DIABETES AND EXERCISE

Like everyone else,people with diabetes have different levels of physical fitness,some exercise regularly,others only sometimes,and many not at all an exercised body is a healthier body.
If possible,exercise should became a part of your dailly routin.
Physical activity can help you manage your weight,lower your blood sugar levels,and improve yuor strength and muscle tone.It can even help you cope with stress.
Heart,lungs,blood pressure,blood glucose,cholesterol,bowel-you name it-everything works better with a good exercise plan.
If you are diabetes client,exercise has a positive affect on how you balance your medication and food intake.

STEP ONE-PLAN
First you see doctor before making any change to your normal activity.

• With the help of your diabetes educator,plan an exercise routine that you will enjoy.
• Find yourself an exercise partner.Exercise is much more enjoyable when working out with someone else,and also serves as a motivation to stick to a program.
• Exercise can be as simple as a short walk,or working around the house or garden.

STEP TWO-KEEP IT SIMPLE
You will not need special or costly equipment and you will be able to easily fit your exercise schedule into your working day.Remember exercise can be as simple as taking daily walk for 30 minute.
Enroling in group exercise is a good way of not only getting your body in shape but also getting out and meeting people.
Exercise can be fun-but it can be boring-and that is when we start making exuse to skip a session,so take the time to think it through,and try diffrent form of exercise.Dancing,swimming,tennis and bowling are all fun thing to try.What key is to find something you enjoy.

STEP THREE-PACE YOUR SELF
How often you exercise is,of course up to you -but there are some guidlines obout getting the most benefit from what you are doing-in particular,exercise should be regular activity.
Not everyone can or want to exercise every day so it is important to start exercise program at the pace that you feel comfortable with and that you can maintain that level.
The rule of thumb for those starting a new program is to exercise three times per week on alternate days.However,if exercising only twice a week is more realistic to you,that is where you need to start.

STEP FOUR-IT IS NO OLYMPICS
Ideally we should exercise anywhere from 15 to 60 minutes at a time-depending on our level of fitness.If you can manage 15 minutes to start out with,that is very good.it does not have to be at the same level of intensity for entire period of time.

Just listen to your body and adjust the intensity to keep you going at comportable pace.A good way of measuring how hard you are working is to use ypur heart rate as an indicator.While everyone has a diffrent maximumheart rate,a good overall average has been calculated at 220 beats per minute.

DIABETIC RETINOPATHY

Diabetic retinopathy is the most common form of diabetic eye disease but further complications such as cataracts and glaucoma also affect diabetic.all people having diabetes should have a dilated eye examination at least once every year.Diabetic retinophaty occurs when changes in blood glucose levels cause changes in retinal blood vessels.

RISK FACTOR OF DIABETIC RETINOPATHY

• High levels of blood glucose
• Hypertension
• High lipid profile levels
• Pregnancy
• Diabetic Kidney disease

The symptoms of each stage and how they present

1. Preclinical stage :in this stage are symptomless so they are not detected early.Without regular check of their blood sugar and opthalmic examination,they progress into more complicated stage.
2. Nonproliferative retinopathy :is condition in which the small capillaries in the retina break and cause macullar oedema.The fluid make maculla swell,causing blured vision.
3. Proliferative retinopathy:occur of the when demage to the retina causes new blood vessel grow abnormally.These vessels also bleed easily into the inner part of the eye causing blurred vision and dark spots that appear to the float in the vision and eventually destroy the retina.
4. Late proliferative retinopathy-severe visual loss is noticed and on examination.Retinal detachment may be noticed sometimes.More new blood vessel are seen in the retina.

THE DIAGNOSIS OF DIABETIC RETINOPATHY

• VISUAL ACUITY TEST this eye chart measures how well you see at various distances
• DILATED EYE EXAM drops are put to dilate or widen the pupil to check retina for early sign of disease,which include leaking blood vessels,demage optic nerve tissue and any changes in the blood vessels in the eye.
• TONOMETRY an instrument which measures the pressure inside the eye-numbing drops may be applied prior.
• FLOURESCEIN ANGIOGRAM-to know the extent of diabetic retinopathy.The opthalmologist injects a special dye into a vein,when the dye reaches the retinal vein trough circulation,photographs show any leaking blood vessels.

TREATMENT FOR DIABETIC RETINOPATHY

1. Laser photocoagulation to seal demaged or abnormal blood vessels and prevent them from leaking.
2. Virecomy is a surgical procedure that is perfomed to remove the clauded vitrues gel in the center of the eye.This treatment has a very high success rate for improving vision.

COMPLICATION OF DIABETIC RETINOPATHY

• VTREOUS HAEMORRAGE
• TRACTION RETINAL DETACHMENT
• NEOVASCULAR GLAUCOMA

source:nursing orientation DDC;presented by SHIELA.

BODY MASS INDEX-BMI

EASY TIPS TO KNOW HIGH RISK OR NO HIGH RISK FOR TYPE 2 DIABETES

• Body mass index(BMI) is height/weight formula used by health and weight professionals around the world to assess a person body weight
• BMI equals a person weight in kilograms devided by height in meter squared.Or: BMI=kg/m2.

BMI CLASSIFICATION

• UNDERWEIGHT<18.5
• NORMAL WEIGHT 18.5-24.9
• OVERWEIGHT 25-29.9
• OBESITY=>30
  
• EXTREME=>40

JUST CHECK YOUR BMI NOW!!!whether you include high risk for type 2 diabetes or NO.

From nursing orientation DDC:presented by ETNA.S

Diabetic foot ulcer

WHAT IS DIABETIC FOOT?

Diabetic foot is ulcer which locate in the foot of people who has got diabetes either type 1 or type 2.neurophaty and vascular disorder such as artherosclerosis can affect foot to get ulcer caused lost of sensation and poor blood supply.

MONOFILAMENT 10gr NEUROPHATY TEST

PERIPHERAL NEUROPHATY

Nuerophaty can cause inability to feel pain,heat and cold.People with diabetes suffering from neurophaty can develop minor cuts,scrapes,blister or pressure sore that they may not be aware of due to the

insensitivity.

If these minor injuries are left untreated,complication may result and lead to ulceration and possibly even amputation.neurophaty also can cause deformities such as bunion,hammer toes and charcot feet.

PERIPPHERAL VASCULAR DISEASE

Diabetes can lead peripheral vascular deaseas that inhibit a person blood circulation especially to the foot.Poor circulation contibutes to diabetes related foot problem by reducing the amount of oxigen and nutrition splied to the skin and other tissue,therefore causing injuries to heal poorly.

Poorly circulation can also lead swelling and dry skin.

Preventing foot complication is more critical for diabetes clien because of poor circulation impairing the healing process,and can lead to ulcer,infection,and other serious foot condition.if you have diabetes and are experiencing a foot problem,immedietly consul your foot doctor.

EASY TIPS TO KEEP YOUR FEET HEALTY

• Always keep your feet clean
• After bathing or showering always dry your feet well.
• Avoid temperature extreem when washing your feet and always test the water temperature with elbow before soaking your feet.
• Make sure that you buy shoes that fit well,dont rub and have plenty of toe room.
• Inspect your shoes regulary for foreign objects and rough and torn areas.
• If your feet are cold at bed time,wear warm socks and avoid using heating pads or a hot water bottle.
• Shock should be clean,dry and soft.
• Cut your toenail only if they are still soft from bathing-a podiatrist does this best.
• Never EVER go bare foot.
• Have your doctor check your feet at every visit.
• When you do your own daily inspection use a good light and a mirror to see a bottom of your feet.
• look carefully for open sores,cuts,calluses,blister and corns.
• Always check between the toes.If you notice any problems call podiatrist at once.
• Beware of "bathroom surgery"-let podiatrist look after corns and calluses.

(source:From nursing orientation foot clinic DDRCT Kuwait;presented by SYLVIE.D)

TREATMENT OF HYPERGLYCEMIA
If BG ketones over 250mg/dl,check urine ketones
if urine ketones are psitive,deliver insuline manually with a syringe,give asupplement injection every 2 hours until BG is normal and ketones are negative.

If ketones are negative,give a supplement injection every 4 hours until BG is normal

If nausea and vomiting occur,give injection by syringe first;the change infusion set and proceed with the above trouleshooting protocol and give supplement bolus every 2 hours.

If BG is not falling,force fluid,call physicisn and continue giving insulin by injection.

from minimed

My diabetic info test

This is my first blog about diabetic nursing care