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1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with...

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Know Your Options Living an Uncomplicated Life with Diabetes This material is copyrighted by Bayer HealthCare LLC and is intended solely for use in the “Know Your ” Series educational programs supported by Bayer HealthCare in the United States and Canada. Unauthorized use of this material without the express written consent of Bayer HealthCare, Diabetes Care is forbidden. © 2007 Bayer HealthCare LLC
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Page 1: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Know Your Options™ Living an Uncomplicated Life with Diabetes

This material is copyrighted by Bayer HealthCare LLC and is intended solely for use in the “Know Your™” Series educational programs supported by Bayer HealthCare in the United States and Canada. Unauthorized use of this material without the express written consent of Bayer HealthCare, Diabetes Care is forbidden.

© 2007 Bayer HealthCare LLC

Page 2: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

As you view the show, make sure to also read the notes underneath each slide because there is a lot of information to keep you healthy in these notes.If you do not see the notes on the bottom of the slides, click on the View tab at the top of the page, and select “notes page”.

If you have any difficulties, call Florey at 748-4501 ext 6410.

Enjoy the show, it is a good one!

Page 3: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Diabetes Complications are Not Inevitable!

� Over the years if you do not control yourblood sugar, complications can occur� Keeping your blood sugar within recommended guidelines can prevent recommended guidelines can prevent and/or reduce complications� Best way to assess control� Must be performed daily to affect control

� Results can be applied to adjustmedications, nutrition and physical activity

� “Know Your Numbers”

Page 4: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Small Vessel Complications

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Large Vessel Complications

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Eye Disease

� Retinopathy is damage to the back of the eye (retina)

� Usually occurs in people that have diabetes for over 5 years

First signs are blurry vision� First signs are blurry vision

� Glaucoma and Cataracts are seen in people with diabetes

� Need to get an eye exam every year by an Ophthalmologist

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Treatment of Eye Disease

� Laser Therapy� Scatter Photocoagulation

� Focal Photocoagulation

� Surgery

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Tips to Prevent Eye Problems

� Keep your blood sugar as close to normal as possible� Control your blood pressure� Quit smoking� See your eye specialist � See your eye specialist (Ophthalmologist) once a year� See your doctor immediately if:� Your eyes hurt or become red� Blurred vision or spots� Trouble reading books or signs� Your peripheral vision

(vision on the side) is not the same

Page 9: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Types of Skin Conditions

� Bacterial infections

� Fungal infections

� Dry skin/itching

� Scaly patches or brown spots

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Types of Skin Conditions, continued

� Allergic reactions due todiabetes medications

� Xanthomatosis

� Acanthosis Nigricans

Page 11: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Tips for “Good” Skin Care

� Keep your blood sugar under control

� Keep skin clean and dry

� Avoid “hot” baths and showers

Moisturize on a daily basis� Moisturize on a daily basis

� Treat cuts right away

� See a Dermatologist if you have any problems with your skin

Page 12: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Foot Care

� Inadequate foot care can lead to amputation� Foot problems are due to:

Lack of sensation� Lack of sensation

� Poor circulation

� Important to seea Podiatrist on a regular basis

Page 13: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Suggestions for “Good” Foot Care

� Examine feet daily

� Wash and dry feet thoroughly

� Cut toenails straight across

� Avoid self-treatment of corns Avoid self-treatment of corns and calluses

� Wear cotton socks

� Inspect shoes for foreign objects

� See a Podiatrist on a regular basis

Page 14: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Dental Care

� People with diabetes have an increased risk for gum disease and cavity formation� The warning signs of � The warning signs of gum disease are:� Bleeding gums when

you brush or floss

� Red, swollen or tender gums

� Bad breath

� Loose teeth

Page 15: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Types of Dental Conditions

� Oral infections

� Pain when chewing

� Increase in cavities

Fungal infections – Thrush� Fungal infections – Thrush

� Dry mouth

Page 16: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Tips for “Good” Dental Care

� Brushing and flossing are the best way to prevent gum disease

� See your Dentist on a regular basis

� Tell your Dentist you have � Tell your Dentist you have diabetes

� Take your usual medications before your dental visit

� Make sure you are able to get your normal amount of daily calories. Plan ahead

Page 17: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

What is Depression?

� Depression comes from a change in

the chemical functioning of the brain

� Depression can be triggered by stress,

difficult life events, environment,difficult life events, environment,

medications

� Depression affects your ability to

function in day to day life

Page 18: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Diabetes and Depression

� Diabetes doubles the risk of being depressed� Depression may be due to stressDepression can lead to:� Depression can lead to:� Poorer physical and

mental functioning� Not following your meal plan

or exercise routine which can lead to weight gain� Not taking your medications

as prescribed

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What Causes Depression in Diabetes

� Depression is caused by a number of factors; physical, psychological and genetic� Everyone reacts differently to stressful events. Just finding out you have diabetes can be stressfulcan be stressful� People with diabetes may have depression due to:� Worrying about long term complications� Effect of their diabetes on daily life� Effect of diabetes on their work environment� Remembering the damaging effects of diabetes

on relatives and/or friends

Page 20: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Symptoms of Depression

� People with “true” depression have symptoms that occur almost every day� Symptoms include:� Prolonged sadness/feeling down� Irritability, anger, worry, anxiety� Irritability, anger, worry, anxiety� Tired� Feeling guilty, worthlessness� Weight loss or gain� Trouble sleeping� Thinking about death or suicide

Page 21: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Treatment of Depression in Diabetes

� Important to see a trained mental health professional for counseling

� May need antidepressant medicationsmedications

� Effective treatment of depression has been shown to improve diabetes control

� St. John’s Wort can cause drug interactions

Page 22: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Erectile Dysfunction or Impotence?

� Erectile Dysfunction describes:� Difficulty getting or maintaining an erection

of the penis

� Impotence describes:Impotence describes:� Erectile dysfunction

� Lack of sexual desire

� Inability to reach or experience an orgasm

� Inability to ejaculate sperm during orgasm

Page 23: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Symptoms of Erectile Dysfunction in Men Can Vary

� Complete inability for erection

� Frequent inconsistent ability to achieve erection

� Inability to maintain an erection throughout intercourse

Page 24: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Risk Factors for Erectile Dysfunction in Men

� Physical diseases and disorders

� Surgery or trauma

� Medications� Medications

� Substance abuse

� Stress, anxiety, or depression

� Smoking

Page 25: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Diabetes and Erectile Dysfunction (ED)

� Men with diabetes are 3 times more likely to develop ED than those without diabetes

� ED in patients with diabetes may be a sign of poor blood may be a sign of poor blood sugar control

� By age 60, more than half of all men with diabetes will have experienced ED

� ED is often the first sign of autonomic neuropathy

Page 26: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Diabetes and Erectile Dysfunction (ED)

� ED can be seen at a younger age in men with diabetes

� Male infertility in diabetes is due to both erectile and ejaculatory failureejaculatory failure

� Response to visual stimulation may be decreased

� The quality of the semen may be affected which can lead to infertility

� Improving glycemic control may help

Page 27: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Psychological Component of ED in Men with Diabetes

� Important in over 50% of cases� Diminished self worth

� Fear of failure – patients fear impotence more than blindness impotence more than blindness

� Marital disharmony

� More “stress”

� Decreased libido

� Decrease in sexual arousal

� Couples counseling can be very beneficial

Page 28: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Prevention of Erectile Dysfunction

� Limit or avoid use of all forms of tobacco

� Limit or avoid use of alcohol and other similar drugs

� Exercise regularly� Exercise regularly

� Use methods of stress reduction

� Get enough sleep

� Use effective approaches to deal with anxiety or depression

� See your doctor for regular checkups and medical screening tests

Page 29: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Treatment of Erectile Dysfunction in Men

� Simple change of some lifestyle choices� Review of medication side effects� PsychotherapyMedication therapy� Medication therapy� Oral PDE inhibitors (caution with nitrates!)• Levitra* • Cialis*• Viagra*

� Oral testosterone* Levitra is a registered trademark jointly shared by

Bayer Pharmaceuticals Corporation, GlaxoSmithKline and Schering Corporation.

* Cialis is a trademark of Lilly ICOS LLC.

* Viagra is a registered trademark of Pfizer Inc.

Page 30: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Symptoms of Sexual Dysfunction in Women

Four types of sexual problems observed in women� Desire disorders

Arousal disorders� Arousal disorders

� Orgasmic disorders

� Sexual pain

Page 31: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Risk Factors for Sexual Dysfunction in WomenSome causes of sexual dysfunction� Physical conditions � Diabetes� Arthritis

High blood pressure � High blood pressure � Vaginal Infections

� Hormonal-Estrogen deficiency – Menopause� Psychological – counseling is recommended� Depression� Anxiety� Stress

Page 32: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Treatment of Sexual Dysfunction in Women

� If desire is the problem� Change your usual routine� Muscle relaxation exercises

� If arousal is the problem� If arousal is the problem� Vaginal or estrogen creams� Psychotherapy

� If orgasm is the problem� Extra stimulation

� If pain is the problem� Different positions� Vaginal creams

Page 33: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Stress

� What is stress?� Stress can be acute or chronic� Stress can occur when:• An event produces a strain on

a person a person • A person thinks a situation as

challenging or threatening

� Stress is influenced by the• Individual • Environment

Page 34: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

What makes something stressful for you?� What are your major stressors?� Life events

• Negative (traffic, arguing, doctor visits, tests, phone calls, holidays

• Positive (marriage, graduation, birth of • Positive (marriage, graduation, birth of a child, new job)

� Evaluating a stressful situation� Our perspective and perception

changes the way we view stress• Beliefs, values and goals• Change is stress

Page 35: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

How does your body react to stress?

� Stress hormones (catecholamines, glucagon, cortisol, and growth hormone)� Symptoms (nervous, sweaty,

palpitations, nausea)

How does stress affect � How does stress affect diabetes and vice versa?� Increase blood glucose

and ketones� Some people actually

have a decrease in blood glucose initially

Page 36: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Coping and Stress Management

� Coping is how each of us respond to a stressful situation� There are certain questions that you need to ask yourself� Strategies and Coping Skills� Different for everyone

� Good strategies – help us to maintain control and feel less tense, relaxed

� Bad strategies – make you feel tired, angry, sick, tense

Page 37: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Important Factors in Coping

� Having enough information� Write down what causes stress and

anxiety in your life

� Feeling in control� Do fewer things better� Do not over commit� Avoid stressful situations

� Having the support of others� Family and friends� Support groups – talk with other

people who have diabetes� Healthcare team – social worker, Psychologist

Page 38: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Schedule Regular Visits With YourHealthcare Team

� Every Day:� Check blood glucose

at home

Every Visit:

� Every Year:� Blood lipid test

� Dilated eye exam

Test for urine protein� Every Visit:� Blood pressure

� Foot exam

� Every 3 months:� A1C

� Weight

� Test for urine protein

� Flu shot and other vaccinations

� Dental checkup

Page 39: 1052009 Know your options - Manatee Your Choice · Diabetes and Erectile Dysfunction (ED) Men with diabetes are 3 times more likely to develop ED than those without diabetes ED in

Conclusion

� Managing your blood sugar and keeping it under control can decrease your risk of complications

� Many of the complications of diabetes can be prevented by understanding more about foot, skin and dental care,strategies to cope with stressful situations and making the right lifestyle choices

� Working closely with your healthcare team is crucial

You Can “Live An Uncomplicated Life With Diabetes”


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