ORGANISMOS INTERMEDIOS ESTATALES

BLOOD VESSELS

heart and Blood vessels – Part 1

people with diabetes are more likely to get atherosclerosis (hardening of the arteries), caused by a build up of fat inside the blood vessel walls. The blood vessels become hard and narrow so that the blood cannot flow through as easily. The vessels going to the legs, heart, and brain can be affected. A way to measure the amount and types of fat in your blood is by checking your cholesterol level.

The legs and feet are often the first part of the body to be affected. Because there is less oxygen and other nutrients flowing to the legs and feet, sores or cuts may heal slowly in those areas. Sores that do not heal can become infected, and these infections can quickly become very serious.

pain and cramps while walking are also signs that there is not enough blood and oxygen flowing to the legs and feet. When the blood vessels are narrow, the oxygen cannot get there quickly enough. The pain usually goes away with rest because less oxygen is needed when the muscles are resting. This is called intermittent claudication. Walking short distances and gradually increasing the length of time walked may help, along with medicines. The heart is muscle. If the vessels to the heart are affected by atheroscle- rosis, and when not enough blood gets through, you can have chest pain (angina). If the lack of blood is severe enough, or if there are parts of the heart where the blood flow is blocked, you can have a heart attack.

heart and Blood vessels – Part 2

Signs of a heart attack are:

- Fullness, discomfort, squeezing, pressure, or pain in the center of the chest

- pain going to your shoulders, neck, back, arms, or jaw - Stabbing chest pain

- pounding heartbeat or feeling extra heart beats - Sweating, feeling faint, or nauseated

Women with diabetes have the same rate of heart attacks as men of the same age. Along with the symptoms listed above, they are more likely to have:

- Shortness of breath - Nausea or vomiting - Back or jaw pain

people with diabetes are also prone to “silent” heart attacks because of nerve damage from diabetes. Instead of chest pain, signs may be short- ness of breath, nausea or vomiting, and back or jaw pain.

❱ LECTURETTE:

HEART AND

BLOOD VESSELS

If you have signs of a heart attack:

- Call 911 right away. In order to use the “clot buster medicine”, you must be seen within 3 hours from the start of your chest pain. The sooner you get to the hospital, the better your chances of surviving. - Chew one baby or adult aspirin. Aspirin helps break up clots and

chewing helps to get the aspirin into your system more quickly. Non- coated aspirin also works faster.

When the blood vessels to the brain are blocked, you can be confused, get dizzy, or pass out. If no blood can get to a part of the brain, you can have a stroke.

The goal of the treatment for the heart and blood vessels is to keep the blood vessels clear and keep the blood flowing. Many people take an aspirin a day to decrease clotting. Because the risk for heart attacks is so high among people with diabetes, many people also take a medicine to lower choles- terol. Because medicines called statins also protect you from heart attacks, these medicines are often used. See page 201 in the Lifelong Management Guidebook for a list of medicines commonly used to lower cholesterol levels. Ask to have your cholesterol checked at least once year. Talk to your pro- vider about what you results mean and what can be done to improve them.

❱ GRoUP FACILITATIon

SIMULATIon

Trainer: Imagine that during the discussion about the long-term compli- cations, one of the participants says, “There is just too much to do. You are going to get the complications no matter what. I am just going to “eat, drink, and be merry.”

Select two participants to facilitate a group discussion on how to address this comment. During the discussion, the trainer will list the questions and strategies used on the board. Debrief at the end of the discussion.

- Acknowledge the difficulty in doing all there is to do - Ask other group members their thoughts on this response - Ask other group members what they do to stay motivated - Ask what experiences he/she has had that led to that belief

- Ask if it would help to know about what is known from the research about preventing the complications

- Do not argue with the participant’s experiences or beliefs

Trainer: Ask the group, “Are there additional questions or strategies you could think of that you might have used? Were there any that you did not feel were effective, or ones that could have been used more effectively?” Ask the group, “What feelings do you think were the cause of this partici- pant’s belief? How might you find out if you are correct? In what ways does

❱ LECTURETTE: