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LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

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Page 1: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

LONG TERM COMPLICATIONSLauren Martin RD, LDNRachel Sedgwick Intern

Page 2: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

SKIN COMPLICATIONS

Page 3: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

GENERAL SKIN CONDITIONS

1. Bacterial Infections 2. Fungal Infections Styes Boils Folliculitis Carbuncles Infections around

nails

Candida albicans (yeast-like fungus)

Jock itch Athlete’s foot Ringworm

Page 4: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

GENERAL SKIN CONDITIONS

3. Itching Localized Caused by dry skin,

yeast infection, poor circulation

Use mild soap with moisturizer & apply skin cream after bathing

Page 5: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

SKIN CARE TIPS

Talcum powder for skin-skin contact (armpits, etc.)

Avoid extremely hot baths or showers Use mild shampoos and soaps Moisturize often, especially in cold or windy

weather Treat cuts immediately to prevent further

infection Check feet daily for sores or cuts

Page 6: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

FOOT COMPLICATIONS & CARE

Page 7: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

DIABETES & YOUR FEET

Decreased circulation causes slow healing of injuries

Peripheral neuropathy: nerve damage in legs & feet Causes little or no feeling in feet – risk for

undetected trauma/injury Untreated problems may lead to infection &

possible amputation very preventable! Examine your feet every day!

Page 8: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

PREVENTION OF FOOT PROBLEMS

Wear shoes and socks that fit & allow feet to breathe

Look for areas of redness when taking shoes off – sign of improper fitting shoe

Avoid going barefoot & use hard-soled slippers Get tested for sensation in your feet:

“monofilament” This should be done once every year Tell doctor if any areas of feet are numb

Page 9: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

MONOFILAMENT TEST

Page 10: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

DAILY FOOT CARE Wash with mild soap & water daily & dry completely Look at tops & bottoms of feet (use mirror as needed)

Fissures, cracks, calluses, red spots, cuts, bruises

Use lotion for dry feet or powder for sweaty feet Remove calluses by gently rubbing with emery board

or pumice stone Do not use chemical removers or sharp instruments

Trim toenails to follow curve of toe & be even with end of toe Nails are softer & easier to cut after bathing

Page 11: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

XX

Page 12: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern
Page 13: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

EYE COMPLICATIONS

Page 14: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

THE EYE

When you look at an object… The image is sent from the lens vitreous

(area filled with clear gel-like fluid) retina Retina = thin membrane at back of eye

that receives images Optic nerve = transmits image from

retina to brain Macula = center of vision of retina

Page 15: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern
Page 16: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

Optomap Technology

www.optos.com

Page 17: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

DIABETIC RETINOPATHY

Weak spots develop in walls of smallest blood vessels & balloon-like outpouchings occur – “microaneurysms”

If the outpouchings cause swelling in the retina vision impairment Vision impairment from

retinopathy ≠ blurred vision from high glucose levels

Page 18: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

PROLIFERATIVE RETINOPATHY

New, smaller blood vessels form to help blood flow “Neovascularization”

Very fragile & break easily Bleeding can occur

between the retina & vitreous or into vitreous

Visual loss or total blindness if untreated

Page 19: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

RETINAL DETACHMENT

Scars may develop & attach the retina & vitreous

If scars contract… Retina torn away

from back surface of eye & cause blank spots in vision

Immediate care is necessary!

Page 20: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

PREVENTION & TREATMENT

Dilated eye exam by eye specialist Regular eye exams at diagnosis & yearly thereafter Keep blood pressure within recommended targets

Diabetes is the leading cause of new blindness…

Get checked!

Page 21: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

CATARACTSAccumulation of sugars in the lens of the eye causing swelling & clouding

Page 22: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

GLAUCOMAIncreased pressure in the eye causing damage to optic nerve in back of eye•Tunnel vision•Diabetics 2x as likely to develop

Page 23: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

ORAL & DENTAL HEALTH

Page 24: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

Diabetes and Oral healthDiabetes and Oral health

Nearly 26 million Americans who have gum disease have unexpected oral health problems

Oral Health Problems is added to the list of “other complications” associated with diabetes

Blood sugar levels that are poorly controlled may lead to oral health problems

Page 25: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

Types of Oral Health ProblemsTypes of Oral Health Problems

Plaque/Tartar – the “bad guy” of gum disease

Gingivitis – early stage of gum disease Periodontitis – severe gum disease Thrush – fungal infection Dry Mouth – increased risk of cavities Poor healing of ulcers

Page 26: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

Warning signs Warning signs Bleeding gums – even if there is

no pain Red, swollen, or tender gums Gums that have pulled away from

teeth Puss between teeth and gums Bad breath Loose teeth Changes in bite Ill fitting dentures

Page 27: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

Is This A Two Way Street?Is This A Two Way Street?

Yes! The relationship between serious gum

disease & diabetes goes two ways Those with diabetes are more

susceptible to serious gum diseaseAND…

Serious gum disease can affect blood sugar control and contribute to the progression of diabetes

Page 28: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

How can I prevent Oral Health How can I prevent Oral Health Problems?Problems?

Good Blood Sugar Control Take good care of your teeth, gums &

tongue Brush and floss

Regular dental check-ups Every 6 months

Avoid smoking Remove and clean dentures regularly

Page 29: LONG TERM COMPLICATIONS Lauren Martin RD, LDN Rachel Sedgwick Intern

QUESTIONS?