Picture Introduction to Self-Control

About Diabetes

1

Diabetes occurs when the pancreas does not produce or secreteenough insulin or when insulin does not perform effectively.

Stomach

Blood

Insulin is a hormone that sendsnutrients (glucose) from the bloodinto cells of tissues and organs.

Pancreas

Glucose

Cells

1

2 Causes of Diabetes

Diabetes may develop because of congenital conditions combined with one or more of the following causes.

Lack of exercise

Overeating and overdrinking

Obesity

Stress

2

Symptoms of Diabetes

3

Get tired easily

Frequent sores that arelikely to become infected

Frequently thirsty (polydipsia)

Diabetes usually has no obvious symptoms. However, subjective symptoms may be noted if blood glucose levelsare particularly high.

3

Polyuria

Always hungry (eating constantly but still not satisfied)

Sudden loss of weight

Diabetic coma(causing a trip to the hospital in an ambulance)

Need to

urinate 9,10,

15 times

a day?

4

Diabetes may cause the following complications.

Complications

4

Retinopathy (causes vision problems)

Nephropathy(kidney problems causing proteinin the urine and swelling in the legs)

Neuropathy (numbness in the legs)

Protein

5

Constipation or diarrhea

Brain infarction

Myocardial infarction

Prone to infections

Gangrene (foot ulcers)

Erectile dysfunctionED

Periodontal disease

6

The following tests are used to help diagnose diabetes.

Testing

5

Fasting blood glucose

Blood glucose level before breakfast.The normal range is 70110mg/dL. 70110mg/dL

Hemoglobin A1c (HbA1c)A1cHbA1c

Hemoglobin A1c (HbA1c), also called glycated hemoglobin, shows the status of blood glucosecontrol in the previous 12 months.12

Previous12 months

1 2

Normal range is 4.6%6.2%

4.6 6.2

110

70mg/dL

7

Sugar in the urine

Glucose appears in the urine when blood glucose levels are markedly high.You can test the level yourself using testpaper.

Oral glucose tolerance testOGTT

This test can be used to diagnose diabetes and investigate the state of insulin secretion.

Other tests are used to look for complications of diabetes.

You can measure your blood glucose yourself.

Bloo

d gl

ucos

e le

vel

Time

8

3

There are three approaches to the treatment of diabetes.

Three approaches to treatment3

6

1. Diet therapy

2. Exercise therapy

3. Drug therapy

9

Standard weight (kg) = Height (m) height (m) 22kg= mm22

It is important to eat a balanced diet!

years old, light work, men, obesity

The quantity of food intake is determined based on standardweight calculation.

Diet Therapy

7

Necessary caloric intake

Determine how many calories are required per day taking factors including age, sex, and amount of exercise into account.1

10

Food Exchange Lists

The Food Exchange Lists describes foods by nutrient content, showing 80 kilocalories as 1 unit.801

The Cover of "The Food Exchange Lists for Dietary Guidance for Persons with Diabetes, 7th Edition" Edited and Authored by The Japan Diabetes Society.Cited from the Japan Association for Diabetes Education and Care/Bunkodo 20137, 2013

Food Exchan

ge Lists

11

List 11

List 22

List 33

List 44

List 55

List 66

Season

ing Foods which mainly contain carbohydrates

Foods which main

ly cont

ain pr

otein

Foods w

hich ma

inly con

tain vita

mins an

d minera

ls

Foods which mainly contain lipid

Seasoning

If the Food Exchange Lists is used, then a largevariety of food can be enjoyed every day.

Chapters 12 and 13 of "The Food Exchange Lists for Dietary Guidance for Persons with Diabetes, 7th Edition" Edited and Authored by The Japan Diabetes Society. Created based on the Japan Association for Diabetes Education and Care/Bunkodo 2013 71213 2013

12

Cooked rice 50gr(half a small bowl)

50g

White bread 30gr(about half a sliceof a 6-slice loaf)

30g6 )

Udon (boild) 80gr(1/3 ball)

80g

Apple 150gr(including peel and core 180gr)

150g, 180g

Horse mackerel 130gr(with head, bones and internal

organs 130gr) 130g, , 1

Chickin egg 50gr 50g1

Pork loin 40gr (without fat) 40g

Beef chuck loin 30gr(without fat)

30g

Momen tofu; regular tofu 100gr 100g

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List 1 1

Cereals Potatoes Vegetables high in carbohydrates, nuts and seeds Beans (not including soybeans)

List 2 2

Fruits

List 3 3

Seafood Meats Eggs, cheeses Soybeans and soybean products

Potato 110gr(1, medium with peel)

110g1 120g)

Pumpkin; squash 90gr(1/8, small)

90g )

Strawberries 250gr(including calyx 260gr) 250g260g

Japanese mandarin oranges 200gr

(including peel 270gr) 200g270g

Banana 100gr(including peel and

peduncle 170gr) 100g170g

Mackerel 40gr 40g

Chapters 3797 of "The Food Substitution Table for Diet Therapy for Diabetes, 7th Edition" Edited and Authored by The Japan Diabetes Society. Created based on data extracted from the Japan Association for Diabetes Education and Care/Bunkodo 2013 73797 2013

The amount of food in 1 unit.1

18

13

Consult your primary physician about alcohol consumption

Milk (regular milk)120mL

120mL

Mayonnaise 10gr(1 small tablespoon) 10g1

300g of vegetables is one unit!

300g1

List 4 4

Milk and dairy products(not including cheeses)

List 5 5

Oils and fats Oily and fatty foods

Seasoning

List 6

Vegetables (not including some vegetables high in carbohydrates) Sea weed Mushrooms Konnyaku

Yogurt 120gr(skimmed, sweetened

/whole milk, non-sugar) 120g )

Bacon 20gr 20g

Sugar 20gr 20g

Tomato ketchup60gr

60g

Miso 40gr 40g

Normal quantities of seaweed, mushrooms, and konnyaku contain few calories. You do not need to calculate the quantities that you eat.

Table luxuries

Alcohol Juice and candy

Beer 200mL2/5 of medium-

sized bottle 200mL

Shochu (25) 50mL25 50mL

Shochu (35) 40mL35 40mL2

5 Soft drink 200mL1/2 to 2/3 of a can

200mL 1223

1/2 Manjyu;bean jam bun 25gr

25g12

14

It is important to exercise every day.

Fast walking

Exercise Therapy

8

Swimming

Exercise to music

Cycling

Anytime Anywhere

You can do itby yourself

15

Make sure to consult your primary physician before starting a therapeutic exercise program.

Patients with complications might be subject to exercise restrictions.

Patients using oral medication or insulin should take care regarding hypoglycemia. Make sure not to exercise on an empty stomach.

Devices such as pedometers can be helpful!

16

Remember the names and dosages of the medications that you take.

Drug therapy includes both oral and injectable medications.The type of medication prescribed is determined based on thestatus of the disease.

Drug Therapy

9

Oral medications

Insulin

GLP-1 receptoragonists

GLP-1

17

Oral medications and injections do not cure diabetes.You must continue with diet and exercise therapies.

Take it regularly at the specified time!

Do not stop taking your medications or increase the dosage without talking to your physician.

18

These are some symptoms of hypoglycemia.

Precautions to Help Avoid Hypoglycemia

10

Cold sweat and palpitations

Weakness, abnormal hunger, and nausea

Tremors or shaking of the arms and legs

Headache, heavy feeling in the head, and dizziness

Hypoglycemic coma

Racing heart beat

19

Hypoglycemia occurs when diet, exercise, and medication are out ofbalance.

If hypoglycemia occurs, eat some glucose or sugar.

If you miss a meal or eat later than usual

If you engage in exercise that is more intense than usual or exercise on an empty stomach

If you increase your medication dosage without permission

Always keep some glucose* or sugar with you in case hypoglycemia occurs.If your symptoms do not improve, goto the hospital! *

If you are taking alpha glucosidase inhibitors, eat some glucose or drink water mixed with glucose.-

20

Brush your teeth.Thoroughly wash any false teeth.

Make sure to keep your genital area clean.

Treat tinea.

Treat any injuries, corns, or calluses.

Do not cut your fingernails too short.

Practice good personal hygiene

Precautions for Daily Activities

11

21

Regular health check-ups

Sun.

Mun.

Always take your Diabetes Cooperation Notebook with you as well as some glucose, sugar, or sweets in case you experience hypoglycemia.

If you get fever or an upset stomach, go to the hospital without delay!

Take care to lead a regular lifestyle and regularly schedule appointments for testing and check-ups.

22

In addition to hyperglycemia, the presence of some diseases and conditions makes complications more likely to occur.

Preca