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Diabetes - Separating Fact from Fiction
 

Diabetes - Separating Fact from Fiction

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Diabetes is one of the most prevalent diseases in this country, and also one of the most misunderstood. As the illness becomes more and more widespread, the need for knowledge is growing by the day. ...

Diabetes is one of the most prevalent diseases in this country, and also one of the most misunderstood. As the illness becomes more and more widespread, the need for knowledge is growing by the day. Dr. David Pittman answers questions and addresses the truth and debunks the myth.

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    Diabetes - Separating Fact from Fiction Diabetes - Separating Fact from Fiction Presentation Transcript

    • Diabetes:  Separating Fact From Fiction
      David D. Pittman, MD
      Internal Medicine
      www.SpringfieldClinic.com
    • Question #1
      True/False:The incidence of diabetes mellitus is on the decline.
    • Question #2
      Diabetes can affect individuals of which age group:
      a.  children
      b.  teenagers
      c.  adults
      d.  seniors
      e.  all of the above
    • Question #3
      True/False:
      Once an individual is diagnosed with diabetes, he or she will need to begin taking insulin. 
    • Visit our Health Library section for more information
      http://springfieldclinic.staywellsolutionsonline.com/
    • Diabetes:  What's the Big Deal?
      Nearly 24 million Americans are affected
      Of those, almost 6 million are unaware that they have diabetes
      These numbers are expected to rise
    • What is Diabetes?
      Diabetes is a metabolic disorder characterized by an imbalance of circulating glucose and the body's supply or action of insulin.
    • Who cares?
      Diabetes is the 7th leading cause of death in the U.S.
      Serious complications include:  heart disease, stroke, blindness, nerve damage, kidney disease, impotence, and amputations.
    • Possible Symptoms of Diabetes - or Not
      Thirst
      Frequent Urination
      Fatigue
      Blurred vision
      Weight Loss
    • Diagnosis of Diabetes
      Fasting Plasma GlucoseLevel > 126mg/dL
      Oral GlucoseTolerance Test
      Random Plasma Glucose > 200
      Hemoglobin A1C > 6.5%
    • WhatisHemoglobin A1C?
      Glycosylated hemoglobin is a rough estimate of the amount of "sugar" that "sticks" to a red blood cell (which contains hemoglobin) during it's 90 day lifespan.
      It is expressed as a percentage.
      Normally < 6%
    • Whatdoes HgBA1c Mean?
      HgBA1c            Mean Glucose
          6                          135    7                          170
          8                          205
          9                          240
         10                         275
         11                         310
         12                         345
    • My Doctor Said that I am "Pre-Diabetic"
      Fasting Plasma Glucoselevel 100 - 126
      2 hr post-meal glucose 140 - 199
      High likelihood of progressing to diabetes if no action taken.
    • Type 1 Diabetes
      Children, teenagers, young adults
      Insulin deficiency resulting from auto-immune destruction of insulin-secreting pancreatic beta cells
      Typically present with classic features or emergent hyperglycemia (Diabetic Ketoacidosis -- DKA)
    • Type 2 Diabetes
      90 - 95% diabetics worldwide
      Typically patients 40yr and older
      Family history
      Overweight or obese
      Insulin resistance and relative insulin deficiency
    • Type 2 Diabetes
      Plasma glucose levels remain normal for many years prior to onset of frank Diabetes.
      As insulin resistance builds, pancreatic insulin secretion increases.
      Over time, pancreatic function declines and glucose subsequently increases.
    • Type 2 Diabetes
      Most patients have co-existing clinical and biochemical features:
                 Abdominal obesity            Hypertension            Dyslipidemia            = Metabolic Syndrome            
    • Other Types of Diabetes
      Gestational diabetes (7% of US pregnancies)
      Drug induced
      Chronic pancreatitis
                  
    • Now What?
      Patient EDUCATION and self-management
      Diabetic educators/RN/dieticians
      Multi-Disciplinary team approach
                  
    • Treatment
      Foundation of treatment begins with :
                
                  Diet            Weight loss            ExerciseThese reduce insulin resistance, glucose levels and improve cardiovascular risk factors.             
    • Treatment
      Medication
      Dramatic changes
      Nine separate classes
      Older therapies continue to be effective
    • Treatment
      Lower blood pressure < 130/80
      Use Ace inhibitors (ACEi) or Angiotensin Receptor Blockers (ARB's)
      Lower cholesterol to goal (LDL < 100mg/dL)
    • Long term Complications
      Macrovascular
      Coronary Arteries
      Carotid Arteries
      Cerebral Vascular Supply
      Peripheral Arteries
    • Long term Complications
      Microvascular
      Kidneys:  Diabetic nephropathy
      Eyes:  Diabetic retinopathy
      Peripheral nerves:  Diabetic neuropathy
      These disorders tend to correlate with degree of hyperglycemia
    • Diabetic neuropathy and peripheral arterial disease
      retinopathy
    • d
      Long-term management of Diabetes depends largely upon individual action and attitudes.
    • Questions?