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  1. 1. Diabetes Healthy Schools, Healthy Families Mithila Jegathesan, M.D. Kate Avitabile, M.D.
  2. 2. What is Diabetes? <ul><li>A disease in which there are high levels of blood glucose in the body </li></ul><ul><li>Glucose is the medical term for sugar </li></ul><ul><li>It is the fuel the body uses to stay active, just like gas in a car </li></ul>
  3. 3. Why does diabetes happen? <ul><li>Normally, an organ called the pancreas produces a hormone called insulin </li></ul><ul><li>Insulin controls the level of sugar in the body </li></ul><ul><li>In diabetes the insulin does not control the sugar correctly </li></ul>
  4. 4. Type 1 Diabetes <ul><li>The body destroys the cells in the pancreas that usually make insulin </li></ul><ul><li>There is no insulin in the body to control the levels of sugar </li></ul><ul><li>Insulin must be injected into the person to control the levels of sugar </li></ul>
  5. 5. Type 1 Diabetes <ul><li>Usually happens in children and young adults </li></ul><ul><li>May be “in their genes” </li></ul><ul><li>No way to prevent or cure this type of diabetes yet </li></ul>
  6. 6. Type 2 Diabetes <ul><li>At the beginning the pancreas is able to produce insulin to control the sugar </li></ul><ul><li>But the other cells in the body, like the muscles, cannot respond to this insulin </li></ul><ul><li>The pancreas tries to produce more and more insulin but the organs cannot respond </li></ul><ul><li>This is called “insulin resistance” </li></ul>
  7. 7. Type 2 Diabetes <ul><li>The pancreas eventually gets tired out and cannot produce any more insulin </li></ul><ul><li>The body’s sugar levels are uncontrolled </li></ul><ul><li>Some people need medications to decrease the level of sugar in the body </li></ul><ul><li>Other people may eventually need insulin injections </li></ul>
  8. 8. Who often gets Type 2 Diabetes? <ul><li>Older age - adult and young adult cases </li></ul><ul><li>Overweight or obese people </li></ul><ul><li>Women who had diabetes during pregnancy </li></ul><ul><li>People who do not exercise often </li></ul><ul><li>Some races and ethnicities </li></ul><ul><ul><li>African American </li></ul></ul><ul><ul><li>Hispanic/Latinos </li></ul></ul><ul><ul><li>Native Americans </li></ul></ul><ul><ul><li>Some Asians </li></ul></ul><ul><li>May run in families </li></ul>
  9. 9. Gestational Diabetes <ul><li>Diabetes in pregnant women </li></ul><ul><li>May go away after the baby is born </li></ul><ul><li>But some women with this type of diabetes may be more likely to develop permanent diabetes after pregnancy </li></ul><ul><li>Can cause problems for the baby including heart and lung problems and problems with the baby’s sugar </li></ul>
  10. 10. Who may get diabetes of pregnancy? <ul><li>Obese women </li></ul><ul><li>Women with family members with diabetes </li></ul><ul><li>More common in African Americas, Hispanic/Latina Americans, and Native Americans </li></ul>
  11. 11. Body Parts Affected by Diabetes <ul><li>Eyes </li></ul><ul><ul><li>Diabetes causes the blood vessels of the back of the eye called the retina to grow too much </li></ul></ul><ul><ul><li>This may cause the retina to separate from the back of the eye </li></ul></ul><ul><ul><li>This may lead to permanent blindness </li></ul></ul><ul><ul><li>Some people may have surgery to remove these blood vessels </li></ul></ul>
  12. 12. Body Parts Affected by Diabetes <ul><li>Kidneys </li></ul><ul><ul><li>Diabetes causes the blood vessels of the kidneys to become weak </li></ul></ul><ul><ul><li>This may lead to leaking of important proteins into the urine </li></ul></ul><ul><ul><li>These important proteins are lost from the body </li></ul></ul>
  13. 13. Body Parts Affected by Diabetes <ul><li>Kidneys </li></ul><ul><ul><li>Loss of proteins may lead to swelling of the feet and ankles </li></ul></ul><ul><ul><li>Kidney damage can also cause high blood pressure </li></ul></ul><ul><ul><li>Some people need kidney transplants </li></ul></ul>
  14. 14. Body Parts Affected by Diabetes <ul><li>Heart </li></ul><ul><ul><li>High sugar causes damage to the blood vessels that bring blood to the muscle of the heart </li></ul></ul><ul><ul><li>The vessels can become narrow </li></ul></ul><ul><ul><li>Blood cannot get to all parts of the heart </li></ul></ul><ul><ul><li>This may lead to chest pain, heart attacks, and possibly death </li></ul></ul>
  15. 15. Body Parts Affected by Diabetes <ul><li>Other blood vessels </li></ul><ul><ul><li>The vessels of the legs, ankles, and feet may be damaged by diabetes </li></ul></ul><ul><ul><li>This may lead to change in color, pain, and ulcers </li></ul></ul><ul><ul><li>Some diabetics need to have amputations </li></ul></ul>
  16. 16. Body Parts Affected by Diabetes <ul><li>Nerves </li></ul><ul><ul><li>The nerves of the feet are often damaged </li></ul></ul><ul><ul><li>This can cause changes in feeling as well as burning sensations in the feet </li></ul></ul><ul><ul><li>The nerves of the stomach and intestine can also be damaged and cause problems with digestion </li></ul></ul>
  17. 17. Body Parts Affected by Diabetes <ul><li>Infections </li></ul><ul><ul><li>Diabetics are more prone to getting infections </li></ul></ul><ul><ul><li>They may get very serious infections with fungi </li></ul></ul><ul><ul><li>The ulcers of the feet can become infected and spread to infection of the bone </li></ul></ul>
  18. 18. What is Pre-Diabetes? <ul><li>A condition that may later develop into diabetes </li></ul><ul><li>The levels of sugar in the blood are higher than normal but not as high as in diabetes </li></ul>
  19. 19. Who can get Pre-Diabetes? <ul><li>Adults </li></ul><ul><li>Also children! </li></ul><ul><li>As more and more children are overweight, more and more children are getting pre-diabetes </li></ul>
  20. 20. What are the signs of Pre-Diabetes? <ul><li>A person with pre-diabetes has high sugar on a blood test taken first thing in the morning, before eating anything </li></ul><ul><li>The doctor may then test the blood after the person eats a sugary meal and the blood sugar is even higher </li></ul>
  21. 21. What are the signs of Pre-Diabetes? <ul><li>Acanthosis nigricans </li></ul><ul><ul><li>Dark color of the skin on the back of the neck or under the armpits </li></ul></ul><ul><ul><li>May be seen in both light and dark skinned people </li></ul></ul><ul><ul><li>Sign of high levels of blood sugar </li></ul></ul><ul><ul><li>Especially important in finding children at risk of pre-diabetes and diabetes </li></ul></ul>
  22. 22. Now for some GOOD NEWS!!
  23. 23. How can I prevent diabetes in myself and my children? <ul><li>Exercise </li></ul><ul><ul><li>30 minutes per day or 3 times per week </li></ul></ul><ul><ul><li>Try walking more rather than taking the bus or subway </li></ul></ul><ul><ul><li>Take the stairs instead of the elevator </li></ul></ul><ul><ul><li>Try buying an exercise video to use at home </li></ul></ul><ul><ul><li>Find a friend to exercise with you! </li></ul></ul>
  24. 24. How can I prevent diabetes in myself and my children? <ul><li>Eat healthy </li></ul><ul><ul><li>Eat a diet low in fat, low in carbohydrates, and high in fiber </li></ul></ul><ul><ul><li>Limit fast food </li></ul></ul><ul><ul><li>Limit soda and juice </li></ul></ul><ul><ul><li>Parents’ examples help children form good habits! </li></ul></ul>
  25. 25. How can I prevent diabetes in myself and my children? <ul><li>Lose weight </li></ul><ul><ul><li>Obesity is a major risk factor for developing diabetes </li></ul></ul><ul><ul><li>Exercise and healthy eating can help you maintain a healthy weight and lower your risk of developing diabetes </li></ul></ul>
  26. 26. How can I prevent diabetes in myself and my children? <ul><li>Decrease screen time </li></ul><ul><ul><li>Instead of watching TV or playing video games with your kids, go for a walk or go to the park together </li></ul></ul><ul><ul><li>Cutting down TV time from 4 hrs a day to 2 hrs a day can decrease children’s risk of being overweight and developing pre-diabetes </li></ul></ul>
  27. 27. How can I prevent diabetes in myself and my children? <ul><li>See your doctor for regular check-ups </li></ul><ul><ul><li>Follow advice on how to lower blood pressure and cholesterol </li></ul></ul><ul><ul><li>Having diabetes along with obesity, high blood pressure, and high cholesterol increases your risk of heart and kidney disease </li></ul></ul>
  28. 28. How can I prevent diabetes in myself and my children? <ul><li>Limit alcohol intake </li></ul><ul><li>Ask your doctor for information about how you can stop smoking </li></ul><ul><li>Dial 411 for other programs </li></ul>