Diabetes Presentation - Texas A&M Health Science Center

PRACTICAL TIPS FOR GETTING IT D.O.N.E.: DIABETES, OBESITY, NUTRITION, & EXERCISE

© 2020 by the Texas A&M School of Public Health, Center for Community Health Development, National Community Health Worker Training Center, DSHS Approved CHW Curriculum

CONTACT INFORMATION

Center for Community Health Development’s

National CHW Training CenterTexas A&M School of Public Health

1266 TAMU, College Station, TX 77843-1266

http://nchwtc.tamhsc.edu/

(979) 436-9360, [email protected]


http://nchwtc.tamhsc.edu/

mailto:[email protected]

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CALENDAR


GOALS AND OVERVIEW


1.Understand what diabetes is and the different types2.Be able to show patients how to control diabetes

3.Be knowledgeable about the process of testing

and insulin intake

4.Know how to prevent Type II and Gestational

diabetes5.Understand CHW role in aiding diabetes patients

THE BASICS: DIABETES

What is diabetes?


BASIC CONCEPTS: DIABETES

What do we know?

http://www.clker.com/cliparts/0/d/7/5/128267303072605009sugar-make-us-age-1-hi.png© 2020 by the Texas A&M School of Public Health, Center for Community Health Development, National Community Health Worker Training Center, DSHS Approved CHW Curriculum

http://www.clker.com/cliparts/0/d/7/5/128267303072605009sugar-make-us-age-1-hi.png

Age-Adjusted Prevalence of Obesity & Diagnosed Diabetes

Obesity (BMI ≥30 kg/m2)

Diabetes

1994

1994

2000

2000

No Data <14.0% 14.0-17.9% 18.0-21.9% 22.0-25.9% >26.0%

No Data <4.5% 4.5-5.9% 6.0-7.4% 7.5-8.9% >9.0%

2010

2010






Socioeconomic risk factors

Health behavior risk factors

Diagnosed diabetes


Socioeconomic risk factors

Health behavior risk factors

Diagnosed diabetes

THE FACTS


What’s the difference between Type I and Type II Diabetes?

Type I

Body doesn’t make enough insulin

Type II

Body can’t use insulin properly


Type I

Body doesn’t make enough insulin

Type I Diabetes

• Can develop at any age• No known way to prevent it 5-10%

of all diagnosed cases



Type 1 diabetes:

• Immune system attacks the cells that make insulin

•Type 1 diabetics need to take insulin


WHAT CAN YOU DO TO MANAGE TYPE I DIABETES?

If you have Type I Diabetes, you can’t prevent it. Your body automatically doesn’t make insulin.

BUT you can:

Work with a healthcare provider

Eat a healthy and balanced diet

Stay active


Type II

Body can’t use insulin properly

Type II Diabetes

• Can develop at any age• Most cases can be prevented 90-95%

of all diagnosed cases



Type 2 Diabetes

•Occurs over time

•Resistant cells

•May require medication

•Often controlled by diet & exercise


WHAT CAN YOU DO TO PREVENT OR DELAY TYPE II DIABETES?

If you have Type II Diabetes, or want to prevent yourself from getting it, there are steps you can take!

Lose weight if needed Eat a healthy and balanced diet

Be active


RISK FACTORS FOR TYPE II DIABETES

Being overweight

Family history

Being physically inactive

Being 45 or older

Things you can changeThings you can’t change



Glucose•Body’s main source of energy

•Comes from food we eat

http://www.clker.com/cliparts/0/d/7/5/128267303072605009sugar-make-us-age-1-hi.png© 2020 by the Texas A&M School of Public Health, Center for Community Health Development, National Community Health Worker Training Center, DSHS Approved CHW Curriculum

http://www.clker.com/cliparts/0/d/7/5/128267303072605009sugar-make-us-age-1-hi.png


Insulin•Hormone made in pancreas

•Allows glucose into the cell

•Needed for survival



Pancreas•Organ in the body

•Makes insulin & hormones


THE PROCESSFood turns into glucose in stomach, which moves to

pancreas that makes insulin,

which is then received by muscle

Food turns into glucose in stomach, but pancreas doesn’t

make any insulin. This makes it so

that the muscle can’t convert any into energy

Food turns into glucose in stomach, and pancreas makes

insulin, BUT it is not recognized

by muscle and muscle is not able to utilize it for energy


KEY AND LOCK

And if you don’t have a key at all, it won’t open!


VIDEO

Youtube.com/watch?v=wmOW091P2ew&t=61s



Hemoglobin A1C

•Blood test that gives average of blood sugar over 3 months

•Goal for diabetics is to have A1C <7%


HEMOGLOBIN A1C


• A1C test is usually preformed 2 times a year

• A1C can identify prediabetes

Glucose inbody sticks

to hemoglobin

A

Glucose remains stuck to

hemoglobin for up to 120

days

Test measures percent of

hemoglobin A with

glucose

A1C VS EAG

• eAG is Estimated Average Glucose

• Mirrors the glucose test most diabetics

use at home



Diagnosing Diabetes

•FPG test

FPG Results


Normal<100

mg/dL

Pre-

diabetes100-150

mg/dL

Diabetes126 mg/dL

or >

WHAT IS A GLUCOSE MONITOR AND WHAT IS IT FOR?

Tests blood sugarAlso called “glucometers”

Some diabetics have finger-prick glucose monitors, where it draws a small amount of blood and measures the blood sugar.

Most recently, many diabetics adopted the scanner, which is a patch that a person can scan to show blood sugar levels.


LOW BLOOD SUGAR

What if the monitor shows low blood sugar?

Diabetics usually are aware that they have low blood sugar

You should eat or drink quickly digested carbohydrate food, such as:

Fruit juice Hard candies Saltine crackers Sugar or honey


REAL TEST RESULTS (SHOWN WITH PERMISSION)


ACTIVITY: LET’S READ SAMPLES



Patient #1 AVERAGE LEVEL

240 mg/dL

A1C

10%

RISK OF

COMPLICATION

❑ HIGH❑ MODERATE

❑ LOW

HIGH


155 mg/dL

A1C

7%

RISK OF

COMPLICATION MODERATE


111 mg/dL

A1C

5.5%

RISK OF

COMPLICATION LOW


ACTIVITY: Risk of Diabeteshttps://www.diabetes.org/risk-test


VIDEO: MANAGING DIABETES FAMILY STYLE

Managing Diabetes Family Style – “My Almost Life” webisode: Meet Matt!

https://www.cdc.gov/diabetes/library/socialmedia/podcasts.htmlhttps://www.cdc.gov/diabetes/library/socialmedia/podcasts.html


https://www.cdc.gov/diabetes/library/socialmedia/podcasts.html

https://www.cdc.gov/diabetes/library/socialmedia/podcasts.html


Gestational diabetes

•May occur during pregnancy

•Often managed through diet; may require insulin

•Often goes away after baby is born

•A risk factor for type 2 diabetes

http://diabetesmyway.com/wp-content/uploads/2013/03/gestational-diabetes-diet -plan.jpg


http://diabetesmyway.com/wp-content/uploads/2013/03/gestational-diabetes-diet-plan.jpg

GESTATIONAL DIABETES

High blood sugar levels than normal during pregnancy


2-10%of pregnancies in the United States

GESTATIONAL DIABETES

Can be associated with a variety of risk factors, including:

Being over age 25

Being overweightHaving a close

relative with Type II Diabetes

Having PCOSHigh blood

pressure

Being pregnant with multiples

(twins, triplets)

Things you can’t change Things you can change




DIABETES

http://www.glasbergen.com/wp-content/gallery/diabetes/diabetes5.gif© 2020 by the Texas A&M School of Public Health, Center for Community Health Development, National Community Health Worker Training Center, DSHS Approved CHW Curriculum

http://www.glasbergen.com/wp-content/gallery/diabetes/diabetes5.gif

EXCUSES RELATED TO DIABETES

•There’s nothing I can do

•It’s genetic and I can’t avoid it.

•I can’t do that. I’m diabetic.

•I’m not REALLY diabetic

http://www.diabeticconnect.com/discussions/5930-excuses-excuses-excuses

http://ts1.mm.bing.net/th?&id=HN.608018707633340630&w=300&h=300&c=0&pid=1.9&rs=0&p=0


http://www.diabeticconnect.com/discussions/5930-excuses-excuses-excuses

http://ts1.mm.bing.net/th?&id=HN.608018707633340630&w=300&h=300&c=0&pid=1.9&rs=0&p=0


-It’s too hard to monitor my blood sugar every day.

-My medication & monitoring supplies are too expensive.



-I don’t have the energy to exercise.

-I have to eat often or my blood sugar will get too low.

http://www.glasbergen.com/wp-content/gallery/diabetes/diabetes8.gif© 2020 by the Texas A&M School of Public Health, Center for Community Health Development, National Community Health Worker Training Center, DSHS Approved CHW Curriculum

http://www.glasbergen.com/wp-content/gallery/diabetes/diabetes8.gif

RESOURCES FOR CHWS

CDC National Diabetes Statistics Report

https://www.cdc.gov/diabetes/pdfs/data/statistics/national -diabetes-statistics-report.pdf

Fast Facts

https://www.cdc.gov/chronicdisease/resources/publications/factsheets/diabetes-prediabetes.htm

Managing Medicines with Diabetes

https://www.cdc.gov/diabetes/ndep/pdfs/toolkits/working-together/152-all-medicines-matter.pdf

Diabetes and Pregnancy

https://www.cdc.gov/pregnancy/documents/Diabetes_and_Pregnancy508.pdf


https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf

https://www.cdc.gov/chronicdisease/resources/publications/factsheets/diabetes-prediabetes.htm

https://www.cdc.gov/diabetes/ndep/pdfs/toolkits/working-together/152-all-medicines-matter.pdf

https://www.cdc.gov/pregnancy/documents/Diabetes_and_Pregnancy508.pdf

RESOURCES FOR CHWS


HOW WE AS CHWS CAN HELP


Be educated on diabetes so we can

share information to the community

Have resources and know where to direct

people to resources

Be aware of diabetes groups and

physicians that are specific to disease

Be an advocate for patients with diabetes

or those that might get it

LET'S LOOK AT SOME CASE STUDIES!


BREAKOUT ROOMS


https://youtu.be/sLPX8tSP9VU

https://youtu.be/sLPX8tSP9VU

CASE STUDY INSTRUCTIONS

For each case study...

• Read the case study.

• Identify the health issues, behaviors, and excuses.

10 minutes

• After identifying the problems and excuses, write down the excuses and think of ideas for addressing the excuses.

• Next, develop a detailed plan/activity to address the health issues and to promote healthier behaviors.

10 minutes• Be prepared to share your

plan with the larger group.

10 minutes


BREAKOUT ROOMS

FacilitatorMaking sure the team is

addressing questions in a

timely manner

ReporterResponsible for

submitting answer on

Google Forms

https://forms.gle/JKRd3v

qk4iLuP85Z7


CASE STUDY 1: DIABETES


David Guzman is a 43 year old man that liveswith his wife, Maribel, and two kids who are 14 and 12 years old.

Every day David drives his kids to school, and during their lunch hour he buys a hamburger for each of them and for himself and he goes

to have lunch with them.

David works as a car sales man where he remains in his

office without stepping out until

he sees a client interested in buying a car. He never knows

when he will havea successful day and this causes

him a lot of stress. To de-stress, he

smokes at least three cigarettes a day.

Every day when he getsout of work, David goes

with his co-workers todrink a couple of beers

while his wife picks up hischildren from school.


After dinner and snowcones, the family sits towatch televisionwhilethe children work on

their homework.

At dinner time, David returns to eatwith his family. Maribel works all

week and doesn't always have time to cook, so three times a week

David takes his family to dinner at a pizza place and get snow cones

afterwards.


On weekends David oftengoes out at night with

his friends to bars to helprelieve the stress from the

week and before starting a new week.


Even though David'sbrother and his mother

have diabetes, he doesn'tthink he runs the risk of

getting it because he has never had to be taken tothe hospital and he feels

reasonably healthy.

David has never asked hisdoctor to check him for

diabetes because he thinks it'lltake too much time and he's

too busy to stay at the doctor'soffice for long. David is

content with is life and doesn'tthink a change is necessary.


BREAKOUT ROOMS

Now we'll break out into our breakout rooms for case study #1!


DISCUSSION

What are the health issues, behaviors, and excuses?

How can we address these health issues, behaviors, and excuses?

What plans/activities can we use to address these issues?



Laura is a 13 year old girl; she lives with her mom who is a single parent and with her three older brothers in a rural neighborhood. Since everything is so far away, they travel in a car everywhere they go.


Laura's mom has to work very early in the morning and doesn't have time to make breakfast before taking Laura and her brothers to school. At school, her favorite breakfast are the sweet items like pancakes with syrup and chocolate milk.

Laura likes to eat at school because no one forces her to eat her vegetables, which she hates. She doesn't l ike to drink water, either, because it has no flavor; her favorite drink is Coca-Cola.


During school Laura sits at her desk all day and during recess she prefers to sit and draw instead of running around and getting sweaty. After school, Laura has to quickly leave for home on the school bus.

Even though she would like to paly sports, her mom works really late and wouldn't be able to pick her up from school after practice.

When Laura gets home, if she doesn't find food already cooked, she will eat what she finds, which are usually potato chips, cake, candy, or cookies.



Laura and her brothers spend the afternoons playing on the PlayStation or the

computer while they wait for the ice cream truck to pass by so they could buy

ice cream, nachos or a snow cone.

When their mom gets home from work, Laura begins her homework. Once she's finished, she goes to bed. Laura knows that her mom has problems with her blood sugar but she's not too sure what this means because her mom has never explained it to her.

Laura hardly visits her doctor and believes that she is very healthy.


BREAKOUT ROOMS

Now we'll break out into our breakout rooms for case study #2!


DISCUSSION

What are the health issues, behaviors, and excuses?

How can we address these health issues, behaviors, and excuses?

What plans/activities can we use to address these issues?


FOR NEXT CLASS


1.Review all information and resources

given2.Look over available resources on website

and booklet3.Take pre-test if you haven’t already

4.Come ready to participate and ask

questions

REFERENCIAS (PRESENTACION)

•National Diabetes Statistics Report 2020: Estimates of Diabetes and Its Burden in the United States

•Centers for Disease Control and Prevention: Morbidity and Mortality Weekly Report (MMWR)

•A Snapshot of Diabetes in the United States

•Diabetes 2030: Insights from Yesterday, Today, and Future Trends• Rowley et. Al, 2016


QUESTIONS?

Contact Information

Denise [email protected]

(979) 436-9360

Paula Saldañ[email protected]

(956) 459-1031

Shea [email protected]

(316) 619-2008





Thank you!

Up next: Obesity


Documents

Diabetes Presentation - Texas A&M Health Science Center