Diabetes Care 4 U!

Welcome to Diabetes Care 4 U! Here you will find posters packed full
of information and innovative ideas to ensure you have great Diabetes
Care! Before you enter into the unique experience let us go over the
problems of diabetes.
DIABETIC EYE DISEASE
Most common cause of
blindness in people of
working age

Stroke
Eye
Disease
Heart Disease
High Blood Pressure

HEART and BLOOD VESSELS

2 to 4 fold increased risk of
heart disease and stroke
75% have hypertension

DIABETIC KIDNEY
DISEASE
20% of all new patients
needing renal dialysis
therapy have diabetes

FOOT PROBLEMS
15% of people with diabetes develop foot
ulcer; 5-15% of these need amputation

Kidney Disease

Remember with
good care all
complications
can be reduced
or even
prevented!
Pain or loss of the lower
legs due to impaired
blood flow
Peripheral Neuropathy
(nerve disease)

If you think any area of your care needs to be addressed please

make a note and discuss this with your Diabetes Care Team.

Enjoy the Posters!

Advice

Diet : Maintaining a healthy diet and

preventing or reducing overweight will
help you control your diabetes

Exercise : Regular exercise will help to

maintain an optimum weight and will
benefit all members of the family

Smoking : It is widely accepted that smoking

causes heart and lung disease. Most diabetic
complications are worsened by smoking

Weight control : There is a greater risk of

Developing diabetes and heart disease with
increasing waist circumference

Finnish Diabetes Study

This study was conducted to determine the
effects of a programme of changes in lifestyle in patients with Pre diabetes

Lifestyle changes included

Weight reduction greater than 5% (if needed)
Fat intake less than 30% of calorie intake
Saturated fat less than 10% of calorie intake
Fibre intake greater than 15grams/ 1000 calories
Exercise greater than 4 hours per week (brisk walking)

Carrying out this programme resulted in less diabetes by 58%

Are you eating healthy foods?
How often do you exercise?
Do you smoke?
Do you know your target weight?

B lood P ressure
140 / 80

Target :

Very good control of blood pressure is required!

Raised blood pressure can increase all complications
of diabetes
It is important that it is checked regularly
Tablets maybe taken to control blood pressure

vision
Loss of

Retinopathy progression

Microvascular disease

stroke

60
Heart failure

related death

any diabetes

UK Prospective Diabetes Study

Blood Pressure Control Study

Diabetes

related
endpoints

You may need to change what you eat and exercise more

0%

Aggressive blood pressure

control reduces the risk of
most complications in
Diabetes

24%

-30%

32%
P=0.004

-40%

37%
44%
P=0.019

56%

-60%

Any-70%
diabetes
problem

20

34%
P=0.004

P=0.009
P=0.013

-50%

Its as simple as that!

40
30

-10%
-20%

50

47%

10

P=0.004
P=0.004

Heart
Failure

Stroke

Remember your target is 140/80

Have you hit the bulls-eye?

C holesterol
This is the amount of fat in
blood

FAT
SERUM

Some blood fats are necessary to

provide important energy sources

BLOOD

Too much fat can cause you to be

overweight, making it much more
difficult to control your diabetes

How much fat does your blood

contain?
The optimal target for blood
cholesterol level is

SCANDINAVIAN SIMVASTATIN
SURVIVAL STUDY

This study showed that

long-term simvastatin
(cholesterol lowering drug)
therapy reduces chances
of dying and heart problems
in patients with diabetes

Proportion without major

Heart problems (%)

It can also cause heart problems

LESS THAN 5

100
80
55%

60

Risk
reduction

40
Simvastatin
Placebo

20

0
0

Number of years on simvastatin

Do you know what your level is?

Are you on target?

D iabetes C ontrol
Blood glucose needs to be kept within
a controlled range

47
This can be helped by regular blood
glucose monitoring at home and keeping
an accurate written record. Bring it to clinic!

What is HbA1c%?
This value tells you the amount of glucose
sticking to your blood over the last 60 days
It reflects how well your diabetes has been controlled

7.0%

The aim is to have a value of less than

What drugs help to control diabetes?

Metformin, Gliclazide, Glimepiride,
Pioglitazone , Rosiglitazone, Insulin and
many other drugs
UK Prospective Diabetes
Glucose Control Study
The UKPD study shows that good
glucose control can decrease the
risks of:

Heart attack by 16%

Cataract by 24%
Kidney problems by 33%

Risk of Diabetes Complications

10
9
8
7
6
5
4
3
2
1
0

>8
7 to 8

- >160
-

6 to 7
<6
140 to 150

130-140

Blood Pressure

HbA1c%

<130

Increasing

Are you in control of your diabetes?

What is your HbA1c%?

Eyes
Is Diabetes slowly stealing your vision?
How your eyes work
Your eye has a lens and an opening at the front,
which adjust to bring objects into focus on the
retina at the back of the eye.

The retina is made up of delicate tissue that is

sensitive to light rather like the film in a camera.
At the centre of the retina is the macula, which is
a small area about the size of a pinhead. It is vital
because it enables you to see fine detail.

A person with diabetes can have eye disease and not even know it until
serious, irreversible vision loss has occurred
The only way to diagnose early signs of diabetic eye disease is through a dilated
eye exam at least once a year
DIABETIC EYE DISEASE
Diabetic Eye Disease(Diabetic
retinopathy) is the commonest
Normal retina
Diabetic Retinopathy
cause of blindness under the age of 65
in the Western World
37% of diabetes patients have
retinopathy at diagnosis of diabetes
1500 new cases of blindness could be
prevented by yearly screening in UK
20 years after diagnosis 95% with Type
Macula
Optic Disc Fatty Haemorrhage
1 diabetes have retinopathy
Deposits
20 years after diagnosis 60% of patients
with Type 2 diabetes have retinopathy
Laser treatment can save eye sight
getting worse in 90% of patients

When was the last time you had

your eyes checked?

Feet
During a lifetime, your feet may walk the equivalent of four
times around the world!
To ensure that they continue their trip through life without
complaint, it pays to look after your feet!
People suffering from diabetes can often experience loss of sensation
in their feet. Even the smallest injury can lead to infection, which if
not treated promptly, may lead to serious complications.

It is important that you examine your feet regularly. You should

also feel inside all shoes for any seams or stitching which could
rub the foot and lead to problems.
It is important that you receive regular foot advice or treatment.

Foot Problems
15% of patients with diabetes will develop
foot ulcers due to nerve damage and reduced
blood flow
Foot ulcers come before 85% of amputations
in people with diabetes. Foot ulcers are the
commonest cause of amputation in the UK

Liverpool Diabetes Clinic: Foot Protection Programme

When patients with diabetes and foot deformities attended regular clinics with a
trained podiatrist and foot education, it was found that
At 2 years ulceration was reduced to 2.4% compared with 3.5%
Amputation was reduced by 3 times

When was the last time you had your feet checked?

Guardian Drugs
What are Guardian Drugs?
Guardian drugs are given to protect you from further diabetes
complications

ASPIRIN

30
% Decrease in Events

Diabetes UK recommends taking

aspirin to prevent against heart
problems in all diabetes patients
(greater than 30yrs) with any of the
following:
Heart attack, angina, high blood
pressure, eye problems, blood
vessel diseases and kidney
problems
Also if: Indo - Asian, overweight, high
cholesterol, Heart Disease risk
greater than 15%, family history,
history of heart disease, smokers

- 29%

25
20
15
- 14%

10
5
0
Any cardiovascular
problem

Heart Attack

ACE INHIBITORS
ACE - inhibitors are drugs that have a special role in preventing diabetic complications.
The HOPE study showed that one ace inhibitor, Ramipril reduced:

Heart Disease
Stroke
Kidney
Eye disease

The names of these drugs end in PRIL

Do you know if you are taking any of

the guardian drugs?

CHECKOUT

We hope you have enjoyed Diabetes Care 4 U! At your consultation

your concerns will be discussed. Any factors that are relevant in your
diabetes management will be highlighted.
Once learnt never forgotten, so make sure you know your

ABC of Diabetes Care!

Advice
Blood Pressure
Cholesterol
Diabetes Control
Eyes
Feet
Guardian Drugs
Thank you for participating in your Diabetes Care and Good Luck!

Diabetes Care 4 U! SCORE Card

SCORE

ADVICE: Stop smoking, close attention to diet, weight reduction and

exercise. Ensure diabetes education and regular follow-up with your
diabetes care team. Comply with recommended treatment.

If Not smoking

1 POINT

Weight normal or if
overweight and losing

1 POINT
1 POINT

If you exercise for more

than 4 hours per week
BLOOD PRESSURE: Know your blood pressure. In most
cases the ideal aim is less than 140/80.
CHOLESTEROL: Aim total cholesterol levels less than 5.0 mmol/l
or bad to good cholesterol ratio of less than 3. This is the LDLcholesterol divided by the HDL-cholesterol.

If BP l40/80 or less

1 POINT

If level is below 5

1 POINT

DIABETES CONTROL: The usual aim is for a HbA1c% less than or

equal to 7.0%. The HbA1c% is the amount of glucose that sticks to
your blood over the last 2 months.

If HbA1c% is equal to or
less than 7.5%

EYE Examination: Make sure that your eyes are looked at carefully
at least yearly after special eye drops have been put in. You should be
referred to an Eye Specialist if needed.

If you have your eyes

checked at least once a year

FEET Examination: You should check your own feet regularly and
seek advice if needed. Make sure that your feet are looked at
carefully at least yearly by a health care professional trained in
diabetic feet examination. You should see a podiatrist if problems are
identified.
GUARDIAN DRUGS:
Aspirin 75mg once daily: to protect against heart disease in all over
the age of 30 years with any of the following: previous heart attack,
angina, high blood pressure (once the pressure is less than 150/90),
diabetic eye disease, blood vessel disease of the legs, early kidney
disease, cholesterol problem, family history of heart disease, weight
problem, Indo-Asian and smokers. Side effects should be discussed.
ACE-inhibitors have a special role in preventing diabetic
complications in most patients with diabetes. Please discuss
this with your diabetes care team.

1 POINT
1 POINT

1 POINT
If you have your feet
checked yearly

If taking aspirin

1 POINT

If taking an ACE-inhibitor

1 POINT

GOLD

SILVER

BRONZE

8-10

6-7

4-5

HOW DID YOU SCORE?