2013 Georgia Diabetes Community Resource Guide Featuring Diabetes and Chronic Disease Self-Management Education Programs, Care and Support Resources For Georgians with Diabetes, Prediabetes and Gestational Diabetes Mellitus (GDM) Returning To The Tradition of Healthier Living Learn More..Move More..Eat Healthy Diabetes, Prediabetes and Gestational Diabetes in Georgia This Georgia Diabetes Community Resource guide provides a general listing of services and resources for Georgians diagnosed with diabetes, prediabetes (also known as borderline diabetes) or gestational diabetes mellitus (GDM), their loved ones as well as healthcare and public health professionals providing care and support to them. Prepared by: Georgia Diabetes Prevention and Control Program OUR VISION Georgians living well free of diabetes and its complications within environments with increased access to qualityoriented diabetes care and healthier options where they live, work, play, and learn. OUR MISSION Protecting and Preserving the Eyes, Hearts, Kidneys and Feet of Georgians Living Well with Diabetes, Pre-Diabetes and Gestational Diabetes INTRODUCTION This resource guide was developed by the Georgia Department of Public Health's Diabetes Prevention and Control Program (DPCP) to support Georgia residents at risk for diabetes or diagnosed with diabetes, prediabetes and gestational diabetes mellitus (diabetes during pregnancy). The information contained in this resource guide is not a replacement for medical advice or treatment. If you feel that you may be at risk for prediabetes (borderline diabetes) or diabetes or already diagnosed with diabetes or gestational diabetes mellitus (diabetes during pregnancy), please seek routine medical care by finding or contacting your doctor or healthcare professional. It is important to discuss any changes and questions regarding diet changes and physical activity levels with your doctor, nurse, registered dietician, certified diabetes educator before making a change. Some changes in your eating and physical activity may affect your blood sugar (glucose) level. It is also important to work with your doctor to obtain additional information about local resources to maintain proper vision care, foot care and dental care. TABLE OF CONTENTS Diabetes Overview....................................................... 6 Learn More Now..........................................................10 Diabetes Care..............................................................12 Healthy Eating..............................................................14 Being Active.................................................................18 Medication Monitoring................................................20 Diabetes Supplies.........................................................22 Eye Care.......................................................................24 Kidney Care..................................................................26 Foot Care......................................................................28 Diabetes Prevention Programs.....................................30 Reference: AADE7 Self-Care Behaviors http://www.diabeteseducator.org/ProfessionalResources/AADE7/ Diabetes Overview DIABETES OVERVIEW About one-third (1/3) of individuals with diabetes are unaware they have diabetes. If not controlled, diabetes is a serious disease that can lead to other severe health conditions including vision problems (including blindness), kidney failure, nerve damage, amputations (legs, toes, feet) and significantly impact daily living. Good A1c Control is Important to Preventing Complications Diabetes is a condition in which the body cannot change sugars and starches (carbohydrates) into energy. This happens when the body cannot make enough insulin or cannot use the insulin it makes. As a result, extra sugar in the blood can lead to damage in the blood vessels, eyes, kidneys, heart, and nerves. 6 | Live Healthy Georgia TYPE 1 DIABETES TYPE 2 DIABETES (MOST COMMON) A medical condition in which the body makes no insulin or so little insulin that the body cannot change blood sugar into energy. Type 1 diabetes usually develops during childhood or adolescence, before a woman becomes pregnant. Insulin helps the body use glucose from food for energy. People with Type 1 need to take insulin every day. A medical condition in which the body produces too little insulin or cannot use the insulin properly to change blood sugar (glucose) into energy. Individuals diagnosed with Type 2 diabetes may require medication along with other lifestyle changes: dietary changes and physical activity modification to manage their diabetes condition. OVERVIEW: GESTATIONAL DIABETES AND PREDIABETES How can I learn more about preventing Type 2 Diabetes? How can I prevent developing Type 2 Diabetes if I have prediabetes (borderline diabetes)? How can I prevent developing Type 2 Diabetes if I have gestational diabetes (diabetes during pregnancy)? GESTATIONAL DIABETES Gestational diabetes is a type of diabetes that first occurs during pregnancy or detected when a woman is pregnant. Gestational diabetes usually goes away following pregnancy but women with a history of gestational diabetes have a 35%-60% chance of developing diabetes within 10-20 years after delivery. But with risks associated with diabetes can be reduced with dietary changes and routine physical activity leading to modest appropriate weight reduction and maintenance. PRE-DIABETES (BORDERLINE DIABETES) Prediabetes (also known as borderline diabetes) is condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of Type 2 diabetes. Prediabetes is sometimes referred to as "impaired fasting glucose" or " impaired glucose tolerance" by healthcare providers. Individuals diagnosed with prediabetes are at higher risk for developing Type 2 diabetes. In addition, individuals with prediabtes also have a higher risk of heart disease. But by adopting healthy lifestyle changes including modest and appropriate diet changes along with weight reduction and maintenance at this point may prevent progression to a diabetes diagnosis. Its never too early to prevent or delay diabetes. Early and routine screening and detection of prediabetes (borderline diabetes) may also provide an opportunity to prevent or delay the onset of Type 2 diabetes prior to pregnancies as well as during the postpartum period following each pregnancy. Diabetes Overview 7 | Live Healthy Georgia Diabetes Overview RISK FACTORS: DIABETES & PREDIABETES Age: 45 or older Weight status: Overweight [Body Mass Index (BMI) over 25] or Obese (BMI 30 or above) Family history of diabetes History of gestational diabetes mellitus (GDM) Having a baby over 9 lbs High blood pressure (hypertension) History of borderline diabetes (prediabetes) High "LDL" cholesterol levels Member of certain ethnic groups: African American, Asian American, Native American, Hispanic/Latino, or Pacific Islander origin Lack of routine physical activity 8 | Live Healthy Georgia SYMPTOMS OF HIGH BLOOD GLUCOSE (HYPERGLYCEMIA) Increased thirst Increased urination Dry mouth or skin Tiredness or fatigue Blurred vision Slow healing cuts and sores Unexplained weight loss SYMPTOMS OF LOW BLOOD GLUCOSE (HYPOGLYCEMIA) Difficulty paying attention or confusion Difficulty speaking Shakiness Dizziness or light-headedness Sweating Hunger Sleepiness Headache Sudden moodiness or behavior changes Diabetes Overview 9 | Live Healthy Georgia Learn More Now 10 | Live Healthy Georgia LEARN MORE NOW Now that you have been diagnosed, you may have many questions and concerns. You may be wondering... What foods can I eat daily? Do I need medication and other supplies? Where can I obtain more information and education about how to live with and manage my condition successfully? What do I do now? There are variety of programs and other resources that you can go to find answers and long-term support. Control your blood sugar and manage your care by learning as much as you can about diabetes. Resources DIABETES SELF-MANAGEMENT EDUCATION PROGRAMS (DSME) - Educators with the designations of Certified Diabetes Educator (CDE) are certified by the National Certification Board of Diabetes Educators. Professional organizations including the American Association of Diabetes Educators and the American Diabetes Association (ADA) are committed to successful self-management of diabetes. Programs recognized by the American Association of Diabetes Educators (AADE) and American Diabetes Association (ADA) both meet the national standards for excellence in diabetes education. Diabetes Self-Management Education Programs recognized by these organizations are delivered in several settings throughout Georgia including: medical centers (hospitals), pharmacies, and doctor offices. American Association of Diabetes Educators (AADE) Call 1-800-338-3633 Website(s): http://www.diabeteseducator.org/Diabetes Education/Programs.html https://www.healthmonitor.com/AADE/finder.do American Diabetes Association Call 1-800-DIABETES (1-800-342-2383) Website(s): http://professional.diabetes.org/ERP_List.aspx STANFORD CHRONIC DISEASE SELF-MANAGEMENT PROGRAMS (CDSMP) - Living Well Workshops are for adults with any chronic condition or for caregivers of persons with chronic conditions to learn more skills about managing their health and well-being. CDSMP is intended to support recommendations patients receive from their doctor, these evidence-based programs teach participants some aspects including: how to exercise properly and eat healthy, how use medications appropriately, how to solve everyday challenges or problems, how to speak to and partner effectively with family members and healthcare providers As a result, learning these new skills help participants reduce symptoms such as: pain, depression, fear, and frustration; and to also improve mobility and exercise; increase energy; and boost confidence in their ability to manage their condition. Living Well Workshops in Georgia are held once a week. Participants meet for 2 hours for 6 weeks throughout several regions statewide. Living Well Workshops are hosted in various settings: senior centers, churches, clinics, libraries, etc. For additional information, Georgians may contact their local Area Agency on Aging (AAA)-Georgia Division of Aging Services. DIABETES EDUCATION PROGRAMS & SUPPORT WEBSITES American Diabetes Association (ADA) www.diabetes.org American Association of Diabetes Educators (AADE) www.diabeteseducator.org Diabetes Association of Atlanta http://diabetesatlanta.org/web/ Diabetes Self-Management http://www.diabetesselfmanagement.com/about/ Emory Latino Diabetes Education Program http://www.medicine.emory.edu/divisions/endocrinology/diabetes_education_center/index.cfm Living Well CDSMP Workshops (Georgia Division of Aging) http://www.livewellagewell.info/CDSMP/cdsmp.html Learn More Now 11 | Live Healthy Georgia Diabetes Care MEDICAL CARE AND CHECK UPS : FINDING A "MEDICAL HOME" FOR ROUTINE CARE Where can I go for regular medical care to help me control my diabetes, prediabetes or gestational diabetes? How can I learn more about what supplies or resources I need to address or prevent diabetes complications? Federally Qualified Health Centers (also known as Community Health Centers) provide quality-oriented primary care and preventive services to children and adults with limited and no health insurance. In addition, Federally Qualified Health Centers (FQHCs) also provide services to adults with health insurance and also offer payment fee schedules based on income and ability to pay (where applicable). FQHCs and Local Health Departments are available throughout Georgia. Some Georgia FQHCs also provide Diabetes Self-Management Education (DSME) programs accredited by the American Association of Diabetes Educators (AADE). In addition, there are several clinics, medical centers and other healthcare sites providing Diabetes Education Programs recognized by the American Diabetes Association (ADA) throughout Georgia. 12 | Live Healthy Georgia Resources Georgia Local Public Health Departments Website: http://health.state.ga.us/regional/ Georgia Federally Qualified Health Centers (FQHCs) Website: http://findahealthcenter.hrsa.gov/Search_HCC.aspx?byCounty=1 Telephone: 1 (877) 77-GAPHC or (404) 659-2861 Georgia Free Clinic Network Website: http://www.gfcn.org/ Telephone: (678) 553-4939 American Academy of Home Care Physicians http://www.aahcp.org/associations/11307/files/ProviderLocator.cfm Diabetes Care 13 | Live Healthy Georgia Healthy Eating HEALTHY EATING How can I obtain more information about making an exercise plan suitable for my lifestyle? Where can I learn more about making a nutrition plan suitable to my cultural needs? What resources can help me reach and maintain my weight goals? Registered dietitians (RDs) provide nutrition counseling. If you are diagnosed with diabetes, you can be referred by a doctor to a registered dietitian to assist with developing a healthier diet or nutrition plan tailored to meet your needs. American Dietetic Association Website: www.eatright.org Telephone: 1-800-877-1600 Georgia Division of Aging Services (Georgia Department of Human Services) Nutrition/Wellness Services and Help At Home Services Website: http://aging.dhs.georgia.gov/programs-and-services Telephone: 1-866-55-AGING (1-866-552-4464) 14 | Live Healthy Georgia Healthy Eating Tips Eat three meals at regular times plus three healthy snacks Balance carbohydrates, proteins and fats in your snacks and meals Watch your portion sizes at each meal and snack Build a healthy plate one-quarter protein, one-quarter starch and one-half vegetables Eat more high fiber foods Limit processed grains, sugars and sweets Limit or eliminate trans fats and saturated fats The Academy of Nutrition and Dietetics is one of world's largest organization of food and nutritional professionals. The "Find a RD" or "Find a Registered Dietician" online referral service allows viewers to search a local qualified food and nutrition practitioners throughout the state and nation. The Georgia Department of Agriculture features a network of local state farmers' markets. It also features community farmers' markets which are places where farmers sell directly to their neighbors. The Georgia Cooperative Extension sponsors events including Diabetes Cooking School in various Georgia locations. In addition, it also sponsors "Expanded Food and Nutrition Program" a training program that assists parents feed their children healthier and cost-saving meals and snacks. Nutrition education is also provided to Georgia children ages 4-18. Healthy Eating 15 | Live Healthy Georgia Healthy Eating The Georgia Food Bank Association is made up of seven regional food banks. Working through more than 2,300 partner agencies and pantries to reach 159 counties statewide. Food banks work to increase food security among low-income and needy children, seniors and working families in Georgia. The Georgia Women, Infants and Children (WIC) Clinics provide nutrition education and supplemental foods to pregnant women, postpartum women, women who are breastfeeding, as well as children up to age 5. Services are provided to women population groups featured above with a low income or an annual income at or below 185 percent of thefederally poverty level or enrolled in Medicaid; and who are at risk for nutritional deficiencies. Open Hand is an organization that assist Georgians to prevent or better manage chronic disease through Comprehensive Nutrition Care by combining home-delivered meals and nutrition education. 16 | Live Healthy Georgia Resources Academy of Nutrition and Dietetics Website: www.eatright.org/programs/rdfinder Georgia Department of Agriculture Georgia Grown Website: http://georgiagrown.com/find/farmers_markets Farmer's Markets State Farmers' Markets is a network for sales of fruits and vegetables throughout Georgia and the Southeast. Website: http://agr.georgia.gov/community-farmers-markets.aspx Telephone: (404) 656-3680 Georgia WIC (Women, Infants and Children) Farmer's Market Nutrition Program Website: http://wic.ga.gov/gafarmersmarket.asp Telephone: 1-800-228-9173 Georgia Cooperative Extension Diabetes Cooking School Events Website: http://extension.uga.edu/food/preparation/ Expanded Food and Nutrition Program Website: http://www.fcs.uga.edu/ext/food/efnep.php Telephone: 1-800-ASK-UGA1 Georgia Food Bank Association Website: http://georgiafoodbankassociation.org/find-your-food-bank/ Telephone :(404) 601-2462 Georgia Department of Public Health: Georgia Women, Infants and Children (WIC) Clinics Website: http://wic.ga.gov/ or https://sendss.state.ga.us/ sendss/!wicclinic.screen Telephone : (404) 601-2462 Georgia Division of Aging Services-Local Area Agencies on Aging Website: http://aging.dhs.georgia.gov/local-area-agenciesaging-aaas Telephone: 1-866-552-4464 or 1-866-55AGING Open Hand Website: www.projectopenhand.org/ Telephone: (404) 872-6947 Healthy Eating 17 | Live Healthy Georgia Being Active BEING ACTIVE How can I exercise with my busy life? How can I learn about the most appropriate physical activity for me and my condition? How can I work with my healthcare provider to develop an exercise plan that meets my interests and daily schedule? Physical Activity Tip Partner with your healthcare provider to develop an exercise plan and to choose a list of physical activities most appropriate for your lifestyle and condition (diabetes, prediabetes, gestational diabetes) Listed in this guide are just a few walking programs available in Georgia. Please work with your healthcare provider and other members of the healthcare team to obtain information about additional walking programs available in your city, town or county. Walking programs maybe sponsored by community organizations, faith-based organizations, neighborhood associations as well as businesses for their employees. And maybe conducted at local parks or schools. "Walk Georgia" is an 12-week program to increase your physical activity in a fun, community-oriented way. Georgians may participate as an individual or form a team. "Walk Georgia" is sponsored through the local Cooperative Extension Office. Georgians may also sign up to obtain a weekly newsletter which features recipes and other healthy lifestyle tips. 18 | Live Healthy Georgia Resources "Walk Georgia" Program Website: www.walkgeorgia.org Telephone: 1-800-ASK-UGA1 Community in Motion (Northwest Georgia Healthcare Partnership) Website: http://www.mileschallenge.org/ or http://www.mileschallenge.org/places/ Telephone: (706) 272-6662 Walk with Ease & Tai Chi Programs (Sponsored by the Arthritis Foundation) Website: http://www.arthritis.org/resources/community-programs/ walk-with-ease/ Telephone: 1-800-283-7800 Georgia Parks and Recreation Association Website: http://www.grpa.org/ Telephone: (770) 760-1403 Georgia Bike Trails Website: http://www.n-georgia.com/bike_trails.htm TrailLink-Find trails by state and activity Website: http://www.traillink.com/ Telephone: (202) 331-9696 Being Active 19 | Live Healthy Georgia Medication Monitoring TAKING MEDICATIONS Diabetes is a serious medical condition disease requiring daily management. If uncontrolled, diabetes can lead to the complications of heart disease, stroke, kidney disease, nerve damage, including amputations and eye disease. Important factors such as: taking medications as prescribed as well as maintaining regular physician, lab, and specialist visits to monitor diabetes and its complications, can help prevent or delay the onset of complications. Medication Tips If you are prescribed diabetes medications such as: pills or insulin injections, please ask questions. Provide your primary care doctor and specialists with a list of all of your medications and medication changes during each visit. Always share with your healthcare provider and members of the healthcare team if you are unable to refill your medications or forget to take your medications as recommended. The healthcare team will work with you to prevent or reduce these any issues or challenges with taking your medications. Maintaining an annual dilated eye exam each year is very important. Try to maintain a pair of eyeglasses based on your most recent prescription so that words and numbers are clearly seen for reading medication bottles, syringes as well as glucometers. 20 | Live Healthy Georgia Having the Right Diabetes Supplies and Routinely Checking Blood Sugar (Glucose) Levels are Important for Preventing Complications Resources Express Scripts (Home Delivery of Medications) Website: www.express-scripts.com Telephone: 1 (800) 769-3880 Medicare Preventive Services -Diabetes Screening, Supplies, and Self Management Training Website: www.medicare.gov/Health/Diabetes.asp Needy Meds Website: http://www.needymeds.org/ Telephone: (215) 625- 9609 Partnership For Prescription Assistance Websiter: http://www.pparx.org/ Telephone: 1-888-4PPA-NOW or 1-888-477-2669) Rx Hope Website: https://www.rxhope.com/Patient/Home.aspx Telephone: (401) 729-3284 Rx Assist-Patient Assistance Program Center Website: http://www.rxassist.org/ Together Rx Access Website: http://www.togetherrxaccess.com/ Telephone: 1-800-444-4106 Medication Monitoring 21 | Live Healthy Georgia Diabetes Supplies SUPPORT: DIABETES MONITORING SUPPLIES Featured in this guide are a few resources to assist you with information to access and take your medications as prescribed along with other supplies to control your diabetes condition. It maybe helpful to ask your local pharmacy or pharmacist about the availability of home delivery services. Diabetes Supply Tips Try to maintain a current glucometer (glucose monitoring device) and other glucose monitoring supplies (i.e. diabetes strips, etc.). Work with your healthcare provider and diabetes educator by asking questions before and during visits to ensure that your diabetes equipment is up-to-date, calibrated corrected and working properly. If you are unsure of a glucose reading, always ask a loved one or another person to review the reading on your glucometer or diabetes equipment. Additional information regarding additional financial information regarding Diabetes medications and supplies are also featured below: Medicare Coverage of Diabetes Supplies and Services Website: www.medicare.gov/Publications/Pubs/pdf/11022.pdf Financial Help For Diabetes Care (Featured by the National Diabetes Information Clearinghouse) http://diabetes.niddk.nih.gov/dm/pubs/financialhelp/ 22 | Live Healthy Georgia LifeScan and Abbott pharmaceutical companies both participate in the TogetherRx Access program (www.togetherrxaccess.com), which provides certain medications and testing supplies at a 25-40% discount to patients who are not Medicare-eligible and who do no have any prescription coverage. As always, make sure you discuss any change in your testing habits or glucometer brand with your Primary Care Provider. Diabetic control should never be sacrificed for financial reasons, so make sure you're putting the time in to find the best deals. Compare these programs to your insurance benefits and see what works best for you financially: Listed below are just a few resources, please check with your healthcare provider, diabetes educator as well as other members of the healthcare team. www.accuchek.com www.ibgstar.us www.relion.com www.onetouch.com www.myfreestyle.com www.bayercontour.com Resources BD (Becton, Dickinson and Company) Diabetes Learning Center & Insulin Syringe Assist Program Website: http://www.bd.com/us/diabetes/ Telephone: 1-866-818-6906 Georgia Drug Card Website: http://www.georgiadrugcard.com/index.php Free Drug Card Website: www.freedrugcard.us Telephone: 1-877-321-6755 Free Medicine Program Website: http://www.freemedicineprogram.org/ SelectCare Benefits Network Website: http://www.myrxadvocate.com/ Telephone: 1-877-331-0362 Veterans' Prescription Service Website: www.va.gov/healtheligibility Telephone: 1-877-222-8387 Diabetes Supplies 23 | Live Healthy Georgia Eye (Vision) Care EYE (VISION) HEALTH How often should my eyes be checked? What services are available to obtain an annual dilated eye examination and new eyeglasses if needed? Diabetic eye diseases including: diabetic retinopathy, glaucoma and cataracts can lead to vision problems among persons diagnosed with diabetes. It is recommended that you have a dilated eye exam every year, as vision (eye) problems from diabetes may be prevented with early diagnosis and treatment. Additional healthcare professionals including an optometrist can refer you for an appointment with a eye specialist: ophthalmologist. Vision Health is Important to Preventing Complications 24 | Live Healthy Georgia Eye Care Tips Try to maintain all regular vision (eye) examination appointments. And notify your healthcare provider immediately about any changes in your vision (eye). Check with your eye doctor to maintain a current pair of eyeglasses each year. Having clear vision is helpful for reading medication labels, taking the correct amount of medication as well as preventing falls. Administer your eye drops as recommended by your physicians. Please share with your healthcare care provider if you experience problems with refilling your prescription for your eye drops. Diabetic Eye Disease-Patient Information (National Eye Institute) Website: http://www.nei.nih.gov/health/diabetic/ Resources Financial Aid Information-Eye Care (National Eye Institute) Website: http://www.nei.nih.gov/health/FactsAboutFINANCIALAID2011.pdf Eye Care America Website: http://www.eyecareamerica.org/ Telephone: 1-877-887-6327 Georgia Lions Lighthouse Foundation (Clinic sites available in several regions statewide) Website: http://www.lionslighthouse.org/programs/eyeglasses_exams Telephone: (404) 325-3630 Georgia Society To Prevent Blindness (Prevent Blindness Georgia) Website: http://www.pbga.org/ Telephone: (404) 266-2020 or 1-800-477-4448 Center For The Visually Impaired Website: http://www.cviga.org/ Telephone: (404) 875-9011 Eye (Vision) Care 25 | Live Healthy Georgia Kidney Care KIDNEY CARE No symptoms may occur during early kidney disease. How often should my kidneys be checked or tested? Where can I go to have my kidneys checked? What steps can I take daily keep my kidneys healthy? Am I at high risk for developing kidney disease, if I have diabetes? What is GFR? Have my urine albumin or kidney function test results changed since the last time it was checked? Kidney Care Tips During routine doctor visits, ask about what annual kidney function tests and what kidney function test results mean. During routine doctor visits, it maybe helpful to ask if you need to make changes to your diet or healthy patterns. It maybe helpful to participate in local kidney screening events held in your community and share results from tests with your physician(s) or doctor(s). Print out a list of questions to ask your doctor or healthcare professional before your next visit. A few examples are featured on the National Kidney Disease Education program website. 26 | Live Healthy Georgia Kidney disease, if unmanaged; can lead to kidney failure (also known as end stage renal disease). Additional organizations provide information to support Georgians diagnosed with kidney disease. They include the Renal Support Network and National Kidney Disease Education Program (NKDEP) featured on this page. For example, the Renal Support Network aims to help dialysis and renal transplant centers achieve high standards of care for kidney patients in Georgia, North Carolina, and South Carolina. The National Kidney Disease Education Program (NKDEP) features kidney health resources for individuals diagnosed with kidney disease. NDEP also features information for the general public, healthcare professionals, families and communities. Resources AMERICAN KIDNEY FUND (AKF) Website: http://www.kidneyfund.org/kidney-health/ For questions about kidney health and paying for treatment, please contact AKF Helpline: 1-866-300-2900. For questions about financial assistance programs, please contact AKF Patient Services: 1-800-638-8299. For information about local kidney health screenings in Georgia, please contact AKF office: 404-658-1422. NATIONAL KIDNEY FOUNDATION SERVING GEORGIA AND ALABAMA E-mail: nkfga@kidney.org Website: www.kidneyga.org Phone: (770) 452-1539Toll Free: 800-633-2339 Fax: (770) 452-7564 Kidney Early Evaluation Program (KEEP) Website: http://www.kidney.org/news/keep/index.cfm Telephone number: 1-800-622-9010 NKF of Georgia, Inc. Phone: (770) 452-1539Toll-free: (800) 633-2339 Fax: (770) 452-7564 E-mail: bsachs@kidneyga.org Website: www.kidneyga.org/ RENAL SUPPORT NETWORK-SOUTHEAST KIDNEY COUNCIL Phone: (919) 855-0882 Toll-free: (800) 524-7139 Fax: (919) 855-0753 Website: www.esrdnetwork6.org/ NATIONAL KIDNEY DISEASE EDUCATION PROGRAM Phone: 1-866-4-KIDNEY Phone: 1-866-454-3639 Website: http://nkdep.nih.gov/learn.shtml Kidney Care 27 | Live Healthy Georgia Foot Care FOOT CARE People diagnosed with diabetes can over time experience poor circulation and nerve damage throughout the body. Diabetes-related nerve problems are sometimes more common among people who experience a combination of factors such as: high blood glucose (sugar) levels, long duration of uncontrolled diabetes, high levels of cholesterol and blood pressure or lifestyle factors such as smoking. Foot Care Tips Many of these serious problems can be prevented by taking good care of your feet and your health daily. Listed below are a few helpful tips. Manage your diabetes, including keeping your blood sugar (glucose), blood pressure and cholesterol at levels your health care provider recommends. Continue to take your medicines as prescribed even when you feel good. Ask your healthcare provider for assistance to quit smoking. Smoking reduces blood flow to the feet and increases risk of foot problems and amputation. Ask for help to stop smoking by calling 1-800-QUIT-NOW (1-800-784-8669) or the Georgia Tobacco Quit Line (1-877-270-STOP). Ask your doctor to provide a comprehensive foot examination during visits. Comprehensive foot care programs can reduce amputation rates by 45 % to 85 % (percent). Check your feet for sores, blisters, cuts, redness, swelling, infections and calluses as well as other foot problems. 28 | Live Healthy Georgia Reference: Diabetic Neuropathies: The Nerve Damage of Diabetes NIH Publication No. 09-3185. February 2009 Website: www.diabetes.niddk.nih.gov Resources Georgia Podiatric Medical Association Website: http://www.gapma.com/ Free Microfilaments for Foot Examinations http://www.hrsa.gov/hansensdisease/leap/ National Diabetes Education Program (NDEP) Website: http://www.ndep.nih.gov/publications/ PublicationDetail.aspx?PubId=67&redirect=true Living With Diabetes: Keep Your Feet Healthy (CDC) Website: http://www.cdc.gov/features/diabetesfoothealth/ index.html Foot Care 29 | Live Healthy Georgia Diabetes Prevention 30 | Live Healthy Georgia DIABETES PREVENTION PROGRAMS Individuals diagnosed with prediabetes (also known as borderline diabetes) have blood glucose (blood sugar) levels that are higher than normal, but not high enough to be diagnosed as type 2 diabetes. Individuals diagnosed with prediabetes are more likely to develop type 2 diabetes, heart disease, and stroke. On the other hand, individuals diagnosed with prediabetes can take steps to prevent or delay the onset of Type 2 diabetes. In addition, individuals with gestational diabetes mellitus (GDM) can also take steps during and following pregnancy to prevent or delay the onset of Type 2 diabetes. What are some daily steps that I can adopt to prevent my risk for diabetes? What is prediabetes or borderline diabetes? Are there local Diabetes Prevention Programs nearby? What are some other places in my community, city or town that provide an environment for me to participate in physical activity on a regular basis? How can I obtain more information about how my organization or employer can apply to become a part of the Diabetes Prevention Program registry? Prevention Tips Partner with your doctor and other members of the healthcare team to develop a care plan to reduce your risks for diabetes. Partner with your doctor to select the most appropriate physical activity and meal plans to fit your health condition and lifestyle. Resources CDC DIABETES PREVENTION RECOGNITION PROGRAMS Website: http://www.cdc.gov/diabetes/prevention/ recognition/registry.htm#program Telephone: 1-800-CDC-INFO (1-800-232-4636) YMCA DIABETES PREVENTION PROGRAM Website: http://www.ymca.net/test-path Telephone: 1-800-872-9622 Diabetes Camps Website: http://www.diabetes.org/living-with-diabetes/ parents-and-kids/ada-camps/ DiabetesLocal http://www.diabeteslocal.org/ Diabetes Support Groups Website: http://www.diabetes.org/in-my-community/ local-offices/atlanta-georgia/diabetes-support-groups.pdf Georgia Libraries Website: http://www.georgialibraries.org/directories/ publiclibdir.php Medical Alert Website: http://www.americanmedical-id.com/extras/diabetesbuildpage.php Telephone: 1-800-363-5985 To obtain additional information, please access the following websites: Live Healthy Georgia-Diabetes Section http://www.livehealthygeorgia.org/peoplediabetesshtml? Georgia Diabetes Prevention and Control Program http://health.state.ga.us/programs/diabetes/index.asp References: AADE7 Self-Care Behaviors http://www.diabeteseducator.org/ProfessionalResources/AADE7/ Buchanan TA, et al. Diabetes Care 2007; 30 Suppl 2: S105-11. National Diabetes Fact Sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf National Diabetes Information Clearinghouse. "Insulin Resistance and Pre-Diabetes. National Institutes of Health. NIH Publication No. 03-4893. April 2003. Diabetes Prevention 31 | Live Healthy Georgia 2013 Georgia Diabetes Community Resource Guide Diabetes Prevention and Control Program Health Promotion & Disease Prevention (HPDP) Section