Diabetes: What you Need to Know

•Nutrition

•Physical Activity

•Mental Health

Today ….

Learn about:• Risk Factors• Symptoms• Diagnosis• Healthy Eating• Active Living• Mental Health

Facts About Diabetes

• By 2020, 9 million Canadians will have pre-diabetes or diabetes

• That is 1 in 3 people in Canada

What is Diabetes?

• The body gets energy by converting carbohydrate from food into a form of sugar (glucose)

• The body needs insulin to use the sugar (glucose)

• Having diabetes means: – the body makes little or no insulin

And/Or– the body does not properly use the insulin it

makes

Type 1 Diabetes

• Pancreas makes little or no insulin

• About 10% of people with diabetes have type 1

• Seen most often in children and young adults

• They need insulin shots

Type 2 Diabetes

• About 90% of people with diabetes have type 2

• Seen most often in adults

• Insulin resistance and/or pancreas not working properly

• Managed with good food, exercise, blood sugar testing, pills, and sometimes insulin

Gestational Diabetes

• Affects 3.7% of all pregnant women

• It means a higher chance of developing diabetes later in life

• All pregnant women should be tested

Prediabetes

• Blood sugar levels are higher than normal but below the level for diabetes

• Higher chance of developing type 2 diabetes and heart disease

The Risk Factors

• There are 2 kinds of risk factors for type 2 diabetes:– things you can’t change– things you can change

Risk Factors You Can’t Change• Age

– people over 40 are at a greater risk

• Family history– risk is highest when a parent,

brother or sister.• Ethnic background

– Aboriginal, Hispanic/Latino, Asian, South Asian, or African/Caribbean

• Other risk factors

Risk Factors You Can Change

• Too little exercise

• Being overweight, especially around the middle

• High blood pressure

• High cholesterol

Signs and Symptoms

• Very thirsty

• Need to urinate often

• Change in weight

• Very tired

• Blurred vision

Signs and Symptoms

• Many infections

• Cuts and bruises are slow to heal

• Tingling or loss of feeling in hands or feet

Signs and Symptoms

• With type 1 diabetes, symptoms are quick

• With type 2, symptoms are slow or not even there

• Many people who don’t know they have type 2 diabetes have no symptoms at all

• Get tested!

Testing for Diabetes

• Blood test

• Talk to a doctor

Blood Sugar Levels

• Healthy levels differ from person to person

• For most people with diabetes, healthy levels are:

4.0 – 7.0 mmol/L before meals5.0 – 10.0 mmol/L two hours after meals

Diabetes is Serious

• Diabetes is serious and can be life-threatening– early death– heart disease– Stroke– Blindness– kidney failure– difficulty getting or keeping an erection– amputation

Diabetes Affects Us All

• Diabetes epidemic

• It costs $13.2 billion each year

• Costs will rise to $19.2 billion by 2020

• Diabetes costs us all!

Diabetes & Nutrition

•To make healthier food choices, follow “Eating Well with Canada’s Food Guide”

•Eating from all colours of the ‘rainbow’….

How Much is Enough?

• Number of servings based on age and gender

• The guide provides culturally specific examples

• Create a “My Food Guide” online at the Health Canada website

How Much is Enough?

• Divide dinner plate into 3 sections:•Add a glass of milk and a piece of fruit

Vegetables and Fruits

• Carrot, broccoli, salad, orange, frozen peas and canned beans

• 7-10 servings per day based on age and gender• 1 serving =

• 1 medium size fruit or vegetable• ½ cup (125 ml) chopped fruit or veggies• ½ cup (125 ml) juice • 1 cup (250 ml) salad

• Fruit: an amount the size of your fist

• Vegetables: As much as you can hold in both hands

Small Changes

•Eat carrots, potatoes and apples with their peels on

•Add grated carrots or zucchini to spaghetti sauce

•Experiment with a vegetarian meal•Get kids involved with cooking and

menu planning•Try a new fruit or vegetable this

week

Grain Products•Whole grain bread, pasta, rice, pita, cereal

•6 - 8 servings per day based on age and gender

•1 serving =•1 slice of bread, or•½ small bagel or ½ pita, or•½ cup of rice or pasta

•An amount the size of your fist•Suggested servings for a sedentary individual, increase only if active regularly

Small Changes to Increase Fiber

• Add barley, bulgur or brown rice to soup or stews

• Use bran or whole grain flour in baking

• Try whole wheat pasta• Use whole grain breads in

sandwiches• Try bran and oat cereals

Milk and Alternatives

• Milk, cheese, yogurt, fortified soy beverage• Children: 2 - 4 servings per day• Teen; pregnant & breastfeeding women: 3 – 4

servings • Adults: 2 - 3 servings per day• 1 serving =

• 1 cup (250ml) milk• 1 cup (250ml) fortified low-fat soy milk

• The need for vitamin D increases after the age of 50• Vitamin D fortified soy beverage is suitable if you do

not drink milk

Small Changes

• Add milk or skim milk powder to soups, puddings and home-baked goods

• Lower fat content by using skim, 1% or 2% milk

• Make a vegetable dip with low-fat yogurt• Enjoy a blender drink made with low-fat milk

or yogurt • Switch from cream to milk in coffee

Meat and Alternatives• Beans, dried peas, lentils, tofu

• Fish, poultry, lean beef, pork, lamb, eggs

• 2 - 3 servings per day • 1 serving =

• 2 eggs• 125 – 250 mL (1/2 - I cup) red kidney beans• 100 g or 1/3 cup tofu • 2 Tbsp peanut butter• 75 g fish, poultry, or meat

• An amount the size of your palm and the thickness of your little finger

Small Changes

• Bake, broil, barbecue, poach or stir-fry

• Try a vegetarian meal one day a week

• Experiment with lentils and rice, quiche or an omelet, bean salad with pita, or tofu burgers

Fats• Limit fat to an amount the size of the tip of

your thumb• Try lower fat salad dressings or flavoured

vinegars• Use herbs to season foods • Use cooking spray, and healthier fats such as

canola, olive and soybean oil• A handful of almonds, pecans, and walnuts

make an excellent snack• Limit trans fats (as listed on food labels)• Use soft margarine rather than butter

Don’t Forget Snacks!

• Snacking can be good for you

• Watch portion sizes and make smart choices

• Avoid fatty, sugary, low-nutrient snacks

• Keep lots of good-tasting healthy snacks on hand (dry cereal, fruit and nuts)

• Combine two or more food groups

• Drink water

Diabetes & Physical Activity

• Goal: to add up 150 minutes of physical activity every week

• Add in some resistance exercises

• Start slow and build up

• SIT LESS, MOVE MORE

Diabetes & Mental Health

At the end of this session you will:

• Understand the importance of mental health and diabetes management.

• Be able to identify signs of depression and anxiety.

• Understand the importance of finding help.

Diabetes and Emotions

• Living with diabetes can be difficult at times

• It’s about more than just eating right and taking medications

• Managing stress is important for maintaining healthy blood glucose levels

Increased Stress

• A person with diabetes may feel stress:– because they blame themselves for having diabetes

or not doing enough to manage their diabetes.– from having to manage their diabetes on an

ongoing/daily basis.– from the fear of developing diabetes-related

complications such as nerve damage and heart disease.

Denial

• A normal emotion

• Ignoring denial can cause serious health problems

• Tips:– Staying informed about their

health– Sharing thoughts and feelings

Guilt

• No one is to blame for developing diabetes

• Proper nutrition and exercise doesn’t always work for everyone

Diabetes and Depression

• Depression is twice as common in people with diabetes as compared to the general population, and major depression affects at least 15% of people with diabetes.

• It often takes a mental health professional to:– Ask about the symptoms– Diagnose the disorder – Suggest treatment

Diabetes and Anxiety• It’s normal to feel anxious or worried at times.

Everyone does. • Anxiety disorders affect approximately 14% of

people living with diabetes.

• A little anxiety can be good as it helps the person react to danger, and can help motivate them to excel at work and at home.

• But if the person often feels anxious without reason and their worries impact their quality of life, they may have an anxiety disorder.

Eating Disorders

• Anorexia• Bulimia• Binge Eating Disorder

Diabetes and Eating Disorders

• Teen females and young women with type 1 diabetes have about twice the risk of developing an eating disorder as their peers without diabetes.

• In people with diabetes, eating disorders can lead to poor blood glucose control and repeat hospital visits for dangerously high or low blood glucose levels.

Building a Support Network

• Feeling alone makes diabetes harder to handle

• Sometimes support can turn into “nagging”

• It is challenging when others dictate what to do

• Engaging in Family members to participate

Asking for Help

• Nothing to be embarrassed about

• Talk to friends, family and their doctor

• Resources are right here in the community

References

[1] Psychological Aspects of Diabetes – 2008 Clinical Practice Guidelines

[2] Canadian Diabetes Association website - http://www.diabetes.ca/Section_About/diabetes-and-depression.asp

[3] The Emotional Side of Diabetes – Behavioural Diabetes Research Institute

[4] Diabetes and Mental Health – Presentation by Dr. Patricia Colton, University Health Network, Toronto Canada

[5] American Diabetes Association website - http://www.diabetes.org/pre-diabetes/denial.jsp

[6] Something Fishy Website on Eating Disorders - http://www.something-fishy.org/

Key Messages

• By 2020, 1 in 3 Canadians will have pre-diabetes or diabetes

• Diagnosis is fasting BG of 7.0 mmol/L or higher

• 14% of people with Diabetes will have depression

• Eating from Canada’s Food Guide

• 150 minutes of Physical Activity

Questions?

Call 1-800-BANTING(1-800-226-8464)

Visit www.diabetes.ca

For more information