Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
How to find your way around … You can play the PowerPoint and the Test here. START FINISH How to find your way around … Always click the ‘home’ icon to save your progress and log off. This is important! START FINISH Diabetes Awareness Level 1 is aimed at all clinical staff. START FINISH Objectives The objective of this lesson is to give an overview of diabetes. Along with the basic principles of managing the care of a person with diabetes. At the end of this lesson you should have an understanding of:o o o o o What diabetes is and the signs and symptoms Medication and treatment Nutrition and Diet Where to find additional help / information within the Trust Identification and treatment of hypoglycaemia START FINISH Introduction What is diabetes? Diabetes is a common life-long health condition, where the amount of glucose in your blood is too high because the body cannot use it properly. This is either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced. Insulin is the hormone produced by the pancreas that allows glucose to enter the body’s cells, where it is used as fuel for energy so we can work, play and generally live our lives. Within the UK there are over 3 million people that have been diagnosed with diabetes with research also estimating that there are also nearly a million people that are unaware that they have the condition. START FINISH Type 1 Diabetes Type 1 diabetes often develops before the age of 40. In type 1 diabetes, the pancreas (which is the small gland behind the stomach) does not produce any insulin. Insulin being the hormone that regulates blood glucose levels. If the amount of glucose in the blood is too high, it can damage the body's organs. If a person has type 1 diabetes, they will need to take insulin injections for life. START FINISH Question Continue Type 1 Diabetes is treated with… Tablets START Insulin FINISH Type 2 Diabetes Type 2 diabetes develops when the body can still make some insulin, but not enough, or when the insulin that is produced does not work properly (known as insulin resistance). Type 2 diabetes usually appears in people over the age of 40, with a greater prevalence among the Asian and Afro-Caribbean community. It is also becoming more common in children, adolescents and young people. It my be possible to control the symptoms by altering the persons lifestyle, such as controlling their diet and regular exercise. Type 2 diabetes is a progressive condition, that can lead to the person requiring medication to keep their blood glucose at normal levels. This will usually take the form of tablets, but later on it may include injected therapies. This type of diabetes accounts for between 85 and 95 per cent of all people with diabetes within the UK. Diabetes Types In addition to Type 1 and Type 2, there are other types of diabetes. The most common are: o Gestational diabetes - Gestational diabetes mellitus (GDM) is a type of diabetes that arises during pregnancy (usually during the second or third trimester). In some women, GDM occurs because the body cannot produce enough insulin to meet the extra needs of pregnancy. o Steroid induced diabetes – High blood glucose levels whilst taking steroids, which may subside once the steroids are stopped. However, some people will develop type 2 diabetes. We will focus on type 1 and type 2. START FINISH Signs and Symptoms Blurred vision Increased thirst and frequent urination In Type 2 diabetes the signs and symptoms may not be so obvious, as the condition develops more slowly over a period of time. Feeling tired or ill Recurrent skin, gum or bladder infections Increased risk of fungal infections Dry, itchy skin Unexpected weight loss Slow healing cuts or bruises Loss of feeling in the feet or tingling feet START FINISH Diagnosis of Diabetes Diabetes is diagnosed when… Fasting blood glucose is higher than 7.0mmol/l or A random plasma blood glucose is higher than 11.0mmol/l Diabetes can also be diagnosed with an Oral Glucose Tolerance Test or HbA1c (blood test). The term HbA1c refers to glycated haemoglobin. It develops when haemoglobin, a protein within red blood cells, joins with glucose in the blood, becoming 'glycated'. By measuring glycated haemoglobin (HbA1c), we are able to get an overall picture of what our average blood sugar levels have been over a period of weeks/months. Ref WHO. START FINISH Question Continue What range is considered as a normal blood glucose level? START 0-5 mmol/l 4-8 mmol/l 5-9 mmol/l 5-10 mmol/l FINISH Treatment Successful treatment can make all the difference to long-term health, and achieving a balanced diabetes treatment is key to living with all types of diabetes. Treatment varies for each individual, and is not based solely on the type of diabetes that they have. Treatment of Type 1 diabetes Type 1 treatment requires insulin with dose adjustment to match diet and lifestyle. Treatment of Type 2 diabetes Treatment typically includes diet, exercise and medication. Type 2 is a progressive condition, often requiring insulin once lifestyle and other medications have not achieved target blood glucose levels. All should be offered a structured education programme. START FINISH Treatment Please click on the arrows below: Diet and lifestyle Healthy eating, regular exercise, alcohol intake, weight management and smoking cessation. Oral Medication Examples include Metformin, Gliclazide and Sitagliptin. GLP1 eg. Byetta and/or insulin Injectable Therapies Continue START FINISH Diet and Nutrition Food choices that are made impact on the management of diabetes and a persons longterm health. It is recognised that there are some key messages that help in the management of diabetes, these are:o Eat three meals a day - Avoid skipping meals and space the meals out over the day, as this helps control the blood glucose levels o Include starchy carbohydrate foods – such as bread, pasta, chapattis, potatoes, yam, noodles, rice and cereals. The amount of carbohydrates are important to control the blood glucose levels o Cut down on fat consumed in particularly saturated fats - use unsaturated fats or oils, especially monounsaturated fat (eg olive oil and rapeseed oil) o Eat more fruit and vegetables - help with the overall diet o Limit sugar and sugary foods - to reduce the sugar consumption o Drink alcohol in moderation only Lifestyle changes Changes that can be made in every day life to help control diabetes and reduce the risk of developing complications are:o o o o o Healthy diet Stop smoking Losing weight and reducing waist size Alcohol intake is within acceptable limits Increasing physical activity START FINISH Question Continue People with diabetes should avoid eating bananas. True START False FINISH Hypoglycaemia Some of these symptoms are more visible than others. A ‘hypo’ (Hypoglycaemia) is triggered when blood glucose levels fall below 4 mmol/l. Common symptoms include (please click on the pictures): SHAKING DIZZINESS SWEATING Continue START HUNGER ANXIOUS FINISH Hypoglycaemia Some of these symptoms are more visible than others. More common symptoms include (please click on the pictures): PALLOR IMPAIRED VISION Continue START IRRITABLE, BEHAVIOURAL CHANGES WEAKNESS, FATIGUE FAST HEARTBEAT FINISH HEADACHE Question Continue Which of the following is NOT a sign of hypoglycaemia? START Pallor Irritability Thirst Sweating FINISH Hypoglycaemia – what should I do? If possible check blood glucose but do not delay in treatment. NOTE: If your patient is semi or unconscious, DO NOT GIVE FLUID BY MOUTH. Dial 999 immediately or contact a doctor. TREATMENT OF HYPOGLYCAEMIA Give a quick acting carbohydrate ie. Glucose as 90-120ml LUCOZADE OR 3-5 GLUCOSE TABLETS eg. Dextrosol OR 1-1½ tubes GLUCOGEL OR 3-4 teaspoons sugar (in water or squash) NOT milk NOT food supplements OR 150-200ml orange juice or regular coca cola If possible, check blood glucose after 10-15 minutes. If still below 4mmol/l, repeat the above treatment and seek medical advice. Once symptoms have passed and blood glucose has risen above 4 mmol/l, give a small snack e.g. biscuit, toast, cereal or if it is a meal time, give normal meal with normal insulin/tablet dose. Note: Hypoglycaemic incidents and treatment must be recorded in the patients’ notes START FINISH Possible Complications Eye damage (Retinopathy) Vascular disease- Cardiovascular, Cerebral, Peripheral (leading to heart attacks, stokes and amputations) Kidney damage (Nephropathy) sometimes requiring dialysis or transplantation Nerve damage (Neuropathy) START FINISH Foot Care Foot care is incredibly important as foot related complications are common for those with diabetes. Foot ulcers for example, which affect as many as 1 out of 10 people with diabetes, can all to easily develop from blisters and small wounds too posing a threat of amputation. It is recommended that:Apply moisturiser to keep the skin supple Feet are washed daily and are dried carefully Cut toe nails straight across and file the corners. Do not cut down the sides or cut too short. Any breaks in the skin should be covered with a dry sterile dressing and seek advice from a podiatrist. START Look for signs of infection, red or swollen areas. Do not cut corns or callouses, refer to podiatry. FINISH Avoid walking barefoot. SEPT Teams Within the Trust there are several teams that will be able to help and advise you further on Diabetes, treatment and Trust procedures. Please log onto the intranet and search diabetes using the search SEPT.net facility: For team information please click on Diabetes. For links, click on Links for Diabetes. START FINISH Remember, if you want to find more information / evidence about this subject or anything else which is relevant to your work or study, join your local healthcare library. For staff in Essex contact Basildon Healthcare Library. www.btuheks.nhs.uk [email protected] 01268 524900 EX3594 It may be that you work in a different area, for example Luton. Details of all the Health Libraries in the East of England can be found at this site… www.eel.nhs.uk You are welcome to join any of these. START FINISH Review of Objective(s) Before completing the test, please ensure you have acquired the relevant knowledge against the modules objective(s) below: “The objective of this lesson is to give an overview of diabetes. Along with the basic principles of managing the care of a person with diabetes. At the end of this lesson you should have an understanding of:o o o o What diabetes is and the signs and symptoms Medication and treatment Nutrition and Diet Where to find additional help / information within the Trust o Identification and treatment of hypoglycaemia” If not, please take this opportunity to revisit the presentation content. CONTINUE START FINISH Progression Are you likely to advise on or administer insulin? Yes No Upon completing the Level 1 test, please complete the Level 2 Diabetes Awareness course as part of your professional accountability. Please complete the test for Level 1 Diabetes Awareness. Continue START FINISH You now need to take the test! Remember to click the ‘home’ icon when you have finished the test to save your results! START FINISH