetter blood sugar/pressure/cholesterol controlReduced risk of complicationsReduced need for medicationsYou could put your diabetes into REMISSION SMALL CHANGES

BIG

DIFFERENCE

Slide47

TIPS FOR WEIGHT LOSS

Get support

Be wary of faddy or extreme diets

Healthy Cooking

Portion sizes

Get active!

…and write them down

Set realistic goals….

Healthy Swaps

Slide48

GET ACTIVE! Benefits of Physical Activity

Better diabetes controlWeight loss Improved blood pressure and cholesterolStrength and stamina Mental health and wellbeing Aim for 30 mins moderate activity 5 times per week

Find something you enjoy!

Make it part of your lifestyle

Slide49

Summary – Eating Well with DiabetesLifestyle is the cornerstone of diabetes treatmentEating healthily and keeping active will help you to control your diabetes and reduce complications

Small changes can make a big difference if sustainedIf you are overweight, weight loss can improve your diabetes and reduce complications No need to follow a ‘special diet’ and there’s nothing you have to avoid completely. You can still enjoy your food!

Slide50

Useful websites

Diabetes UKLots of information, meal plans, recipes, Learning Zone

https://www.diabetes.org.uk/type-2-diabetes

British Dietetic Association

Free Food fact sheets on diabetes, sugar, fats, salt, alcohol

https://www.bda.uk.com/food-health/food-facts.htmlBritish Heart Foundation Food portion guides

https://www.bhf.org.uk/informationsupport/support/healthy-living/healthy-eating/healthy-eating-toolkit/food-portions