Diabetes Mellitus

It’s common in the Caribbean.

 Trinidad and Tobago is the 3rd in the world for diabetes mellitus.
 More money is spent by the health department.
 Dr Maxwell and his team keeps track of diabetes and helps to preserve the country to
reduce diabetes in the country.

Diabetes mellitus is a problem in how we break down food such as carbohydrates, saturated fats
when insulin doesn’t work well.

There are two types of diabetes;

Type 1- Born with a problem that leads to insulin reduction and also gets it from a young age.

It has little insulin.

Type 2- Not born with it.

Can get type 2 by:

 Insulin resistance.
 Gets it from fatty food.
 Lack of exercise.
 Family history
 Being over the age of forty five
 Smoking

You can get diabetes mellitus by:

 Gestational Diabetes from pregnancy

 Laziness
 Vomiting
 Pregnancy

How do you know when you have diabetes? (Symptoms)

 Poor healing of wombs

 Night blindness
 Numbness of hands or feet
 Infections

Test
Blood test to look for glucose level;

 Glucometer:

If you have more than 126 you are most likely diabetic. This is done via blood test.

 A red blood cell test 3 months:

If the Amount of glucose gained by red blood cells is large you can identify if you’re diabetic.

Cure

 If you can get an organ transplant you can get a cure.

 Don’t really have a cure for it.
 If the sugar control is kept good enough you can prevent any other complications.

What is insulin made of?

 Protein that comes from pig (Artifactual Insulin)

How can you treat Diabetes?

 Exercise
 Taking insulin tablets
 Proper diet

Complications of Diabetes;

 Diabetic retinopathy
 Problem with\ poor healings o the womb
 Affect the eyes
 Kidney failure
 Lifestyle diseases
 Heart attack
 Stroke

Microvasculopathy in Dm. (Eye)

 Loss of endothelial cells

 Thickening of the basement membrane
 Pericytes loss
 Increased capillary permeability
 Capillary occlusion
 Microaneurysm Formation

Vessels are weak and bursting. When keep happening over and over it will scar the tissues of the
eyes.
Classification of diabetic retinopathy

Proliferative diabetic retinopathy

Rubeosis Iridis in PDR- Poorly control and Allot of pain

Need a special type of surgery when the vessels are going in the wrong Direction of the eye.

93 million people globally suffer from Diabetic Retinopathy 17 million of which are Proliferative.

28 million of which have sight threatening retinopathy.

80% of Diabetic patients live in low and middle income countries

12-20% of adults in the country has diabetes

1 in 8 maybe ( 1 in 5) of all adults has diabetes

1997-2004

12.2-14%

What must we do in Trinidad and Tobago?

SCREENING!!!!!X5

The ABCs of Diabetes prevention

A- Assess your risk

B- Be Active
 Do at least one hour of physical activity each day
C- Choose a healthy balance diet
 Cut down on the excessive amount of sugary foods and beverages
 Eat fruits and vegetables daily
 Drink allot of water ;and avoid replacing water with sugary beverages
 Cut down on high fat fast foods . These should be ‘sometimes’ foods and not be
‘always’ foods. E.g Whole wheat bread instead of white bread, lentil peas, sweet
potatoes, healthy snacks such as granola bar, popcorn(no butter and no salt),
pumpkin, pawpaw, chow, salad

Fractions for food (small plate size)

1\2 Vegetable

1\4 Staple

1\4 Protein
Adjustment Process

 Diagnosis typically occurs during crisis, and is an intense problem.

Skills needed for good diabetes management.

 Ability to appreciate future consequences

 Impulse control
 Delay of gratification

Problem?

These are skills developing and normally do not have,

Instead they:

 Testing limits
 Increasing desire for independence
 Developing good judgement through trial and error
 Increased desire to fit in with social group
 Struggle allot

Symptoms you go through when you have Diabetes

 Sorrow
 Anger
 Grief
 Anxiety
 Isolation
 Depression
 Family Dysfunction
 Behavioural challenges

Psychosocial Interventional- The Do’s

 Seek social support

 Can problem solve
 Use distancing
 Develop a positive focus
 Have helpful self-management beliefs
 Engage in less self- blame, happiness, etc

Psychosocial Interventions- The don’ts

 Don’t rely on mental escape/ avoidance
 Don’t reply on behavioural avoidance/escape
 Don’t shut out on your support network – Family and friends