Nursing 4604L Kimberly A. Rogers, RNJune 2013 DIABETES & HEART DISEASE Risk Factors & Prevention Diabetes & Coronary Heart Disease Risk Factors & Prevention

Nursing 4604LKimberly A. Rogers, RN June 2013

DIABETES & HEART DISEASERisk Factors & Prevention

Diabetes & Coronary Heart DiseaseRisk Factors & Prevention

1. Diabetes


Diabetes Disease Facts• Type I • Usually seen in children & young adults• Accounts for approximately 5% of cases

• Type II• Most common form in adults• Commonly the aged population and certain ethnic groups

• 25.8 Million People Have Diabetes• 27% of all people 65 and older have diabetes

(American Diabetic Association, 2013)


Diabetes Diagnosis

(American Diabetic Association, 2013)



Diabetes in Pasco County and the State of Florida

Adults Diagnosed with Diabetes(Percent of Adult Population)

(American Diabetic Association, 2013; Florida Department of Health, 2013)


U.S. Florida Pasco0.0%1.0%2.0%3.0%4.0%5.0%6.0%7.0%8.0%9.0%

10.0%8.3%

10.4%

8.5%

Adults Diagnosed with Diabetes – Long-Term Trend(Percent of Adult Population)

(Florida Department of Health, 2013)


2000 2005 20100.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

Florida Pasco

Average Age at Which Diabetes was Diagnosed



Florida Pasco4042444648505254565860

50

53

Diabetic Patients Who Check BloodGlucose at Least Once per Day



Florida Pasco59.0%60.0%61.0%62.0%63.0%64.0%65.0%66.0%67.0%68.0%

62.1%

67.7%

Diabetic Patients Who Have HadTwo A1C Tests in the Last Year



Florida Pasco72.0%

74.0%

76.0%

78.0%

80.0%

82.0%

84.0%

75.6%

82.4%

Diabetic Patients Who Had an AnnualFoot Examination in the Last Year



Florida Pasco71.5%

72.0%

72.5%

73.0%

73.5%

74.0%

72.2%

73.6%

Diabetic Patients Who Had an AnnualEye Examination in the Last Year



Florida Pasco66.0%

68.0%

70.0%

72.0%

74.0%

76.0%

78.0%

80.0%

70.2%

78.5%

2. Coronary Heart Disease


Coronary Heart Disease Facts

• 385,000 People In the U.S. Die Each Year from Coronary Heart Disease

• The Population of Pasco County is 468,000 People

• There are 935,000 Heart Attacks Each Year in the U.S.

• Coronary Heart Disease Costs the U.S. Economy Approximately $1.89 Billion Dollars Each Year

(Centers for Disease Control and Prevention, 2013)



Coronary Heart Disease in Pasco Countyand the State of Florida

Percentage of People with Cardiovascular Disease



Florida Pasco0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

10.2%

12.4%

Coronary Artery Disease & Anatomy

(Drchandler.com, 2005)


Coronary Artery Disease Progression

(Bean et al, 2006)


3. Diabetes & Coronary Heart Disease


Diabetes & Coronary Heart Disease

• Adults with Diabetes are 2 to 4 Times More Likely to Have Heart Disease

• The American Heart Association Considers Diabetes to be One of the Controllable Risk Factors for Cardiovascular Disease

• People with Diabetes Often Have Other Risk Factors that Increase the Chance of Developing Cardiovascular Disease

(American Heart Association, 2012)


Other Risk Factors for Coronary Heart Disease

• Hypertension

• Elevated Cholesterol & Triglyceride Levels

• Obesity

• Sedentary Lifestyle

• Poorly Controlled Blood Sugar

• Smoking



Signs & Symptoms of Coronary Heart Disease• Chest Pain (squeezing, pressure, or heaviness)

• Pain in Shoulders, Arms, Neck, Jaw, or Back

• Persistent Indigestion or Nausea

• Fatigue and Weakness

• Shortness of Breath

• Sweating

• Lightheadedness

(Centers for Disease Control and Prevention, 2011)


Signs & Symptoms of CoronaryHeart Disease in Diabetics

• Diabetic Nerve Damage Can Interfere with Pain Signals in the Body

• Diabetics Can Have Some or All of the Typical Symptoms

• Some Diabetics May Have a Heart Attack without Symptoms

• When in Doubt, Always Call 9-1-1

(National Institutes of Health, 2011)


Prevention: Controlling Modifiable Risk Factors• Hypertension

• Comply with medications

• Reduce salt intake

• Maintain a healthy weight

• Limit alcohol

• Manage stress



Prevention: Controlling Modifiable Risk Factors• Elevated Cholesterol & Triglycerides

• Adopt a heart healthy diet

• Increase physical activity

• Take any cholesterol medications as directed by your doctor

• Obesity & Sedentary Lifestyle• Exercise at least 30 minutes a day – can be broken into three

10-minute sessions

• Adopt a heart healthy diet



Prevention: Controlling Modifiable Risk Factors• Poorly Controlled Blood Sugar

• Perform blood sugar checks as recommended by doctor

• A1C Checks

• Medications: insulin or oral medications taken as directed

• Diet & Exercise

• Smoking• There are many options & resources available for smoking

cessation



Resources for Success

• American Heart Association – www.heart.org

• American Diabetes Association – www.diabetes.org

• Tobacco-Free Florida – www.tobaccofreeflorida.com

• Florida Quit Line – www.doh.state.fl.us/Tobacco/quitline.html


http://www.heart.org/

http://www.diabetes.org/

http://www.tobaccofreeflorida.com/

http://www.doh.state.fl.us/Tobacco/quitline.html

Quiz1. You’re just not feeling “yourself” today. Which one of

the following “sensations” should send you rushing directly to the emergency room?A. A sudden, strange desire to fill out an insurance form

B. An uncomfortable, squeezing pain in the middle of your chest

C. A long tone ringing in either of your ears

D. A tickling sensation on the bottoms of your feet



Quiz1. You’re just not feeling “yourself” today. Which one of

the following “sensations” should send you rushing directly to the emergency room?CORRECT ANSWER:

B. An uncomfortable, squeezing pain in the middle of your chest



Quiz2. Just because you feel a heart attack warning sign does

not mean you are actually having a heart attack. People feel these quirky sensations all the time. Save yourself some trouble. Wait until you have a few of the signs and in more rapid successionA. Good advice.

B. Bad advice.



Quiz2. Just because you feel a heart attack warning sign does

not mean you are actually having a heart attack. People feel these quirky sensations all the time. Save yourself some trouble. Wait until you have a few of the signs and in more rapid succession.CORRECT ANSWER:

B. Bad advice.



Quiz3. There’s a reason it is called a “heart” attack. The

warning signs all center on your “heart.” The idea that symptoms may occur in other parts of the upper body, such as the arms, back, neck, jaw, or stomach, is pure myth.A. True

B. False



Quiz3. There’s a reason it is called a “heart” attack. The

warning signs all center on your “heart.” The idea that symptoms may occur in other parts of the upper body, such as the arms, back, neck, jaw, or stomach, is pure myth.CORRECT ANSWER:

B. False



Quiz4. Shortness of breath is a warning sign for a heart

attack when:A. You experience a particularly beautiful wonder of nature

such as the Grand Canyon.

B. You walk through the “smokers’ patio” on your way into an office building from the parking lot.

C. You are also feeling some discomfort or pain in your chest.

D. You aren’t feeling anything strange in your chest except shortness of breath

E. C and D.



Quiz4. Shortness of breath is a warning sign for a heart

attack when:

CORRECT ANSWERE. C and D.



Quiz5. Which of these is NOT considered a heart attack

warning sign:A. Cold sweats.

B. Nausea.

C. Ice cream cravings.

D. Lightheadedness.



Quiz5. Which of these is NOT considered a heart attack

warning sign:

CORRECT ANSWERC. Ice cream cravings.



Quiz6. If you are experiencing any of the common signs of a

heart attack (chest pains, shortness of breath, discomfort in areas of the upper body, etc.), what is the fastest way to begin life-saving treatment:A. Call 9-1-1 immediately.

B. Get someone to drive you to the emergency room now.

C. Drive yourself to the emergency room now.

D. Turn your “Bat Finder” to the northern sky & put out a call for Batman!



Quiz6. If you are experiencing any of the common signs of a

heart attack (chest pains, shortness of breath, discomfort in areas of the upper body, etc.), what is the fastest way to begin life-saving treatment:

CORRECT ANSWERA. Call 9-1-1 immediately.



Questions & Answers



ReferencesThe American Diabetic Association (2013). Retrieved from www.diabetes.org .

The American Heart Association (2012). Retrieved from www.heart.org .

Bean, C.A., et al (2006). Image. ACC Atlas of Pathophysiology, 2nd Edition.

Philadelphia: Lippincott & Wilkins.

Centers for Disease Control and Prevention (2013). Heart Disease Facts. Retrieved

from http://www.cdc.gov/heartdisease/facts.htm.


http://www.diabetes.org/

http://www.heart.org/

http://www.cdc.gov/heartdisease/facts.htm

ReferencesFlorida Department of Health. (2013) Retrieved from www.Floridacharts.com.

Drchandler.com (2005). Image. Retrieved from http://

drchander.com/diagnoseCAD.html.

National Institutes of Health (2011). What Are the Signs and Symptoms of Diabetic

Heart Disease? Retrieved from http://

www.nhlbi.nih.gov/health/health-topics/topics/dhd/signs.html.


http://www.floridacharts.com/

http://drchander.com/diagnoseCAD.html

http://drchander.com/diagnoseCAD.html

http://www.nhlbi.nih.gov/health/health-topics/topics/dhd/signs.html

http://www.nhlbi.nih.gov/health/health-topics/topics/dhd/signs.html

Documents

Nursing 4604L Kimberly A. Rogers, RNJune 2013 DIABETES & HEART DISEASE Risk Factors & Prevention Diabetes & Coronary Heart Disease Risk Factors & Prevention