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Treatment

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Treatment Powered By Docstoc
					 LA Sheehan, Francine Coxon, Katie
Chisholm, Jon Chien, and Brooke Cable
        General Overview
very serious, chronic disease
one of the leading causes of death in
Canada
presently, over 2 million Canadians
expected rise to 3 million in 2010
epidemic
         What is Diabetes?
body cannot properly store/use food for fuel
Insulin
  hormone
  Produced by beta cells in the pancreas
  Allows glucose to move from blood stream into
  muscles to be used in energy production
In diabetes insulin is produced in insufficient
amounts, or it is produced but cannot be used
properly
       Types of Diabetes
Type 1 (insulin-dependent or
juvenile diabetes)
 body mistakes beta cells for foreign
 bodies and destroys them, so they
 can no longer produce insulin
 daily injections of insulin are
 required
 Most often seen in children and
 young adults
 Only 10% of all those with diabetes
         Types of Diabetes
Type 2
   pancreas no longer able to meet demand for
   insulin and/or the body can no longer use
   insulin properly
   most often seen in adults (increasing rates of
   childhood obesity causing growth of type 2 in
   children and young adults)
   almost 90% of all cases
         Types of Diabetes
Gestational Diabetes
   temporary condition during pregnancy
   occurs in 3.5 - 3.8% of all pregnancies
   Increases risk for developing other types later
   in life for both mother and child
          Complications
All types involve an inability to store
glucose, and lead to increased blood
glucose levels
high blood sugar can lead to complications
and huge damage to the body
Common complications – heart disease,
kidney disease, nerve damage, vision
problems/blindness, impotence, and
        amputations
               Causes?
Although it is known that diabetes is due to
insufficient or ineffective insulin, it is not
known what causes the body to attack the
insulin producing cells or what causes the
pancreas to be unable to meet the
demands.
However, many factors which increase the
risk of developing diabetes have been
identified…
 Risk Factors for Developing
       Type I Diabetes
Genetics (non-modifiable)
Increased risk if mother experienced
gestational diabetes
      Risk Factors for Developing
            Type II Diabetes
Being:
   Age 40 or older
   A member of a high-risk ethnic group (Aboriginal, Hispanic, Asian, South
   Asian, or African descent)
   Overweight (especially if weight is carried around the middle)
Having:
   A parent, or sibling with diabetes
   Giving birth to a baby that weighed more than 4kg (9lb) at birth
   Had gestational diabetes during pregnancy
   Impaired glucose tolerance (IGT) or impaired fasting glucose (IFG)
   High blood pressure
   High cholesterol or other fats in the blood
Having been diagnosed with:
   Polycystic ovary syndrome
   Acanthosis nigricans (darkened patches of skin)
   Schizophrenia
          Gestational Diabetes

Risk Factors for Developing Gestational Diabetes
  A previous diagnosis of GDM
  Age over 35 years
  Obesity
  A history of polycystic ovary syndrome
  Hirsutism (excessive body and facial hair)
  Acanthosis nigricans (a skin disorder characterized by
  the appearance of darkened patches of skin)
  Being a member of a population considered to be at high
  risk for diabetes, including women of Aboriginal,
  Hispanic, South Asian, Asian or African descent.
   Subjective Assessment:
Signs & Symptoms of Diabetes
Unusual thirst
Frequent urination
Weight change (gain or loss)
Extreme fatigue or lack of energy
Blurred Vision
Frequent or recurring infection
Cuts and bruises that are slow to heal
Tingling or numbness in the hands or feet
Trouble getting or maintaining an erection
Special Note: Some people do not have early
warning signs of low blood sugar.
         Type I Diabetes
Signs & Symptoms of High Blood Sugar
  (Hyperglycemia Above 11 mmol/L)

 Abnormal thirst
 Increased urinate
 Increased exhaustion
Signs & Symptoms of Low Blood
            Sugar
                     (Below 4 mmol/L)
 Hunger
 Shakes or light-headedness
 Nervous or irritable
 Sweaty
 Weak
 Nauseous or dizziness
 Faster heart rate
 Confusion
 A numbness or tingling in tongue or lips
 Difficulty with concentration, seeing or speaking
 Headache
 Experience mood changes
Signs & Symptoms of Very Low
         Blood Sugar
Confusion and disorientation
Loss of consciousness
Seizures
 Causes of Low Blood Sugar
      (Hypoglycemia)
Not eating enough food
Missing or delaying a meal
Exercising without taking the necessary
precautions
Taking too much insulin
Drinking alcohol
        Type II Diabetes
Signs & Symptoms of High Blood Sugar
  (Hyperglycemia Above 11 mmol/L)
  Abnormal thirst
  Increased urinate
  Increased exhaustion
Signs & Symptoms of Low Blood
    Sugar (Below 4 mmol/L)
 Shaky, light-headed
 Nervous, irritable
 Confused
 Hungry
 Faster heart rate
 Sweaty, headachy
 Weak
 A numbness or tingling in your tongue or lips
Signs & Symptoms of Very Low
         Blood Sugar
Confusion and disorientation
Loss of consciousness
Seizures
 Causes of Low Blood Sugar
      (Hypoglycemia)
More physical activity than usual
Not eating on time
Eating less than normally required
Taking too much medication
Drinking alcohol
    Objective Assessment:
  Complications of Type I & II
           Diabetes
When patients present with specific signs and symptoms
related with possible injuries, the Kinesiologist must be
aware of the underlying problems associated with
diabetes.
If positive neural signs are found during an objective
assessment, it may be caused by and injury itself or from
complications related to diabetes.
Digestive Problems
  It is estimated that between 30 and 50 percent of all
  people with diabetes will have some sort of problem with
  their gastrointestinal (digestive) tract and is linked to how
  long a person has had diabetes, their blood sugar
  control, the presence of other diabetes complications,
  cigarette smoking, and a lower level of HDL cholesterol.
Warning Signs: The most common signs of gastroparesis
  are nausea and vomiting. Other symptoms include heart
  burn, constantly feeling full, getting full easily once you
  start to eat, slight abdominal pain and abdominal
  bloating. Some people may also have symptoms that
  note the presence of generalized autonomic neuropathy,
  such as impotence, abnormal sweating or dizziness on
  rising due to orthostatic hypotension (low blood pressure
  that develops when a person stands).
Foot Ulcers
  There are approximately two million persons in Canada
  with diabetes. It is estimated that 4-10% of those with
  diabetes will develop a foot ulcer. The numbers get
  even worse because statistics show that 14-24% of
  those persons with diabetes and foot ulcers will require
  amputation (either a partial foot amputation or a leg
  amputation) because the ulcer won't heal.
Risk Factors:
  Neuropathy or loss of feeling is the single biggest risk
  factor for developing a foot ulcer.
  Foot deformity
  Prior history of foot ulcers
  Loss of circulation.
Hypothyroidism
  Studies have shown that the incidence of hypothyroidism seems to
  be increased in both people with type 1 and type 2 diabetes,
  especially women over the age of 40.
Symptoms:
  Fatigue
  Hair loss
  Weight gain
  Constipation
  Listlessness and depression
  Memory loss and mental 'dullness'
  Muscle and joint pain
  High cholesterol levels
  Feeling cold (when no one else is)
  Husky voice
  Dry skin
  In women, heavy menses
Sexual Dysfunction
  Enough said!
Diabetic Retinopathy
  There are two types of diabetic retinopathy, non-
  proliferative or proliferative (background). Non-
  proliferative diabetic retinopathy is the most
  common form of blood vessel damage in the eye
  due to diabetes. It accounts for about 80 percent
  of all cases.
  About one-third of all diabetics have diabetic
  retinopathy.
Dry Skin
  Diabetes affects many body organs, including the largest
  of the body, the skin. Dry skin (also called xerosis or
  asteatosis) is one of the numerous dermatological
  problems associated with diabetes. Some skin
  conditions are specific to diabetes, but most of them also
  occur in the general population. In addition, the clinical
  symptoms and complications of skin disease are
  frequently more severe in the context of diabetes.
Potential Effects:
  It can cause intense itching and irritation;
  It can lead to secondary infection, localized folliculitis
  (inflammation of the hair follicles on the skin) or even
  cellulitis;
  It can lead to ulceration particularly on diabetic feet with
  loss of sensation.
     Treatment



   Unfortunately,
THERE IS NO CURE!
                Treatment
Education
   Diabetes education is an important first step.
   All people with diabetes need to learn about
   their condition in order to make healthy
   lifestyle choices and manage their diabetes
               Treatment
Physical Activity
   Regular physical activity helps your body
   lower blood glucose levels, promotes weight
   loss, reduces stress and enhances overall
   fitness.
                Treatment

Nutrition
     What, when and how much you eat all play
     an important role in regulating how well your
     body manages blood glucose levels.
               Treatment
Weight Management
    Maintaining a healthy weight is especially
    important in the management of type 2
    diabetes.
               Treatment
Medication
    Type 1 diabetes is always treated with
    insulin. Type 2 diabetes is managed through
    physical activity and meal planning and may
    require medications and/or insulin to assist
    your body in making or using insulin more
    effectively.
               Treatment
Lifestyle Management
    Learning to reduce stress levels in day-to-
    day life can help people with diabetes better
    manage their disease.
               Treatment
Blood Pressure
    High blood pressure can lead to eye
    disease, heart disease, stroke and kidney
    disease, so people with diabetes should try
    to maintain a blood pressure at or below
    130/80.To do this, you may need to change
    your eating and physical activity habits
    and/or take medication.
           Role of Kinesiologist
Prevention (type II)
  Educate clients on unhealthy lifestyle habits that could
  lead to type II diabetes
Identification
  Be able to spot the signs of diabetes
  Refer to physician for blood or any other necessary
  diagnostic tests
Management
  Healthy lifestyle choices
  Exercise
  Referrals to specialists, i.e., nutritionist, podiatrist,
  optomitrists
      Three Exam Questions
What are the three types of diabetes?
  – Type 1
  – Type 2
  – Gestational
       Three Exam Questions
What are three signs or symptoms of diabetes?
    Unusual thirst
    Frequent urination
    Weight change (gain or loss)
    Extreme fatigue or lack of energy
    Blurred Vision
    Frequent or recurring infection
    Cuts and bruises that are slow to heal
    Tingling or numbness in the hands or feet
    Trouble getting or maintaining an erection
      Three Exam Questions
What are the three roles of the
 Kinesiologist?
  – Prevention
  – Identification
  – Management

				
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