Diabetes Mellitus Presented by: Evelyn Schumacher, MS, RD, CDE
What is Diabetes? <ul><li>Diabetes Mellitus - “sweet urine” </li></ul><ul><li>The body’s inability to make or use insulin ...
Types of Diabetes <ul><li>Type 1 Diabetes - body makes  NO  insulin </li></ul><ul><li>Type 2 Diabetes - body doesn’t make ...
The Disease: Diabetes <ul><li>Over  18 million  Americans have diabetes. </li></ul><ul><li>Diabetes is the  sixth  leading...
Signs and Symptoms <ul><li>Frequent urination </li></ul><ul><li>Crave extra liquids </li></ul><ul><li>Always hungry </li><...
Signs and Symptoms <ul><li>Always tired </li></ul><ul><li>Blurry vision </li></ul><ul><li>Wounds that won’t heal </li></ul>
Signs and Symptoms <ul><li>Frequent infections </li></ul><ul><li>Numbness & tingling feet </li></ul><ul><li>Sexual dysfunc...
Risk Factors <ul><li>Family member with diabetes </li></ul><ul><li>Overweight </li></ul><ul><li>Age </li></ul><ul><li>Ethn...
Diabetes Causes Serious Health Problems and Death <ul><li>At least 210,000 deaths each year </li></ul><ul><li>22 every hou...
Diabetes Causes Serious Health Problems and Death <ul><li>Causes about 100,000 diabetic kidney failure -- 1,900 every week...
PRE-TEST  <ul><li>With diabetes, fruit juice raises your sugar less than regular soda?     (T  or  F) </li></ul><ul><li>I ...
PRE-TEST  <ul><li>About 50% of the food we eat in a day should come from?   (Carb, Pro, Fat) </li></ul><ul><li>Eating prot...
BASIC DIGESTION S S S S S S S S S S S S S CELL
BASIC DIGESTION S S S S S S S S S S S S S I I I Insulin Insulin Insulin
BASIC DIGESTION S S S S S S S S S S S S S I I I I I I ENERGY
DIABETES   NOT A  PROBLEM <ul><li>Diabetes is a problem with the  </li></ul><ul><li>way the body uses food . </li></ul>SUGAR
WHAT TO DO... <ul><li>Breakfast  Lunch  Supper </li></ul>B Lunch Dinner
WHAT TO DO... <ul><li>No breakfast - what happens by lunch? </li></ul>Lunch
MORE DIFFICULT FOR YOUR BODY TO HANDLE THE FOOD EATEN S S S S S S S S S S S S S SSSSSS ENERGY I I I I I I
NO DIABETES: <ul><li>Blood sugar levels, appetite, and energy levels can remain stable. </li></ul>Breakfast 6am Lunch 12 n...
3 MAIN FOOD PARTS <ul><li>Carbohydrate  =  </li></ul><ul><li>(sugar) </li></ul><ul><li>Protein = </li></ul><ul><li>Fat = <...
FOOD GUIDE PYRAMID Bread, Cereal, Rice and Pasta Group Vegetable Fruit Milk Yogurt Meat Fish Poultry Oil Mayo Protein Fat ...
3 MAIN FOOD PARTS <ul><li>Carbohydrate  =  </li></ul><ul><li>  (sugar) </li></ul>ENERGY
Sweet Beverages <ul><li>Juice </li></ul><ul><li>Regular Soda </li></ul><ul><li>Sweet Tea </li></ul><ul><li>Kool-aid </li><...
BASIC DIGESTION S S S S S S S S S S S S S CELL
3 MAIN FOOD PARTS <ul><li>Carbohydrate  =  </li></ul><ul><li>(sugar) </li></ul>ENERGY 15 min
Sweet Beverages (absorption is quick) Breakfast 6am Lunch 12 noon
Fruit vs. Juice <ul><li>Skin </li></ul><ul><li>Peel </li></ul><ul><li>Membranes </li></ul><ul><li>Strings </li></ul><ul><l...
Fruit vs. Juice Fiber
Fruit by Itself (absorption is quick) Breakfast 6am Lunch 12 noon
Fruit by Itself (absorption is quick) Breakfast 6am Lunch 12 noon
3 MAIN FOOD PARTS <ul><li>Carbohydrate  =  </li></ul><ul><li>  (sugar) </li></ul><ul><li>Protein = </li></ul><ul><li>Fat =...
Balanced Meal (absorption is slower) <ul><li>Appetite,  energy level, and blood sugar are all more stable. </li></ul>Break...
High Fat Meals (slows gastric emptying) <ul><li>The high fat story </li></ul>
How Much Fat? <ul><li>1 tsp oil = 1 fat serving </li></ul>
How Much Fat? <ul><li>To fry torillas - 1 tsp oil ?  </li></ul><ul><li>NO   </li></ul><ul><li>__?__ Fat servings </li></ul>
How Much Fat? <ul><li>To fry meat - 1 tsp oil ?  </li></ul><ul><li>  NO   </li></ul><ul><li>__?__ Fat servings </li></ul>
How Much Fat?
How Much Fat?
3 MAIN FOOD PARTS <ul><li>Carbohydrate  =  </li></ul><ul><li>  (sugar) </li></ul><ul><li>Protein = </li></ul><ul><li>Fat =...
High Fat Meals (slows gastric emptying) Breakfast 6am Lunch 12 noon 12 noon Midnight
Blood Sugars are Elevated <ul><li>Not because of the </li></ul>
Blood Sugars are Elevated <ul><li>But because of the  </li></ul>
Goals for Meal Planning <ul><li>1 st  Goal:  How many meals per day? </li></ul>
Goals for Meal Planning <ul><li>1 st  Goal:  How many meals per day? </li></ul><ul><li>3 </li></ul>
Goals for Meal Planning <ul><li>1 st  Goal:  How many meals per day? </li></ul><ul><li>  3 </li></ul><ul><li>2 nd  Goal:  ...
Goals for Meal Planning <ul><li>1 st  Goal:  How many meals per day? </li></ul><ul><li>  3 </li></ul><ul><li>2 nd  Goal:  ...
FOOD GUIDE PYRAMID Bread, Cereal, Rice and Pasta Group Vegetable Fruit Milk Yogurt Meat Fish Poultry Oil Mayo 15 gr 15 gr ...
1800 Calorie Meal Plan 4  Carbohydrate Groups 4  Carbohydrate Groups 4  Carbohydrate Groups 2  Carbohydrate Groups 60 gr 6...
Food Labels Nutrition Facts Serving Size  1 cup (248 g) Servings Per Container  4 Amount Per Serving Calories  150  Calori...
Food Labels Nutrition Facts Serving Size  1 cup (248 g) Servings Per Container  4 Amount Per Serving Calories  150  Calori...
Food Labels Nutrition Facts Serving Size  1 cup (248 g) Servings Per Container  4 Amount Per Serving Calories  150  Calori...
What About  Alcohol <ul><li>Alcohol is processed like fat </li></ul><ul><li>Replaces 2 fat servings in the meal </li></ul>...
What About  Alcohol <ul><li>Alcohol is processed like fat </li></ul><ul><li>Replaces 2 fat servings in the meal </li></ul>...
PRE-TEST  <ul><li>With diabetes, fruit juice raises your sugar less than regular soda?     (T  or  F) </li></ul><ul><li>I ...
PRE-TEST  <ul><li>About 50% of the food we eat in a day should come from?   (Carb, Pro, Fat) </li></ul><ul><li>Eating prot...
We’re Here for You. . . Cure. Care. Commitment. <ul><li>Visit us on the web at </li></ul><ul><li>www.diabetes.org </li></u...
WHAT IS DIABETES? <ul><li>A disease in which the body no longer produces or uses insulin properly </li></ul><ul><li>Type 1...
STATISTICS <ul><li>Prevalence of Type 2 diabetes is 1.5 times higher in Latinos than non-Latino whites </li></ul><ul><li>T...
STATISTICS <ul><li>In the United states among those between ages 45 – 74: </li></ul><ul><li>~24% of Mexican Americans have...
DIABETES <ul><li>~ 18.2 million Americans have diabetes </li></ul><ul><li>~  1/3 of these are not diagnosed </li></ul><ul>...
COMPLICATIONS <ul><li>Heart disease </li></ul><ul><li>Leading cause of diabetes related deaths </li></ul><ul><ul><li>Adult...
COMPLICATIONS <ul><li>High Blood Pressure </li></ul><ul><li>~ 73% of adults with diabetes have blood pressure  >  130/80 o...
COMPLICATIONS <ul><li>Blindness </li></ul><ul><ul><li>Diabetes is leading cause of new blindness among adults 20-74 years ...
COMPLICATIONS <ul><li>Kidney Disease </li></ul><ul><li>Diabetes is the leading cause of end stage kidney disease (dialysis...
COMPLICATIONS <ul><li>Nervous System Disease </li></ul><ul><li>60% - 70% of people with diabetes have nervous system disea...
COMPLICATIONS <ul><li>Amputations </li></ul><ul><li>More than 60% of nontraumatic lower limb amputations are among those w...
COMPLICATIONS <ul><li>Dental Disease </li></ul><ul><li>Gum disease more common among those with diabetes. </li></ul><ul><l...
COMPLICATIONS <ul><li>Pregnancy </li></ul><ul><li>Poorly controlled diabetes before  conception and during first trimester...
COMPLICATIONS <ul><li>Other Complications </li></ul><ul><li>People with diabetes are more susceptible to many other illnes...
DIABETES SIGNS & SYMPTOMS   <ul><li>Excessive thirst </li></ul><ul><li>Frequent urination </li></ul><ul><li>Extreme hunger...
RISK FACTORS <ul><li>African Americans </li></ul><ul><li>Latinos </li></ul><ul><li>Native Americans </li></ul><ul><li>Asia...
RISK FACTORS <ul><li>Family history </li></ul><ul><li>Obesity  </li></ul><ul><li>Inactivity </li></ul><ul><li>Women who ha...
RISK FACTORS ( GENETIC IN HISPANICS) <ul><li>American Indian or African genes thought to increase risk </li></ul>
HISPANICS HOW MANY HAVE DIABETES? <ul><li>Of minority groups - the 2 nd  largest  </li></ul><ul><li>The fastest growing mi...
DIABETES PREVENTION PROGRAM (DPP) <ul><li>Diet and exercise can effectively delay diabetes </li></ul><ul><ul><li>in a dive...
FREE PUBLICATION <ul><li>“Take Charge of Your Diabetes” </li></ul><ul><li>Published by the CDC </li></ul><ul><li>In Spanis...
DIABETES & NUTRITION <ul><li>Some studies suggest that  </li></ul><ul><li>More advanced diabetes in Hispanics  </li></ul><...
DIABETES MEAL PLAN <ul><li>A guide to help you determine how much and the types of food you can choose </li></ul><ul><li>I...
DIABETES REMEDIES <ul><li>Many Hispanics may use numerous diabetes remedies based on beliefs , in the hope of curing diabe...
TRADITIONAL ADVANTAGES <ul><li>Many advantages in the traditional Hispanic diet: </li></ul><ul><ul><li>Use of complex carb...
TRADITIONAL DRAWBACKS <ul><li>Traditional Hispanic diets have a few drawbacks: </li></ul><ul><ul><li>Liberal use of added ...
NUTRITION MODIFICATIONS <ul><li>Use corn tortillas (instead of flour) </li></ul><ul><li>Use part-skim cheeses </li></ul><u...
NUTRITION MODIFICATIONS <ul><li>Use no added sugar (or sugar substitutes) in licuados and aguas frescas </li></ul><ul><li>...
NUTRITION MODIFICATIONS <ul><li>Use low-fat milk instead of whole milk or cream </li></ul><ul><li>Bake corn tortilla chips...
NUTRITION MODIFICATIONS <ul><li>Taste food before salting it </li></ul><ul><li>Use lemon instead of salt on fruits or in b...
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Aetna Presentation Diabetes

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Diabetes Mellitus

Evelyn Schumacher, MS, RD, CDE, Shands Jacksonville

May 27. 2005 - UNF Hispanic Health Issues Seminar

This is part 4 of an 8 part series of seminars on Hispanic Health Issues brought to you by the University of North Florida’s Dept. of Public Health, College of Health, a grant from AETNA, and the cooperation of Duval County Health Department.

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  • Transcript of "Aetna Presentation Diabetes"

    1. 1. Diabetes Mellitus Presented by: Evelyn Schumacher, MS, RD, CDE
    2. 2. What is Diabetes? <ul><li>Diabetes Mellitus - “sweet urine” </li></ul><ul><li>The body’s inability to make or use insulin properly. </li></ul>
    3. 3. Types of Diabetes <ul><li>Type 1 Diabetes - body makes NO insulin </li></ul><ul><li>Type 2 Diabetes - body doesn’t make enough insulin or doesn’t use it properly </li></ul><ul><li>Gestational Diabetes - diabetes diagnosed during pregnancy </li></ul>
    4. 4. The Disease: Diabetes <ul><li>Over 18 million Americans have diabetes. </li></ul><ul><li>Diabetes is the sixth leading cause of death by disease among adults and second leading cause of death among children. </li></ul><ul><li>It is a national and world epidemic </li></ul>
    5. 5. Signs and Symptoms <ul><li>Frequent urination </li></ul><ul><li>Crave extra liquids </li></ul><ul><li>Always hungry </li></ul>
    6. 6. Signs and Symptoms <ul><li>Always tired </li></ul><ul><li>Blurry vision </li></ul><ul><li>Wounds that won’t heal </li></ul>
    7. 7. Signs and Symptoms <ul><li>Frequent infections </li></ul><ul><li>Numbness & tingling feet </li></ul><ul><li>Sexual dysfunction </li></ul><ul><li>Unexplained weight loss </li></ul>
    8. 8. Risk Factors <ul><li>Family member with diabetes </li></ul><ul><li>Overweight </li></ul><ul><li>Age </li></ul><ul><li>Ethnicity </li></ul>
    9. 9. Diabetes Causes Serious Health Problems and Death <ul><li>At least 210,000 deaths each year </li></ul><ul><li>22 every hour </li></ul><ul><li>Causes 24,000 cases of diabetic blindness -- about 2 every hour </li></ul>
    10. 10. Diabetes Causes Serious Health Problems and Death <ul><li>Causes about 100,000 diabetic kidney failure -- 1,900 every week </li></ul><ul><li>Causes about 67,000 diabetic amputations -- about 7 every hour </li></ul>
    11. 11. PRE-TEST <ul><li>With diabetes, fruit juice raises your sugar less than regular soda? (T or F) </li></ul><ul><li>I have diabetes - I can eat sweet cereals? (T or F) </li></ul><ul><li>On the “Nutrition Facts” label which is more important? (Sugar or Total Carb) </li></ul><ul><li>High protein diets like Dr. Atkins and Sugar Busters are good for diabetes? (T or F) </li></ul><ul><li>Grapefruit juice burns calories and fat (T or F) </li></ul>
    12. 12. PRE-TEST <ul><li>About 50% of the food we eat in a day should come from? (Carb, Pro, Fat) </li></ul><ul><li>Eating protein provides quick energy? (T or F) </li></ul><ul><li>Cereal, milk and juice is a well balanced breakfast (T or F) </li></ul><ul><li>I understand reading food labels? (T or F) </li></ul><ul><li>People with diabetes need to eat special foods to control blood sugar? (T or F) </li></ul>
    13. 13. BASIC DIGESTION S S S S S S S S S S S S S CELL
    14. 14. BASIC DIGESTION S S S S S S S S S S S S S I I I Insulin Insulin Insulin
    15. 15. BASIC DIGESTION S S S S S S S S S S S S S I I I I I I ENERGY
    16. 16. DIABETES NOT A PROBLEM <ul><li>Diabetes is a problem with the </li></ul><ul><li>way the body uses food . </li></ul>SUGAR
    17. 17. WHAT TO DO... <ul><li>Breakfast Lunch Supper </li></ul>B Lunch Dinner
    18. 18. WHAT TO DO... <ul><li>No breakfast - what happens by lunch? </li></ul>Lunch
    19. 19. MORE DIFFICULT FOR YOUR BODY TO HANDLE THE FOOD EATEN S S S S S S S S S S S S S SSSSSS ENERGY I I I I I I
    20. 20. NO DIABETES: <ul><li>Blood sugar levels, appetite, and energy levels can remain stable. </li></ul>Breakfast 6am Lunch 12 noon
    21. 21. 3 MAIN FOOD PARTS <ul><li>Carbohydrate = </li></ul><ul><li>(sugar) </li></ul><ul><li>Protein = </li></ul><ul><li>Fat = </li></ul>ENERGY Building Block Protects
    22. 22. FOOD GUIDE PYRAMID Bread, Cereal, Rice and Pasta Group Vegetable Fruit Milk Yogurt Meat Fish Poultry Oil Mayo Protein Fat Picture Story Of How We Should Eat
    23. 23. 3 MAIN FOOD PARTS <ul><li>Carbohydrate = </li></ul><ul><li> (sugar) </li></ul>ENERGY
    24. 24. Sweet Beverages <ul><li>Juice </li></ul><ul><li>Regular Soda </li></ul><ul><li>Sweet Tea </li></ul><ul><li>Kool-aid </li></ul><ul><li>Punch </li></ul>
    25. 25. BASIC DIGESTION S S S S S S S S S S S S S CELL
    26. 26. 3 MAIN FOOD PARTS <ul><li>Carbohydrate = </li></ul><ul><li>(sugar) </li></ul>ENERGY 15 min
    27. 27. Sweet Beverages (absorption is quick) Breakfast 6am Lunch 12 noon
    28. 28. Fruit vs. Juice <ul><li>Skin </li></ul><ul><li>Peel </li></ul><ul><li>Membranes </li></ul><ul><li>Strings </li></ul><ul><li>Seeds </li></ul>
    29. 29. Fruit vs. Juice Fiber
    30. 30. Fruit by Itself (absorption is quick) Breakfast 6am Lunch 12 noon
    31. 31. Fruit by Itself (absorption is quick) Breakfast 6am Lunch 12 noon
    32. 32. 3 MAIN FOOD PARTS <ul><li>Carbohydrate = </li></ul><ul><li> (sugar) </li></ul><ul><li>Protein = </li></ul><ul><li>Fat = </li></ul>ENERGY Building Block Protects 15 min- 1 hr 2 - 3 hrs 6 - 12 hrs
    33. 33. Balanced Meal (absorption is slower) <ul><li>Appetite, energy level, and blood sugar are all more stable. </li></ul>Breakfast 6am Lunch 12 noon
    34. 34. High Fat Meals (slows gastric emptying) <ul><li>The high fat story </li></ul>
    35. 35. How Much Fat? <ul><li>1 tsp oil = 1 fat serving </li></ul>
    36. 36. How Much Fat? <ul><li>To fry torillas - 1 tsp oil ? </li></ul><ul><li>NO </li></ul><ul><li>__?__ Fat servings </li></ul>
    37. 37. How Much Fat? <ul><li>To fry meat - 1 tsp oil ? </li></ul><ul><li> NO </li></ul><ul><li>__?__ Fat servings </li></ul>
    38. 38. How Much Fat?
    39. 39. How Much Fat?
    40. 40. 3 MAIN FOOD PARTS <ul><li>Carbohydrate = </li></ul><ul><li> (sugar) </li></ul><ul><li>Protein = </li></ul><ul><li>Fat = </li></ul>ENERGY Building Block Protects 15 min- 1 hr 2 - 3 hrs 6- 12 hrs
    41. 41. High Fat Meals (slows gastric emptying) Breakfast 6am Lunch 12 noon 12 noon Midnight
    42. 42. Blood Sugars are Elevated <ul><li>Not because of the </li></ul>
    43. 43. Blood Sugars are Elevated <ul><li>But because of the </li></ul>
    44. 44. Goals for Meal Planning <ul><li>1 st Goal: How many meals per day? </li></ul>
    45. 45. Goals for Meal Planning <ul><li>1 st Goal: How many meals per day? </li></ul><ul><li>3 </li></ul>
    46. 46. Goals for Meal Planning <ul><li>1 st Goal: How many meals per day? </li></ul><ul><li> 3 </li></ul><ul><li>2 nd Goal: How to balance the meals? </li></ul>
    47. 47. Goals for Meal Planning <ul><li>1 st Goal: How many meals per day? </li></ul><ul><li> 3 </li></ul><ul><li>2 nd Goal: How to balance the meals? </li></ul><ul><li>~50% carbohydrate </li></ul><ul><li>SMALL protein </li></ul><ul><li> SMALL fat </li></ul>
    48. 48. FOOD GUIDE PYRAMID Bread, Cereal, Rice and Pasta Group Vegetable Fruit Milk Yogurt Meat Fish Poultry Oil Mayo 15 gr 15 gr 15 gr 5 gr
    49. 49. 1800 Calorie Meal Plan 4 Carbohydrate Groups 4 Carbohydrate Groups 4 Carbohydrate Groups 2 Carbohydrate Groups 60 gr 60 gr 60 gr 30 gr
    50. 50. Food Labels Nutrition Facts Serving Size 1 cup (248 g) Servings Per Container 4 Amount Per Serving Calories 150 Calories from Fat 35 % Daily Value Total Fat 4 g 6% Saturated Fat 2.5 g 12% Cholesterol 20 mg 7% Sodium 170 mg 7% Total Carbohydrate 17 g 6% Dietary Fiber 0 g 0% Sugars 17 g Protein 13 g
    51. 51. Food Labels Nutrition Facts Serving Size 1 cup (248 g) Servings Per Container 4 Amount Per Serving Calories 150 Calories from Fat 35 % Daily Value Total Fat 4 g 6% Saturated Fat 2.5 g 12% Cholesterol 20 mg 7% Sodium 170 mg 7% Total Carbohydrate 17 g (15g) 6% Dietary Fiber 0 g 0% Sugars 17 g Protein 13 g
    52. 52. Food Labels Nutrition Facts Serving Size 1 cup (248 g) Servings Per Container 4 Amount Per Serving Calories 150 Calories from Fat 35 % Daily Value Total Fat 4 g 6% Saturated Fat 2.5 g 12% Cholesterol 20 mg 7% Sodium 170 mg 7% Total Carbohydrate 17 g (15g) 6% Dietary Fiber 0 g 0% Sugars 17 g Protein 13 g
    53. 53. What About Alcohol <ul><li>Alcohol is processed like fat </li></ul><ul><li>Replaces 2 fat servings in the meal </li></ul><ul><li>Suppresses gluconeogenesis </li></ul><ul><li>Always consume a carb food with alcohol </li></ul>
    54. 54. What About Alcohol <ul><li>Alcohol is processed like fat </li></ul><ul><li>Replaces 2 fat servings in the meal </li></ul><ul><li>Suppresses gluconeogenesis </li></ul><ul><li>Always consume a carb food with alcohol </li></ul><ul><li>count carbs for alcohol </li></ul>DO NOT
    55. 55. PRE-TEST <ul><li>With diabetes, fruit juice raises your sugar less than regular soda? (T or F) </li></ul><ul><li>I have diabetes - I can eat sweet cereals? (T or F) </li></ul><ul><li>On the “Nutrition Facts” label which is more important? (Sugar or Total Carb) </li></ul><ul><li>High protein diets like Dr. Atkins and Sugar Busters are good for diabetes? (T or F) </li></ul><ul><li>Grapefruit juice burns calories and fat (T or F) </li></ul>
    56. 56. PRE-TEST <ul><li>About 50% of the food we eat in a day should come from? (Carb, Pro, Fat) </li></ul><ul><li>Eating protein provides quick energy? (T or F) </li></ul><ul><li>Cereal, milk and juice is a well balanced breakfast (T or F) </li></ul><ul><li>I understand reading food labels? (T or F) </li></ul><ul><li>People with diabetes need to eat special foods to control blood sugar? (T or F) </li></ul>
    57. 57. We’re Here for You. . . Cure. Care. Commitment. <ul><li>Visit us on the web at </li></ul><ul><li>www.diabetes.org </li></ul><ul><li>During the work week </li></ul><ul><li>Call 1-800-DIABETES </li></ul><ul><li>(1-800-342-2383) </li></ul><ul><li>(Monday-Friday, 8AM-8PM, EST) </li></ul>
    58. 58. WHAT IS DIABETES? <ul><li>A disease in which the body no longer produces or uses insulin properly </li></ul><ul><li>Type 1 diabetes – body makes no insulin </li></ul><ul><li>Type 2 diabetes – body doesn’t make enough insulin or doesn’t use it properly </li></ul>
    59. 59. STATISTICS <ul><li>Prevalence of Type 2 diabetes is 1.5 times higher in Latinos than non-Latino whites </li></ul><ul><li>Two million or 8.2% of all Latino Americans aged 20 years or older have diabetes </li></ul>
    60. 60. STATISTICS <ul><li>In the United states among those between ages 45 – 74: </li></ul><ul><li>~24% of Mexican Americans have diabetes </li></ul><ul><li>~26% of Puerto Ricans have diabetes </li></ul><ul><li>~ 16% of Cuban Americans have diabetes </li></ul>
    61. 61. DIABETES <ul><li>~ 18.2 million Americans have diabetes </li></ul><ul><li>~ 1/3 of these are not diagnosed </li></ul><ul><li>~ 41 million Americans have pre-diabetes </li></ul><ul><li>6 th leading cause of death (69,301 listed on death certificates) in 2000 </li></ul><ul><li>Contributed to 213,062 deaths </li></ul>
    62. 62. COMPLICATIONS <ul><li>Heart disease </li></ul><ul><li>Leading cause of diabetes related deaths </li></ul><ul><ul><li>Adults with diabetes have 2 – 4 times higher heart disease death rate </li></ul></ul><ul><li> - 2 studies have shown lower rates of heart attacks </li></ul><ul><li>among Mexican Americans </li></ul><ul><li>Stroke </li></ul><ul><ul><li>Adults with diabetes have 2 – 4 times higher risk for stroke </li></ul></ul>
    63. 63. COMPLICATIONS <ul><li>High Blood Pressure </li></ul><ul><li>~ 73% of adults with diabetes have blood pressure > 130/80 or use medication for hypertension </li></ul>
    64. 64. COMPLICATIONS <ul><li>Blindness </li></ul><ul><ul><li>Diabetes is leading cause of new blindness among adults 20-74 years old </li></ul></ul><ul><ul><li>Diabetic retinopathy causes 12,000 – 24,000 new cases of blindness every year </li></ul></ul><ul><li> - Diabetic retinopathy among Hispanics is twice the </li></ul><ul><li>rate of non-Hispanic whites </li></ul>
    65. 65. COMPLICATIONS <ul><li>Kidney Disease </li></ul><ul><li>Diabetes is the leading cause of end stage kidney disease (dialysis) </li></ul><ul><li>No clear evidence of increased risk among Hispanics (survive longer on dialysis than non-Hispanic whites per one report) </li></ul>
    66. 66. COMPLICATIONS <ul><li>Nervous System Disease </li></ul><ul><li>60% - 70% of people with diabetes have nervous system disease. </li></ul><ul><li>- impaired sensation or pain in hands/feet </li></ul><ul><li>- slowed digestion of food in stomach </li></ul><ul><li>- carpal tunnel syndrome </li></ul><ul><li>- other nerve problems </li></ul>
    67. 67. COMPLICATIONS <ul><li>Amputations </li></ul><ul><li>More than 60% of nontraumatic lower limb amputations are among those with diabetes </li></ul>
    68. 68. COMPLICATIONS <ul><li>Dental Disease </li></ul><ul><li>Gum disease more common among those with diabetes. </li></ul><ul><li>~1/3 of people with diabetes have severe gum disease </li></ul>
    69. 69. COMPLICATIONS <ul><li>Pregnancy </li></ul><ul><li>Poorly controlled diabetes before conception and during first trimester can cause major birth defects in 5% - 10% of pregnancies and spontaneous abortions in 15% - 20% of pregnancies </li></ul><ul><li>Poorly controlled diabetes during 2 nd and 3 rd trimesters can result in excessively large babies </li></ul>
    70. 70. COMPLICATIONS <ul><li>Other Complications </li></ul><ul><li>People with diabetes are more susceptible to many other illnesses. Those who get the flu or pneumonia are more likely to die than those without diabetes </li></ul>
    71. 71. DIABETES SIGNS & SYMPTOMS <ul><li>Excessive thirst </li></ul><ul><li>Frequent urination </li></ul><ul><li>Extreme hunger </li></ul><ul><li>Increased fatigue </li></ul><ul><li>Irritability </li></ul><ul><li>Blurry vision </li></ul>
    72. 72. RISK FACTORS <ul><li>African Americans </li></ul><ul><li>Latinos </li></ul><ul><li>Native Americans </li></ul><ul><li>Asian Americans </li></ul><ul><li>Pacific Islanders </li></ul>
    73. 73. RISK FACTORS <ul><li>Family history </li></ul><ul><li>Obesity </li></ul><ul><li>Inactivity </li></ul><ul><li>Women who have had a baby weighing more than 9 pounds </li></ul><ul><li>45 – 64 years old </li></ul>
    74. 74. RISK FACTORS ( GENETIC IN HISPANICS) <ul><li>American Indian or African genes thought to increase risk </li></ul>
    75. 75. HISPANICS HOW MANY HAVE DIABETES? <ul><li>Of minority groups - the 2 nd largest </li></ul><ul><li>The fastest growing minority group </li></ul><ul><li>30 million had diabetes in 1998 </li></ul><ul><li>By 2050 estimated 97 million Hispanics in the US (1/4 of the US population) </li></ul>
    76. 76. DIABETES PREVENTION PROGRAM (DPP) <ul><li>Diet and exercise can effectively delay diabetes </li></ul><ul><ul><li>in a diverse population of overweight people </li></ul></ul><ul><ul><li>with impaired glucose tolerance (pre-diabetes) </li></ul></ul>
    77. 77. FREE PUBLICATION <ul><li>“Take Charge of Your Diabetes” </li></ul><ul><li>Published by the CDC </li></ul><ul><li>In Spanish </li></ul><ul><li>In English </li></ul><ul><li>Call toll-free 1-877-232-3422 </li></ul>
    78. 78. DIABETES & NUTRITION <ul><li>Some studies suggest that </li></ul><ul><li>More advanced diabetes in Hispanics </li></ul><ul><li>increases risk of inadequate nutrition </li></ul><ul><li>Diet and lifestyle change can prevent or lessen this impact </li></ul><ul><li>People with diabetes have the same nutritional needs as anyone else </li></ul>
    79. 79. DIABETES MEAL PLAN <ul><li>A guide to help you determine how much and the types of food you can choose </li></ul><ul><li>It should fit in with your schedule and eating habits </li></ul><ul><li>The right meal plan will help improve your blood sugar, blood pressure, cholesterol and help with weight goals </li></ul>
    80. 80. DIABETES REMEDIES <ul><li>Many Hispanics may use numerous diabetes remedies based on beliefs , in the hope of curing diabetes </li></ul><ul><li>Some may be harmless, some dangerous </li></ul><ul><li>There is no cure for diabetes – you can control it. </li></ul>
    81. 81. TRADITIONAL ADVANTAGES <ul><li>Many advantages in the traditional Hispanic diet: </li></ul><ul><ul><li>Use of complex carbohydrates </li></ul></ul><ul><ul><li>Consumption of fruits and vegetables rich in vitamins A and C </li></ul></ul><ul><ul><li>Limited use of processed foods </li></ul></ul><ul><ul><li>Simple preparation and nutritionally balanced </li></ul></ul>
    82. 82. TRADITIONAL DRAWBACKS <ul><li>Traditional Hispanic diets have a few drawbacks: </li></ul><ul><ul><li>Liberal use of added fat </li></ul></ul><ul><ul><li>Many foods are fried (beans, meat, tortillas, rice and potatoes) </li></ul></ul>
    83. 83. NUTRITION MODIFICATIONS <ul><li>Use corn tortillas (instead of flour) </li></ul><ul><li>Use part-skim cheeses </li></ul><ul><li>Use more fresh vegetables (cooked without added fat) </li></ul><ul><li>Use sugar substitutes instead of sugar </li></ul><ul><li>Use diet or sugar free beverages and water instead of high sugar beverages </li></ul>
    84. 84. NUTRITION MODIFICATIONS <ul><li>Use no added sugar (or sugar substitutes) in licuados and aguas frescas </li></ul><ul><li>Reduce oil in preparing sopas to < 1 tsp </li></ul><ul><li>Prepare frijoles cocidos (boiled beans) instead of frijoles refritos (refried beans) </li></ul><ul><li>Prepare meats asadas (grilled) instead of fried </li></ul><ul><li>Skim fat off broths and stocks when preparing caldos (soups) </li></ul>
    85. 85. NUTRITION MODIFICATIONS <ul><li>Use low-fat milk instead of whole milk or cream </li></ul><ul><li>Bake corn tortilla chips to replace fried chips </li></ul><ul><li>Instead of frying tortillas, heat them in the oven in foil; or in a heavy pan for a short time of each side; or in the microwave </li></ul>
    86. 86. NUTRITION MODIFICATIONS <ul><li>Taste food before salting it </li></ul><ul><li>Use lemon instead of salt on fruits or in beer </li></ul><ul><li>Add flavor using onions, garlic, cumin, oregano, cilantro, or other spices </li></ul><ul><li>If you fit alcoholic beverage into your meal plan do it according to guidelines and choose “light” beer </li></ul>
    87. 87. Questions
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