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Nursing 4604LKimberly A. Rogers, RN June 2013
DIABETES & HEART DISEASERisk Factors & Prevention
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Diabetes Disease Facts• Type I • Usually seen in children & young adults• Accounts for approximately 5% of cases
• Type II• Most common form in adults• Commonly the aged population and certain ethnic groups
• 25.8 Million People Have Diabetes• 27% of all people 65 and older have diabetes
(American Diabetic Association, 2013)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Diabetes Diagnosis
(American Diabetic Association, 2013)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Diabetes in Pasco County and the State of Florida
Adults Diagnosed with Diabetes(Percent of Adult Population)
(American Diabetic Association, 2013; Florida Department of Health, 2013)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
U.S. Florida Pasco0.0%1.0%2.0%3.0%4.0%5.0%6.0%7.0%8.0%9.0%
10.0%8.3%
10.4%
8.5%
Adults Diagnosed with Diabetes – Long-Term Trend(Percent of Adult Population)
(Florida Department of Health, 2013)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
2000 2005 20100.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
Florida Pasco
Average Age at Which Diabetes was Diagnosed
(Florida Department of Health, 2013)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Florida Pasco4042444648505254565860
50
53
Diabetic Patients Who Check BloodGlucose at Least Once per Day
(Florida Department of Health, 2013)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Florida Pasco59.0%60.0%61.0%62.0%63.0%64.0%65.0%66.0%67.0%68.0%
62.1%
67.7%
Diabetic Patients Who Have HadTwo A1C Tests in the Last Year
(Florida Department of Health, 2013)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Florida Pasco72.0%
74.0%
76.0%
78.0%
80.0%
82.0%
84.0%
75.6%
82.4%
Diabetic Patients Who Had an AnnualFoot Examination in the Last Year
(Florida Department of Health, 2013)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Florida Pasco71.5%
72.0%
72.5%
73.0%
73.5%
74.0%
72.2%
73.6%
Diabetic Patients Who Had an AnnualEye Examination in the Last Year
(Florida Department of Health, 2013)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Florida Pasco66.0%
68.0%
70.0%
72.0%
74.0%
76.0%
78.0%
80.0%
70.2%
78.5%
Coronary Heart Disease Facts
• 385,000 People In the U.S. Die Each Year from Coronary Heart Disease
• The Population of Pasco County is 468,000 People
• There are 935,000 Heart Attacks Each Year in the U.S.
• Coronary Heart Disease Costs the U.S. Economy Approximately $1.89 Billion Dollars Each Year
(Centers for Disease Control and Prevention, 2013)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Coronary Heart Disease in Pasco Countyand the State of Florida
Percentage of People with Cardiovascular Disease
(Florida Department of Health, 2013)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Florida Pasco0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
10.2%
12.4%
Coronary Artery Disease & Anatomy
(Drchandler.com, 2005)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Coronary Artery Disease Progression
(Bean et al, 2006)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Diabetes & Coronary Heart Disease
• Adults with Diabetes are 2 to 4 Times More Likely to Have Heart Disease
• The American Heart Association Considers Diabetes to be One of the Controllable Risk Factors for Cardiovascular Disease
• People with Diabetes Often Have Other Risk Factors that Increase the Chance of Developing Cardiovascular Disease
(American Heart Association, 2012)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Other Risk Factors for Coronary Heart Disease
• Hypertension
• Elevated Cholesterol & Triglyceride Levels
• Obesity
• Sedentary Lifestyle
• Poorly Controlled Blood Sugar
• Smoking
(American Heart Association, 2012)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Signs & Symptoms of Coronary Heart Disease• Chest Pain (squeezing, pressure, or heaviness)
• Pain in Shoulders, Arms, Neck, Jaw, or Back
• Persistent Indigestion or Nausea
• Fatigue and Weakness
• Shortness of Breath
• Sweating
• Lightheadedness
(Centers for Disease Control and Prevention, 2011)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Signs & Symptoms of CoronaryHeart Disease in Diabetics
• Diabetic Nerve Damage Can Interfere with Pain Signals in the Body
• Diabetics Can Have Some or All of the Typical Symptoms
• Some Diabetics May Have a Heart Attack without Symptoms
• When in Doubt, Always Call 9-1-1
(National Institutes of Health, 2011)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Prevention: Controlling Modifiable Risk Factors• Hypertension
• Comply with medications
• Reduce salt intake
• Maintain a healthy weight
• Limit alcohol
• Manage stress
(American Heart Association, 2012)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Prevention: Controlling Modifiable Risk Factors• Elevated Cholesterol & Triglycerides
• Adopt a heart healthy diet
• Increase physical activity
• Take any cholesterol medications as directed by your doctor
• Obesity & Sedentary Lifestyle• Exercise at least 30 minutes a day – can be broken into three
10-minute sessions
• Adopt a heart healthy diet
(American Heart Association, 2012)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Prevention: Controlling Modifiable Risk Factors• Poorly Controlled Blood Sugar
• Perform blood sugar checks as recommended by doctor
• A1C Checks
• Medications: insulin or oral medications taken as directed
• Diet & Exercise
• Smoking• There are many options & resources available for smoking
cessation
(American Heart Association, 2012)
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Resources for Success
• American Heart Association – www.heart.org
• American Diabetes Association – www.diabetes.org
• Tobacco-Free Florida – www.tobaccofreeflorida.com
• Florida Quit Line – www.doh.state.fl.us/Tobacco/quitline.html
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
Quiz1. You’re just not feeling “yourself” today. Which one of
the following “sensations” should send you rushing directly to the emergency room?A. A sudden, strange desire to fill out an insurance form
B. An uncomfortable, squeezing pain in the middle of your chest
C. A long tone ringing in either of your ears
D. A tickling sensation on the bottoms of your feet
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
(American Heart Association, 2012)
Quiz1. You’re just not feeling “yourself” today. Which one of
the following “sensations” should send you rushing directly to the emergency room?CORRECT ANSWER:
B. An uncomfortable, squeezing pain in the middle of your chest
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
(American Heart Association, 2012)
Quiz2. Just because you feel a heart attack warning sign does
not mean you are actually having a heart attack. People feel these quirky sensations all the time. Save yourself some trouble. Wait until you have a few of the signs and in more rapid successionA. Good advice.
B. Bad advice.
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
(American Heart Association, 2012)
Quiz2. Just because you feel a heart attack warning sign does
not mean you are actually having a heart attack. People feel these quirky sensations all the time. Save yourself some trouble. Wait until you have a few of the signs and in more rapid succession.CORRECT ANSWER:
B. Bad advice.
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
(American Heart Association, 2012)
Quiz3. There’s a reason it is called a “heart” attack. The
warning signs all center on your “heart.” The idea that symptoms may occur in other parts of the upper body, such as the arms, back, neck, jaw, or stomach, is pure myth.A. True
B. False
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
(American Heart Association, 2012)
Quiz3. There’s a reason it is called a “heart” attack. The
warning signs all center on your “heart.” The idea that symptoms may occur in other parts of the upper body, such as the arms, back, neck, jaw, or stomach, is pure myth.CORRECT ANSWER:
B. False
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
(American Heart Association, 2012)
Quiz4. Shortness of breath is a warning sign for a heart
attack when:A. You experience a particularly beautiful wonder of nature
such as the Grand Canyon.
B. You walk through the “smokers’ patio” on your way into an office building from the parking lot.
C. You are also feeling some discomfort or pain in your chest.
D. You aren’t feeling anything strange in your chest except shortness of breath
E. C and D.
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
(American Heart Association, 2012)
Quiz4. Shortness of breath is a warning sign for a heart
attack when:
CORRECT ANSWERE. C and D.
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
(American Heart Association, 2012)
Quiz5. Which of these is NOT considered a heart attack
warning sign:A. Cold sweats.
B. Nausea.
C. Ice cream cravings.
D. Lightheadedness.
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
(American Heart Association, 2012)
Quiz5. Which of these is NOT considered a heart attack
warning sign:
CORRECT ANSWERC. Ice cream cravings.
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
(American Heart Association, 2012)
Quiz6. If you are experiencing any of the common signs of a
heart attack (chest pains, shortness of breath, discomfort in areas of the upper body, etc.), what is the fastest way to begin life-saving treatment:A. Call 9-1-1 immediately.
B. Get someone to drive you to the emergency room now.
C. Drive yourself to the emergency room now.
D. Turn your “Bat Finder” to the northern sky & put out a call for Batman!
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
(American Heart Association, 2012)
Quiz6. If you are experiencing any of the common signs of a
heart attack (chest pains, shortness of breath, discomfort in areas of the upper body, etc.), what is the fastest way to begin life-saving treatment:
CORRECT ANSWERA. Call 9-1-1 immediately.
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
(American Heart Association, 2012)
Questions & Answers
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
(American Heart Association, 2012)
ReferencesThe American Diabetic Association (2013). Retrieved from www.diabetes.org .
The American Heart Association (2012). Retrieved from www.heart.org .
Bean, C.A., et al (2006). Image. ACC Atlas of Pathophysiology, 2nd Edition.
Philadelphia: Lippincott & Wilkins.
Centers for Disease Control and Prevention (2013). Heart Disease Facts. Retrieved
from http://www.cdc.gov/heartdisease/facts.htm.
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
ReferencesFlorida Department of Health. (2013) Retrieved from www.Floridacharts.com.
Drchandler.com (2005). Image. Retrieved from http://
drchander.com/diagnoseCAD.html.
National Institutes of Health (2011). What Are the Signs and Symptoms of Diabetic
Heart Disease? Retrieved from http://
www.nhlbi.nih.gov/health/health-topics/topics/dhd/signs.html.
Diabetes & Coronary Heart DiseaseRisk Factors & Prevention
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