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Session 7- Protect Your Heart: Take Good Care of Your Diabetes for Life

Manual Contents

Session 7
Protect Your Heart: Take Good Care of Your Diabetes for Life

Page Contents

Objectives

  • What diabetes is and how it affects the body
  • The symptoms of diabetes
  • That diabetes is a major risk factor for heart disease
  • The levels of blood glucose (blood sugar) and what they mean
  • How to prevent and control diabetes
  • The amount of sugar in common beverages

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Materials and Supplies

  • “Your Heart, Your Life” manual and picture cards
  • Blackboard and chalk or several large pieces of paper, a marker, and tape

Prepare these items before the session for “Prepare the Blood Glucose Demonstration” that is part of “3. Types of Diabetes:”

(Optional) Note: Arrange for a health professional or a promotor(a) diabetes educator to come to the session to measure group members' blood glucose levels.

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Handouts

Give group members these handouts during this session:

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Introducing the Session

  1. Welcome
  2. Review of Last Week's Session
  3. About This Session
  1. Welcome
    • Welcome group members to the session.
  2. Review of Last Week's Session
    • Say:
      At the last session, we talked about aiming for a healthy weight.
    • Ask these questions:
    • Q: Does anyone remember why a healthy weight is important to your heart health?
      A: Keeping a healthy weight reduces your risk of heart disease, stroke, high blood pressure, high blood cholesterol, diabetes, and some cancers.

    • Q: What is the healthiest way to lose weight?
      A: The healthiest way to lose weight is to eat smaller portions of a variety of foods lower in fat and calories and increase your physical activity.

    • Q: How does the food label help people who are trying to lose weight?
      A: The food label tells you the serving size and the number of calories in a serving.

    • Say:
      At the end of our last session, you made a pledge to do something to help you keep or reach a healthy weight. What problems did you have? How did you deal with any problems?
      Note: Allow 2 minutes for group members to respond.
  3. About This Session
    • Say:
      In today's session, we will learn what we can do to prevent and control diabetes. If you have diabetes, you will need to work closely with a doctor, a registered dietitian, or a certified diabetes educator to help you monitor and control your blood glucose.

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Conducting the Session

  1. The Facts Don't Lie
  2. What Is Diabetes?
    What Is Prediabetes?
  3. Types of Diabetes
  4. Risk Factors for Diabetes
  5. Symptoms of Diabetes
  6. Blood Glucose Levels
    1. Hypoglycemia
    2. Hyperglycemia
  7. Complications of Diabetes
  8. ABCs of Diabetes Control
  9. Food Label Activity – Sugar
  10. Think Before You Drink – Hidden Sugar in Drinks Activity
  11. Staying Healthy with Diabetes Group Activity
  12. Strawberry and Pineapple Delight Recipe
  1. The Facts Don't Lie
    • Say:
      • Diabetes is a serious problem for Latino families. It affects men, women, and children.
      • Nearly 1 in 10 adult Latinos has diabetes.
      • Diabetes is a chronic disease that slowly damages the body. Although it has no cure, complications can be prevented.
      • Diabetes is a major risk factor for heart disease.
      • Heart disease is the leading cause of death for people with diabetes. One in four Latinos aged 35 or older with diabetes also has heart disease.
  2. What Is Diabetes?
    • Say:
      Now we will talk about what diabetes is and the types of diabetes.
    • Give group members the “What Is Diabetes?” handout.
    • Say:
      Diabetes happens when the body does not make enough insulin or cannot use it well, causing glucose to build up in the blood. Too much glucose in the blood is not good for your health. As a result, the body does not function well.
    • Show picture card 7.1.
    • Say:
      In a healthy body, the food we eat goes to the stomach where it is digested. The food is broken down into blood glucose. Blood glucose is also called blood sugar.
    • Say:
      The blood takes the glucose to the cells of your body, where it is turned into the energy needed for daily life. However, glucose cannot enter the cells alone. Insulin, a hormone made in the pancreas, helps glucose enter the cells.
    • Show picture card 7.2.
    • Say:
      Diabetes happens when the body does not produce enough insulin, or when the cells cannot use the insulin well. This means that glucose cannot enter the cells and builds up in the blood. People who have high levels of glucose in their blood have diabetes.
    • What Is Prediabetes?
      • Ask:
        What is prediabetes?
        Note: Allow a minute for group members to answer.
      • Add these answers if they are not said.
        • Prediabetes is a condition in which blood glucose levels are higher than normal, but not high enough to be diabetes.
        • People with prediabetes are more likely to develop diabetes within the next 10 years.
        • People with prediabetes are also more likely to have a heart attack or stroke.
  3. Types of Diabetes
    • Show picture card 7.3.
    • Say:
      When a person does not have diabetes, the pancreas produces a healthy amount of insulin, which the body can use. This is shown in the first picture.
    • Say:
      There are two main types of diabetes.
    • Say:
      Type 1 diabetes:
      • Happens when the pancreas no longer produces insulin. This is shown in the second picture.
      • Requires an insulin pump or shots every day.
      • Is usually found in children, adolescents, or young adults.
      • Affects about 5 to 10 percent of those with diabetes.
    • Say:
      Type 2 diabetes:
      • Happens when some insulin is produced, but the body cannot use it well. This is shown in the third picture.
      • Happens more often in people who are overweight and physically inactive.
      • Is usually treated with diet, pills, or sometimes, insulin shots.
      • Can occur at any age, but it is more common after age 40.
      • Is increasing among children, especially if they are overweight and Latino.
      • Affects 90 to 95 percent of people with diabetes.
    • Say:
      Gestational diabetes is a special class of type 2 diabetes.
      • Some pregnant women develop this kind of diabetes, but it usually disappears after the baby is born.
      • Overweight women and women who have a family history of diabetes are also at higher risk for gestational diabetes.
      • Women who have had gestational diabetes have a much higher chance of developing type 2 diabetes later in life. Their children are also at a higher risk for becoming overweight and developing diabetes.
    • Say:
      We have talked about healthy living throughout the sessions. Type 2 diabetes can be prevented and controlled by making healthy food choices, being physically active, and taking medication as prescribed by your doctor. If you have diabetes, it is important to be under a doctor's care and to check your blood glucose as your doctor tells you.
    • Say:
      Now we are going to do an activity to better understand what diabetes is. We will see the difference between normal blood and blood with a high glucose level.
    • Before the session:

      Prepare the Blood Glucose Demonstration

      1. Put two clear plastic bottles on the table.
      2. Add 1 cup of water and 3 drops of red food coloring into one of the bottles. This represents blood with normal blood glucose.
      3. Add 1 cup of corn syrup and 3 drops of red food coloring into the other bottle. This represents blood with high blood glucose.
    • Show the plain water bottle, and slowly tilt it from side to side to show the smooth movement of the liquid.
    • Say:
      Notice how the blood moves easily and freely. This represents the blood of someone with normal blood glucose.
    • Show the bottle with corn syrup, and slowly tilt the bottle from side to side to show the slow movement of the liquid.
    • Say:
      Notice how slowly the blood moves and how thick it is when the blood glucose level is high. This represents the blood of someone with high blood glucose. The glucose stays in the blood instead of being used by the body's cells and muscles. This shows high blood glucose.
  4. Risk Factors for Diabetes
    • Ask:
      What are some risk factors that increase your chances of getting diabetes?
      Note: Allow about 3 minutes for group members to answer. Write their answers on the blackboard or on a large piece of paper taped to the wall.
    • Show picture card 7.4.
    • Give group members the “Are You at Risk for Type 2 Diabetes?” handout. As you read each risk factor, ask group members to make a checkmark next to the risk factors that they have.
    • Say:
      Your chances of getting diabetes increases if you:
      • Are overweight, especially if you have extra weight around the waist.
      • Have a parent or sibling with diabetes.
      • Are Latino, African American, American Indian, Asian American, or Pacific Islander.
      • Have had gestational diabetes or have given birth to at least one baby weighing more than 9 pounds.
      • Have blood pressure that is 140/90 mmHg (millimeters of mercury) or higher or have been told by a health care provider that you have high blood pressure.
      • Have cholesterol levels that are not normal, that is, a level of HDL (high-density lipoprotein) cholesterol (“good” cholesterol) of 35 mg/dL (milligrams per deciliter) or lower, or a triglyceride level of 250 mg/dL or higher.
      • Are fairly inactive (exercise fewer than three times a week).
    • Say:
      The good news is that, if you are at risk for diabetes, you can prevent or delay getting diabetes by being physically active and having a healthy weight.
      It is important to be physically active for 30 minutes on most days and to lose even a small amount of weight. For example, someone who weighs 200 pounds would benefit from losing 10 to 15 pounds.
  5. Symptoms of Diabetes
    • Ask:
      Does anyone know the signs or symptoms of diabetes?
      Note: Allow 3 to 5 minutes for group members to answer.
    • Give group members the “Symptoms of Diabetes” handout.
    • Show picture card 7.5.
    • Now let's review the symptoms of diabetes:
      • Feeling tired
      • Increased thirst
      • Frequent urination
      • Increased hunger
      • Unexplained weight loss
      • Sores that don't heal
      • Very dry skin
      • “Pins and needles” feeling in feet
      • Blurry vision
      • Feeling irritable
    • Say:
      Often, people with type 2 diabetes have no symptoms. If you have one or more symptoms, see your doctor right away.
  6. Blood Glucose Levels
    • Show picture card 7.6.
    • Say:
      To find out if you have diabetes, you can take a fasting blood glucose test at the doctor's office or at a lab.
    • Say:
      • A fasting blood glucose level below 100 mg/dL is normal. You are in good shape.
      • A fasting blood glucose level of 100 to 125 mg/dL is prediabetes. This is a warning that you are at risk for developing type 2 diabetes. It is time to lose weight and be physically active at least 5 days a week.
      • A fasting blood glucose level of 126 mg/dL or higher means that you have diabetes. If you have diabetes, you should work with your doctor and other health care providers to learn to control it. It is important to work with your doctor to learn the ABCs (A1C test, blood pressure, and cholesterol) of controlling diabetes. We will learn about the ABCs of diabetes control later in this session.
      • You can also get a nonfasting blood glucose test at health fairs and other sites in your community. This is done using a glucometer and a small amount of blood. A nonfasting blood glucose level of 200 mg/dL or higher could mean that you have diabetes. See your doctor to get a fasting blood glucose test. You must fast for at least 8 hours before the test.
        More Information: Fasting Blood Glucose Levels
        Level Fasting Blood Glucose 1–2 Hours After Meals Results
        Normal 70–99 mg/dL 70–139 mg/dL Good for you!
        Prediabetes 100–125 mg/dL 140–199 mg/dL This is a warning that you are at risk for type 2 diabetes. A blood glucose level in this range is higher than normal, but not high enough to be diabetes. You need to take action to prevent diabetes.
        Diabetes 126 mg/dL or higher 200 mg/dL or higher You have diabetes. Work with your doctor and other health care providers to control the ABCs of diabetes (A1C, blood pressure, and cholesterol).
    • Say:
      People with diabetes may experience problems if their blood glucose levels get too low or too high.
      1. Hypoglycemia
        • Say:
          Hypoglycemia is a condition that develops when a person's blood glucose level is too low. People with diabetes may develop hypoglycemia.
        • Say:
          People with diabetes may develop hypoglycemia when they:
          • Skip or delay a meal or eat very little.
          • Take too much insulin or oral diabetes medicine.
          • Do too much physical activity.
          • Drink alcohol.
        • Say:
          The symptoms of hypoglycemia are:
          • Having a headache
          • Feeling shaky
          • Feeling anxious
          • Feeling dizzy
          • Feeling weak
          • Feeling irritable
        • Say:
          People with diabetes should talk to their health care providers to learn what to do for low blood glucose.
        • Say:
          People with diabetes may suffer from hypoglycemia. If your blood glucose is below 70 mg/dL, your health care provider may tell you to do one of the following:
          • Drink ½ cup of fruit juice.
          • Drink 1 cup of milk.
          • Take two to three glucose tablets.
          • Eat 2 teaspoons of sugar or honey.
      2. Hyperglycemia
        • Say:
          Hyperglycemia is a condition that occurs when a person's blood glucose level is too high. People with diabetes may develop hyperglycemia when they:
          • Eat too much food.
          • Are less active than usual.
          • Have not taken their medicine.
          • Are sick or feel tension and stress.
        • Say:
          The symptoms of hyperglycemia are:
          • Increased thirst
          • Frequent urination
          • Dry skin
          • Increased hunger
          • Blurry vision
          • Feeling tired
          • Nausea
        • Say:
          • People with diabetes should talk to their health care providers about what to do if they experience the effects of high blood glucose.
          • If your blood glucose is too high, your health care provider may need to change your medication or eating plan.
  7. Complications of Diabetes
    • Say:
      Diabetes can cause changes in the body. These changes can cause problems, called complications. Can anyone name any complications of diabetes?
      Note: Allow 3 to 5 minutes for group members to respond. Write their answers on the blackboard or on a large piece of paper taped to the wall.
    • Say:
      Over time, diabetes can affect the large blood vessels in the brain, heart, legs, and feet. It also can affect the small blood vessels in the kidneys and eyes. Diabetes can lead to:
      • Heart attack
      • Stroke
      • Amputation of the feet or legs – Diabetes can cause nerve damage. The first sign of nerve damage is to lose sensation in the feet or legs. If you have nerve disease, you may lose feeling or have tingling or pain in the toes, feet, or legs.
      • Kidney disease – With diabetes, the excess glucose in the blood damages the blood vessels inside the kidneys.
      • Eye disease – Diabetes can harm your vision or even cause blindness. People with diabetes need to have their eyes examined by a medical eye doctor once a year.
      • Dental problems – An increase in cavities and tooth infections is common in people with poor diabetes control. To prevent tooth decay, brush and floss your teeth every day. See your dentist every 6 months.
    • Say:
      Over time, diabetes can affect all parts of the nervous system. This can lead to:
      • Loss of strength in muscles
      • Changes in digestion, bladder control, and sexual function
      • Loss of feeling in feet – This is why you need to keep your feet clean, dry, soft, and protected.
    • Give out and review the “Tender Care for Your Feet” handout.
  8. ABCs of Diabetes Control
    • Say:
      If you have diabetes, controlling your blood glucose levels can help prevent or delay complications.
    • Say:
      We've learned that people with diabetes have a greater chance of having a heart attack or stroke. Let's find out how to take care of the heart with the ABCs of diabetes control.
    • Give and review the “Be Smart About Your Heart: Control the ABCs of Diabetes” handout.
    • Say:
      Be sure to ask your doctor:
      • What are my ABC numbers?
      • What should my ABC numbers be?
      • What actions should I take to control my ABC numbers?
    • Say:
      Knowing about diabetes can help prevent or delay it. For those who already have diabetes, diabetes education can help reduce the complications the disease can cause.
  9. Food Label Activity – Sugar
    • Say:
      People with diabetes should control their sugar intake, because sugar is high in calories and contributes to weight gain. Eating foods with added sugar can also lead to increased blood glucose levels in those with diabetes.
      Examples of food and drinks with added sugar are regular soda, fruit drinks, candy, cakes, cookies, ice cream, and some baked goods.
    • Say:
      Now let's do an activity that will help us use food labels to find foods that have less sugar.
    • Give group members the “Read the Food Label for Sugar!” handout.
    • Say:
      This handout shows the amount of added sugar in some drinks and foods. Look at the bottom of the handout. Which drink has fewer grams of sugar – grape juice or unsweetened iced tea?
    • Say:
      The iced tea has less sugar. One cup of grape juice has 32 grams of sugar, compared to 0 grams of sugar in 1 cup of unsweetened iced tea.
      Note: Unlike other nutrients, sugar does not have a Percent Daily Value on the food label.
    • Say:
      Let's try another activity. Ana needs our help.
    • Give group members the “Ana's Food Choices” handout.
    • Say:
      First, I am going to read about Ana's problem. Then we will use the food labels to find some solutions.

      Ana's Food Choices

      Ana lives with her mother, who has diabetes. Ana is grocery shopping and wants to buy foods that are lower in calories and added sugar to help her mother. Look at the food labels. Help Ana select foods that are lower in added sugar. Which foods should Ana buy? Write the number of your choice for each pair. Then write the number of grams of sugar saved by this choice.

      • Whole oat cereal or chocolate puffs cereal?
        Choosing the whole oat cereal saves 12 grams of sugar.
      • Gelatin or sugar-free gelatin?
        Choosing the sugar-free gelatin saves 19 grams of sugar.
      • Fat-free, no-sugar-added ice cream or regular ice cream?
        Choosing the no-sugar-added ice cream saves 13 grams of sugar.
      • Guava Nectar or Water?
        Choosing water saves 48 grams of sugar.

      Note: The correct answers to the questions are bold. The sugar and calories saved by making the right choice are given below the choices.

  10. Think Before You Drink – Hidden Sugar in Drinks Activity
    Note: Prepare before the session.
    • Look at the box that appears below. Use drawings or empty cans or bottles to represent these drinks.
    • Prepare five separate displays for each of the five drinks.
    • Follow these instructions to prepare each display:
      • Cut a file folder in half and fold each part in half to make a card (tent).
      • Write the name of the drink on one side. On the other side, write the number of calories, grams of sugar, and teaspoons of sugar in the drink. Glue the cubes of sugar onto the folder to show the number of teaspoons of sugar in each drink. To find the number of teaspoons, divide the grams of sugar on the nutrition label by four. Examples of the displays.
    • Hide the displays until it is time to do the activity.
      Amount of Sugar in Drinks
      Serving Size Drink Amount of Sugar
      12 ounces Powdered drink with sugar 9 teaspoons (36 grams)
      12 ounces Diet soda 0 teaspoons (0 grams)
      12 ounces Grape juice 8 teaspoons (32 grams)
      12 ounces Regular soda 9 ¼ teaspoons (39 grams)
      12 ounces Lemonade 6 ¼ teaspoons (25 grams)
    • Group Activity
      • Say:
        We are going to play a guessing game to learn how much sugar is in some common beverages.
      • Give group members the “Think Before You Drink – Hidden Sugar in Common Beverages handout”.
      • Show group members the front of each of the five cards that you prepared before the session, showing them the names of the beverages.
      • Say:
        Guess how many teaspoons of sugar are in each drink. Write your answers on the handout I gave you.
        Note: Allow 2 minutes for group members to write down their answers.
      • Ask group members to share the amounts of sugar that they guessed. After the group members have shared the amounts they guessed, show them the actual number of teaspoons of sugar that are in each drink. Pass around the cards one by one.
      • Say:
        During the second part of this activity, you will learn how much sugar and how many calories are in your favorite drink.
      • Give group members the “How Much Sugar and How Many Calories Are in Your Favorite Drink?” handout.
      • Say:
        Find your favorite drink on the list. Look to see how much sugar and how many calories are in it. Many drinks have a high amount of sugar and calories.
      • Say:
        As you can see, it is easy for people who choose drinks with added sugar to get too many calories. Getting too many calories leads to weight gain. Try to drink more water or unsweetened drinks instead of drinks with added sugar or regular sodas.
  11. Staying Healthy With Diabetes Group Activity
    • Note: This activity will help group members think about ways they can help their relatives and friends with diabetes stay healthy. You may select one or more stories to review.
    • Give group members the “Staying Healthy With Diabetes: Real-Life Stories” handout.
    • Divide participants into groups of three to five people and give each group a different story to discuss.
    • Say:
      Each group will read the story on the handout and think about ways to solve the problems described. Please choose one member of your group to read the story and the corresponding questions aloud to the group. Write down the group's answers to each of the questions.
      Note: Allow 5 to 7 minutes for group members to do the activity.
    • Say:
      I would like one volunteer from each group to read the story and the answers to the questions aloud.
      Note: After each volunteer reads the story and answers, ask the entire group if anyone has any other solutions to share.

      Staying Healthy With Diabetes: Real-Life Stories

      Scene 1: Alberto's Birthday Party

      Saturday is Alberto's birthday. His family is having a big party for him, and many relatives will bring lots of tasty foods and desserts such as cakes, ice cream, and pies. Marta has not been to a potluck meal since her doctor told her she has diabetes. She has worked hard to learn how to eat healthy foods. Now, Marta wonders what she should bring to the birthday party and what foods she should eat while she's there.

      Note: Share the answers to each question if they are not said.

      • What can Marta bring to the birthday party?
        • Water and diet soft drinks
        • Vegetables seasoned with lemon, a little bit of olive oil, and some herbs or spices
        • Homemade corn tortillas
        • Homemade dessert with fat-free and sugar-free ingredients
        • Fresh fruit salad
      • How can Marta have healthy eating habits while she's at the party?
        • Eat smaller portions.
        • Do not have second helpings of high-calorie foods. Eat salad or fresh fruit if still hungry.
        • Cut back on sweet foods, high-fat foods, white sauces, gravies, and alcohol.
      • What else can Marta do?
        • Eat a healthy snack before the party so she is not hungry.
        • Take a walk after eating.
        • Check her blood glucose 2 hours after eating to see how her food choices affected it.

      Scene 2: Miguel's New Shoes

      Miguel bought a new pair of shoes a week ago. He wore them 2 days in a row because his feet felt fine. When he took off his shoes at the end of the second day, however, Miguel noticed some red spots on both of his feet and blisters on the big toe of his right foot. He wonders what he needs to do about the red spots and blisters on his feet. Miguel is concerned that he did not feel the sores on his feet. He also worries that his diabetes is not under control.

      Note: Share the answers to each question if they are not said.

      • What can Miguel do about the sores on his feet?
        • People with diabetes need to see a health care provider if they see a cut, blisters, or signs of infection on their feet.
        • Miguel should go for a foot screening, which includes inspection, testing for feeling, and other tests.
        • Because he can't feel sensation in his feet, Miguel needs to practice personal foot care every day to look for changes and infections.
      • What should people with diabetes consider when buying shoes?
        • Medicare provides coverage of special shoes for people with diabetes. Check with your doctor to see if you qualify.
        • Buy new shoes carefully.
        • Choose shoes that fit well and are made of leather or canvas, with laces or straps, a smooth lining inside, rounded toes, low and firm heels, and soft insoles.
        • Have the salesperson measure both feet. Test the shoes by wearing them for at least 5 minutes in the store.
        • If the shoes hurt, don't buy them.
        • Break in new shoes slowly by wearing them for only 1 or 2 hours a day. Check for irritation or redness every time you remove your shoes and socks. Never wear new shoes all day long.

      Scene 3: What's Wrong With Andres?

      First visit: Andres visits his sister, Isabel, who is a promotora. Andres tells her that he is tired, thirsty, and that he urinates often. He asks if Isabel thinks he has diabetes.

      Note: Share the answers to each question if they are not said.

      • What can Isabel tell Andres?
        • Advise Andres to go to the clinic and have his blood glucose checked. If he has diabetes, he needs to be treated right away. Isabel cannot make a diagnosis.
        • Explain that people are more likely to have diabetes if they are overweight and inactive. Other risk factors for diabetes include having a parent or other family member with diabetes and being age 40 or older.

      Second visit: Andres sees Isabel again and tells her that he went to the doctor. The doctor confirmed that Andres has diabetes. Andres is afraid.

      • How can Isabel help Andres overcome his fear of having diabetes?
        • Tell Andres that most people with diabetes may feel scared, depressed, or angry at one time or another.
        • Mention that some people with diabetes overcome their fear when they learn what they can do to control diabetes and stay healthy.
        • Encourage Andres to attend classes at the clinic and to join a support group that helps people with diabetes to stay healthy. It helps to talk with others who are living with diabetes.
        • Encourage Andres to ask his doctor to check his blood pressure and cholesterol. Also encourage Andres to learn ways to lower his chances for heart disease and stroke.
        • Advise him to visit the eye doctor to check for eye problems.
  12. Strawberry and Pineapple Delight Recipe

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Review of Today's Key Points

Say:
Let's review what we learned today.

  • What is diabetes?
    • Diabetes happens when the body does not make enough insulin or cannot use it well, causing glucose to build up in the blood. As a result the body does not function well.
  • What are risk factors for diabetes?
    • Overweight
    • Family members with diabetes
    • Age 40 or older
    • Not being physically active
    • Being Latino, African American, American Indian, Asian American, or Pacific Islander, because diabetes occurs more often in people from these groups than in whites
    • Having had gestational diabetes or given birth to at least one baby weighing 9 pounds or more
    • High blood pressure
    • Cholesterol levels are not normal – HDL cholesterol is low, or triglyceride level is high
  • How can you prevent or delay type 2 diabetes?
    • Be physically active for at least 30 minutes on most days.
    • Lose a small amount of weight. For example, losing 10 to 15 pounds is helpful for someone who weighs 200 pounds.
  • What are the ABCs of diabetes control?
    • A is for the A1C test. If you have diabetes, take the A1C blood test at least two times every year. This test measures how well a person's blood glucose level has been controlled over the past 3 months. People who have diabetes should aim for an A1C number that is below seven.
    • B is for blood pressure. High blood pressure makes your heart work too hard. It increases your risk for a heart attack, stroke, or damage to your kidneys and eyes. A person with diabetes should have a blood pressure below 130/80 mmHg.
    • C is for cholesterol. Keep cholesterol at normal levels. Bad cholesterol (LDL) can build up and clog your arteries. It can cause a heart attack. People with diabetes need to keep their LDL cholesterol below 100 mg/dL.
  • How does diabetes affect your body?
    • Diabetes can cause damage to the heart, brain, kidneys, and eyes. It can cause nerve damage, which reduces sensation in your feet. Diabetes may also affect blood flow in your legs and feet. This can lead to sores that don't heal and amputation. Good control of your blood glucose can prevent this damage.

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Weekly Pledge

  • Say:
    You have learned a lot today about diabetes prevention and control. Now let's think about how you can apply what you have learned. Please think of one change you can make in your everyday life to prevent or control diabetes. This will be your pledge for the week.
  • Say:
    Be specific about what you plan to do, how you plan to do it, and when you will start. Here are some examples:
    • I will talk to my doctor about my risk for diabetes and see if I need to get my blood glucose level checked.
    • If I have diabetes, I will check my blood glucose levels as my doctor tells me.
    • I will compare food labels the next time I go to the store to help me choose packaged foods that are lower in sugar.
    • I will drink water with my lunch this week instead of regular sodas or other drinks with sugar.
  • Say:
    Write your pledge on the “Be Smart About Your Heart: Control the ABCs of Diabetes” handout. Keep this handout in a special place so you can review your pledge and keep your goals in mind.
    Note: Allow 5 minutes for group members to think of a pledge.
  • Say:
    Would anyone like to share his or her pledge with the group?
    Note: Write down pledge ideas on the blackboard or on a large piece of paper taped to the wall.
  • (Optional) Say:
    Keeping a personal value in mind can help you reduce your risk for diabetes or control your diabetes if you already have it. Remember that a personal value is a quality that you consider important.
    Today, the value is joy. Joy can help you replace boredom, indifference, and depression with a positive outlook. Joy can help you enjoy preparing foods the healthy way. Joy is contagious, and others may follow your example!
  • Ask:
    How could you use joy, or another value, to help you keep your pledge?
    Note: Allow 3 minutes for group members to share their thoughts.
  • Say:
    We will discuss the results of your pledges next week. Don't forget to continue working on your pledges to be more physically active; to cut back on salt, sodium, saturated fat, trans fat, and cholesterol; and to reach and keep a healthy weight.

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Closing

  • Say:
    Thank you for coming today. What did you think of today´s session?
    Note: Allow a moment for group members to respond.
  • Say:
    I am looking forward to seeing you at the next session. The next session will be about making heart healthy eating a family affair.
    Note: Think about today´s session. What worked? What didn´t work? Have you had changes in your own life as a result of today´s session?

Go to Session 6

Go to Session 8


Information on this page is taken from the English print version of “Your Heart, Your Life, A Community Health Worker's Manual.” U.S. Department of Health and Human Services, National Institutes of Health, National Heart Lung and Blood Institute, NIH Publication No. 08-3674, Originally Printed 1999, Revised May 2008.

Last Updated March 2012

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