As a national leading provider of senior healthcare services, Consulate Health Care is pleased to provide patient education resources for the health conditions that are most prevalent among our elderly population. Below, you will find the topics for each of the nine educational resources. By clicking on any of these topics, you will be able to access information about the medical condition, symptoms, treatment and much more. We hope you find these resources helpful and will consider the compassionate and caring services of Consulate Health Care for all of your senior healthcare needs.

Diabetes Mellitus

Diabetes Mellitus is a chronic disease, requiring lifelong management of food, exercise and medication. There is no cure. The condition is characterized by hyperglycemia-high levels of blood glucose or “high blood sugar”. This is due to not having enough insulin being manufactured by the pancreas. The result is that the body can suffer from disturbances on how carbohydrates, proteins and fat are used.

As food is ingested, the digestive system breaks down sugar and starch (carbohydrates) into glucose, a very simple sugar. This glucose is carried by the blood stream to be used by all the cells of the body. Glucose is essential to health because it is an important source of energy for the all organs and muscles of the body. Glucose is the “food” or “fuel” of the cell. Without it, the cells and organs of your body cannot function.

Insulin is a hormone that transports glucose from the blood- into the cell. Without insulin, glucose cannot get from the blood into the cell to power the cell. Diabetics have too much glucose circling around in their bloodstream and not enough glucose inside the cells where it belongs to create energy.

The result is that the cells of the body, all the organs and tissues and muscles, don’t get the energy they should have. Also, the high levels of glucose circulating in the bloodstream, over time, can cause problems in the body.

1. In the absence of diabetes, insulin is primarily manufactured and released by the pancreas to reduce elevated glucose (sugar) levels from the blood and “drive” that Glucose to the cells to be used or stored.

2. When sugar levels drop, the pancreas slows or stops the release of Insulin.

3. When blood sugar falls below a certain level, the body uses stored glucose as an energy source.

Even if your diabetes is well controlled, blood sugar may elevate if you have an infection, fever, vomiting, diarrhea, recent surgery, a new illness or change in medications. Please tell the clinical staff if you feel any of the following symptoms associated with high blood sugar:

• Not thinking clearly
• Blurred vision
• Sluggishness, weakness or drowsiness
• Sudden red and dry skin
• Behavior changes
• Frequent Urination/ Incontinence that is new
• Unexplained weight loss in a short time
• Increased thirst

High blood sugars are not always symptomatic, but over time can do damage to the body. High blood sugar levels are treated with insulin.

Diabetic Ketoacidosis is a serious condition that can occur, symptoms include:

• Excessive thirst
• Frequent urination
• Nausea and vomiting
• Abdominal pain
• Weakness or fatigue
• Shortness of breath
• Fruity-scented breath
• Confusion

• Confusion or exhaustion
• Hallucinations
• Irritability/aggressiveness
• Shakiness or tremors
• Blurred vision
• Extreme hunger
• Extreme perspiration
• Dizziness
• Unclear thoughts, unclear speech
• Racing heart
• Numbness or tingling to hands, feet or lips
• Stupor and/or coma

Low blood sugars can create symptoms very quickly and can be dangerous. Treatment usually consists of ingesting or injecting sugar, but may vary according to the situation.

What makes blood glucose levels go too low

• Eating less than usual
• Being more physically active than usual
• Missing a meal or snack
• Eating later than usual
• Diabetic with too much medication
• Drinking alcoholic beverages on an empty stomach

Diet control / weight management

The care center dietician as well as the clinical staff can assist you in diet control and weight management. The following items are learning objectives that should be considered prior to your return home:

• Understanding healthy sources of carbohydrates, protein and fat
• Making healthy food choices
• Adjusting portion sizes
• Reading labels
• Counting carbohydrates
• Planning and preparing meals
• Successful adjustments when dining outside the home
• Adjusting intake to level of activity

Glycemic control

This is a method for blood sugar management.

The Glucometer: is a blood glucose testing machine. It will show how much glucose is in the blood at a given point in time. Your Primary Care Provider will give orders as to when testing should be done. Many people use the results to adjust their insulin doses. Work with the clinical department to practice proper use of the glucometer. Prior to discharge, you can establish times to test your blood sugar and when and who to call if the numbers are too high or too low.

A1C testing: This is a blood test that measures your average blood sugar level over a period of several months and a very good test to measure if your blood sugar management plan is working. The American Diabetes Association recommends this level to be below 7 percent. You should know what your particular A1C target is.

Oral Medication

Some oral medications stimulate the pancreas to manufacture or release more insulin. Others slow the release of glucose from the liver, requiring less insulin in the body. A combination of medications may be used.

Insulin

When Insulin is prescribed for a diabetic, it is usually because their pancreas cannot produce enough Insulin to meet the body needs. The diabetic takes Insulin to keep blood sugar levels in a safe range by moving glucose from the blood into the cells of the body.

Insulin is available in short, intermediate, long acting and combination preparations. For example; Insulin that is short acting will start to work shortly after taking it. Long acting Insulin may be taken at night to work early the next morning. Insulin is typically injected using a needle and syringe.

Physical Exercise

Exercise can do the following:

• Lowers blood glucose levels
• Lowers blood pressure
• May lower bad cholesterol and raise good cholesterol
• Improve the body’s ability to use insulin
• Keep the heart and bones strong
• Keep the joints flexible
• Lower the risk of falling
• Assist in weight reduction
• Reduce body fat
• Provide more energy
• Reduce stress and elevate mood

Your Primary Care Provider may order physical therapy to help improve strength, balance and endurance.

Foot Care

Diabetics are at high risk for foot ulcerations, especially diabetics with poor blood flow or neuropathy so caring for feet is important.

Common foot issues like calluses, blisters, dry skin and athletes’s foot put the diabetic at risk for infection, which must be met with aggressive care. Toe nails should be trimmed regularly. Podiatric services are available, if ordered. Report any changes in skin condition to the clinical staff promptly. Report redness, sores, injuries, peeling or cracking between the toes, pain or a numbness / tingling sensation. Try to wear proper fitting shoes, and any custom made splints, braces and prosthetic devices and to cleanse and moisturize the feet daily.

Lipids and Cholesterol Management

As a diabetic, it is important to modify lifestyle food choices and reduce saturated fat, trans fat and cholesterol intake. Arrangements can be made for you to meet with the care center dietician to improve your understanding of lipid and cholesterol management. Your Primary Care Provider may prescribe medication to assist with lowering high levels of bad cholesterol with drugs called “Statins”. The clinical staff can meet with you to discuss lipid lowering therapy.

STOP Smoking

Medications, counseling, smoking cessation programs and nicotine replacement products (gum, inhaler, patch) increase the chances of stopping. Smoking more than doubles the risk for cardiovascular disease. Smoking tobacco can raise your blood sugar and cholesterol levels as well as raise your blood pressure. Smoking cuts down on the amount of oxygen going through your blood stream to your vital organs and skin. Smoking damages blood vessels, the respiratory tree and lung tissue.

GET HELP. TALK WITH YOUR DOCTOR, FAMILY AND FRIENDS ON WAYS AND STRATEGIES TO STOP.

Consider visiting www.smokefree.gov or call 1-800-QUITNOW (1-800-784-8669). Callers are routed to their state’s quit line or the National Cancer Institute’s quit line.