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Diabetes Workshop 2014-TRANSFORMATION IN DIABETES
CARE TODAY IS FOR TOMORROW-1
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Diabetes Workshop 2014-TRANSFORMATION IN
DIABETES CARE TODAY IS FOR TOMORROW-2
DiabetesWorkshop 2014-TRANSFORMATION IN
DIABETES CARE TODAY IS FOR TOMORROW-4
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DIABETES WORKSHOP 2014 - TRANSFORMATION IN
DIABETES CARE TODAY IS FOR TOMORROW-3
Kebanyakan orang dewasa tidak
perlu berjumpa doktor sebelum
memulakan sebarang progm aktiviti
fizikal. Walaubagaimanapun, lelaki
berumur lebih 40 tahun dan
perempuan lebih 50 tahun yang
bercadang melakukan senaman
berat atau anda yang menghidap
masalah kesihatan yang serius
haruslah mendapatkan nasihat
doktor terlebih dahulu.
Hypoglycaemia
Warnai pinggan anda. Sediakan
separuh hidangan anda dengan
buah-buahan dan sayuran.
Hypoglycaemia (also called a ‘hypo’, low blood glucose or insulin
reaction), is when your blood glucose level has dropped too low. This
occurs when your level falls below 4 mmol/L, although this can vary.
Some people may feel symptoms when their level is greater than 4
mmol/L and sometimes it just depends on the situation.
While hypoglycaemia can be experienced by people taking certain
tablets for their diabetes, it is more common in people who inject
insulin. It is generally not a problem for people with type 2 diabetes who
can manage their diabetes through a healthy eating plan and physical
activity alone, however, it is possible.
It is important to treat a ‘hypo’ immediately to stop your blood glucose
level from dropping lower.
Talk to your Credentialled Diabetes Educator about preventing,
managing and treating hypos that is unique to you and your lifestyle.
The information covered in this topic is a general guideline only.
Gantikan bijirin halus dengan
bijiran penuh seperti oat, roti
penuh gandum dan nasi beras
perang.
Causes of Hypoglycaemia
Hypoglycaemia can be caused by
one or a number of events, such
as:
Makan Secara Sihat
Makan makanan yang sihat juga
mempunyai manfaat kesihatan
yang bagus termasuklah
penurunan berat badan. Sebagai
permulaan makan secara sihat,
cuba tips berikut :
Dapatkan protein dari sumber
yang sihat seperti makanan laut,
daging tanpa lemak, ayam, telur,
kekacang, kacang tanpa garam
dan bijirin.
Ingat, kawalan berat badan adalah
usaha yang berpanjangan. Mulakan
dengan langkah kecil dari sekarang
untuk menaikkan taraf kesihatan.
Pelan pemakanan yang sihat dan
aktiviti fizikal yang konsisten adalah
permulaan baik ke arah kehidupan
aktif dan cergas.
change.
usual
hypoglycaemia increases, the
more alcohol you drink
tablets.
While these are known causes of
hypoglycaemia, in many cases, no
specific cause can be identified.
Symptoms of Hypoglycaemia
Symptoms of hypoglycaemia vary
from person to person, however
common feelings are:
fingers.
If you feel any of these symptoms,
test your blood glucose level if time
and circumstances permit. If you
are unable to do so, treat as
dropping glucose levels even if you
feel fine. If you have low blood
glucose levels without any
symptoms you should discuss this
25 Berita Diabetis Malaysia
with your Doctor or Diabetes
Educator.
No Symptoms or Changing
Symptoms
Some people have no symptoms of
consciousness without ever
knowing their blood glucose levels
hypoglycaemia unawareness and
tends to happen to people who
have had diabetes for many years.
Symptoms can also change over
time, which may make it harder to
recognise. If you have hypos
without symptoms or your
symptoms change, you may need
to check your blood glucose more
often and alert your friends and
family to watch out for changes.
even if you feel fine. If you have low
blood glucose levels without any
symptoms should discuss this with
your Doctor or Diabetes Educator.
Treating Hypoglycaemia
Firstly, make sure you’re safe. For
pull over to the side of the road.
Educator if you are having ‘hypos’
often
Unconscious, Drowsy or Unable
to Swallow
If a person with diabetes is unconscious, drowsy or unable to swallow
THIS IS AN EMERGENCY.
Do not give them any food or drink
by mouth. Here is what needs to be
done:
types of diabetes medication,
treatment with you
diabetes carry pure glucose with
you such as glucose tablets or
glucose gel.
drinking alcohol
sure their airway is clear
available and you are trained to
give it
driving a motor vehicle.
‘Hypo’ Pack
000) stating a ‘diabetic
emergency’
episodes of hypoglycaemia.
ambulance arrives
include:
given them carbohydrate to
maintain their blood glucose level.
symptoms
Glucagon
Glucagon is a hormone which
raises the blood glucose level and
is injected in a similar way to
insulin. Glucagon is recommended
to reverse severe hypoglycaemia in
people with diabetes. If you are
need to treat)
muesli bars, fruit bars and biscuits
carbohydrate that is easy to
‘diet’) OR
do not need Glucagon which is
always given by another person.
Your doctor or Diabetes Educator
will recommend you have Glucagon
on hand in case of a severe ‘hypo’
and will show you, your family and
friends how to use it.
grams carbohydrate.
Avoiding & Managing
Hypoglycaemia
carbohydrate from the above list. If
minutes away, eat some longer
you can do to manage and avoid
hypoglycaemia including:
one of the following:
says you have diabetes, so
people will know that you need
urgent medical help
other dried fruit OR
book of any ‘hypos’ you have and
discuss it with your Doctor or
visit
Not Treating Hypoglycaemia
If hypoglycaemia is not treated
continue to drop, which may
progress to:
co-workers, school staff and
carers know how to recognise and
treat hypoglycaemia
so you can try to prevent the
situation from occurring again
26 Berita Diabetis Malaysia
numbers
as nearest relative.
Everybody benefits from regular exercise.
If you have diabetes, or are at risk of diabetes it plays an important role in keeping you
healthy. Regular exercise is an important
part of your diabetes management. If you
are on insulin, it will help your insulin to
work more efficiently and assist with your
blood glucose control. However, if your
diabetes is poorly controlled (i.e. fasting
blood glucose levels greater than 14
mmol/L and urinary ketones) then it is best
to avoid exercise until your blood glucose
has settled. Exercise in these circumstances can actually elevate blood glucose and
increase ketone production.
Diabetes and Exercise - Keeping Active
F
helps:
improve your diabetes management
physiologist before you start increasing Intensity of Exercise
You do not need to puff to gain the
Suitable Types of Exercise
the individual. Here are some
suggestions for you to discuss with
your doctor:
You are discouraged from strenuous
physical activity if you are feeling
unwell or have ketones present in your
blood or urine.
becoming breathless.
Exercise Tips
fluid may be water or a sweetened
Getting Started
one litre of fluid per hour is recom
mended.
program see your doctor for a full
two things you have to be careful of:
too hard because if you are not used
Increasing your general physical
activity is also helpful, e.g. taking the
stairs instead of the lift, getting up to
shoes.
the remote control, housework, and
gardening.
Get checked out. If you have any
health problems such as diabetes
complications like retinopathy,
nephropathy, you should talk to your
Amount of Exercise
are a serious danger for people with
diabetes. It is important to avoid foot
damage especially for middle-aged
and elderly people
not possible, then this time can be
27 Berita Diabetis Malaysia
weight or stress on the feet is ideal such as
good footwear.
Discuss adjusting carbohydrate intake with
your doctor or dietitian.
varies with each individual. Discuss
tialed Diabetes Educator.
People with diabetes are generally
discouraged from strenuous physical activity
if they feel unwell or have ketones present in
their blood or urine.
Diabetis dan Senaman
Setiap orang mendapat manfaat dari senaman yang
konsisten. Jika anda mempunyai diabetes atau
mempunyai risiko diabetes senaman memainkan peranan
penting dalam menjaga kesihatan anda. Senaman adalah
penting di dalam pengurusan diabetis anda. Jika anda
mengambil insulin, ini dapat membantu insulin anda
bekerja secara lebih effisyen dan membantu mengawal
tahap glukos dalam darah anda. Jikalau diabetis anda
mengelak senaman sehingga paras glukos dalam darah
anda kembali normal. Senaman di waktu tahap glukos
dalam darah tinggi boleh meningkatkan lagi paras glukos
dan penghasilan ketone juga turut meningkat.
Bagi seseorang yang mengidap diabetes, senaman
membantu;
- insulin bertindak dengan lebih berkesan, dimana akan
membantu anda dalam pengurusan diabetis
- mengawal berat badan
- merendahkan tekanan darah
- mengurangkan risiko sakit jantung
- mengurangkan tekanan
memberikan anda tekanan seperti membuat anda berasa
kurang selesa atau ketones terhasil di dalam darah anda
atau urin.
Permulaan
Sebelum memulakan program senaman, sila berjumpa
dengan doktor untuk rawatan kesihatan penuh.
28 Berita Diabetis Malaysia
- Jaga kaki anda semasa senaman
- Pakai pakaian yang selesa dan kasut yang kemas
- Sentiasa periksa kaki anda sebelum dan selepas
bersenam
Dua perkara yang perlu diberi perhatian:
guh-sungguh pada peringkat awal senaman jika tidak
anda akan merasa kesakitan pada keesokan harinya
dan pengalaman pertama kali mungkin tidak memberi
usaha senaman anda secara berperingkat.
Jalani pemeriksaan kesihatan menyeluruh. Jika anda
mengalami diabetis komplikasi seperti retinopathy,
nephropathy, anda patut bercakap dengan doktor atau
ahli senaman fisioogi bertauliah sebelum anda meningkat tahap senaman yang anda lakukan.
-
-
Jenis Senaman Yang Sesuai
Jenis senaman yang bersesuaian bergantung pada
individu. Berikut adalah cadangan senaman bagi membolehkan anda berbincang dengan doktor anda:
- berjalan
- berenang
- menari
- senaman air
- berkebun
- bermain golf
- berbasikal
- malakukan senaman basikal
- berjalan diatas treadmill
-
-
-
diabetes adalah sangat serius. Sangat penting untuk
menjaga kaki anda terutama bagi yang pertengahan
umur dan warga emas.
Seeloknya elakkan senaman yang memberi tekanan
pada kaki seperti berlari. Senaman yang kurang
memberi tekanan pada kaki adalah seperti menaiki
basikal senaman atau berjalan dengan menggunakan
kasut khas bagi pesakit diabetis.
Pengambilan karbohidrat sebelum dan selepas
senaman bagi mengelakkan hypoglycemia.
Karbohidrat sentiasa diperlukan setiap senaman
selesai. Bincangkan jumlah karbohidrat yang anda
perlu selepas senaman dengan doktor anda.
Pantau paras glukos dalam darah anda sebelum,
semasa dan selepas senaman bagi mengetahui jumlah
makanan yang perlu diambil.
Mungkin perlu untuk mengurangkan dose insulin
disebabkan senaman. Sukatan insulin berbeza-beza
bagi setisp individu. Bincangkan perubahan sukatan
yang sesuai dengan anda bersama doktor dan penasi
hat diabetik terlatih.
Menggunakan pelindung sinar uv apabila melakukan
senaman diluar rumah
Orang yang menghidapi diabetes tidak digalakkan
melakukan senaman fizikal yang memberi tekanan jika
mereka merasa kurang sihat atau ketones terhasil di
dalam darah atau air kencing.
contoh: menggunakan tangga daripada lif, bangun dari
kerusi untuk menukar siaran daripada menggunakan
alat kawalan jauh, kerja rumah dan berkebun.
Jumlah Senaman
setiap sesi.
Tahap Senaman
Ini bermakna anda mampu bercakap semasa melakukan
senaman dan tidak mengalami masalah sesak nafas.
Tip Senaman
panjang) dan selepas senaman untuk mengelakkan
hidrasi. Dibolehkan air masak dan air manis jika
satu liter setiap jam adalah digalakkan
29 Berita Diabetis Malaysia
Diabetes
Foot Care
When you have diabetes, proper foot
care is very important. Poor foot care
may lead to amputation of a foot or
more vulnerable to foot problems,
because diabetes can damage your
nerves and reduce blood flow to your
tion estimates that one in five people
with diabetes who seek hospital care
do so for foot problems. By taking
proper care of your feet, most serious
health problems associated with
diabetes can be prevented. Your
doctor will check your feet each year
for any problems.
Here are some diabetes foot care tips
to follow.
Wash and Dry Your Feet Daily
doctor) to
cut your toenails.
Be Careful when Exercising
shoes.
sores on your feet.
Protect Your Feet with Shoes and
Socks
for people with diabetes:
inside
end of your longest toe
rough areas
material
your feet
Tips for Foot Care in Diabetes
problem if you have diabetes. Follow
and first aid guidelines.
your health care provider
immediately.
pointed toes.
elbow, not your foot.
Do not use a heating pad on your feet.
increase your risk for injury and
potential infections.
than an hour at a time.
feet.
Have someone else look at your feet
if you cannot see them.
longest toe and as wide as your foot.
Proper Shoe Choices
your feet by wearing shoes or
hard-soled slippers or footwear.
socks you usually wear.
to prevent cracking. Do not put lotion
between your toes.
Examine Your Feet Each Day
too narrow? Is your foot crammed
before putting them on to make sure
there are no foreign objects or rough
areas.
or other foot problems. Go to your
health care provider or podiatrist to
treat these conditions.
When to Talk to Your Doctor about
Foot Care
Your health care provider should
addition, see your health care provider
if you have any of the following
problems with your feet:
toes)
wool, or a cotton-wool blend).
care provider recommends them.
other sores.
your feet from various weather
warmth, or tenderness when
touching any area of your feet.
and calluses.
bandage and wear a different pair of
shoes.
Take Care of Your Toenails
are soft.
smooth with a nail file.
30 Berita Diabetis Malaysia
damage), you may not notice that
your shoes are too tight. Perform the
"footwear test" described below.
Footwear Test
shoes fit correctly:
sure you are standing and not sitting,
because your foot changes shape
when you stand.)
of toes is permanently bent downward)