2. History
Affects children from an early age
Detected from as early as 17th century
AD
Frederick Banting – discovery of insulin
An exact cause not known
Causes insulin dependency
4. Definition:
Decreased insulin production
High blood sugar and
decreased insulin production
Helps the body’s cells to
convert sugar into energy
Absence, causes buildup in
blood
Helps the body’s cells to
convert sugar into energy
Absence, causes buildup in
blood
5. Juvenile Diabetes
The symptoms of Type 1
diabetes (juvenile diabetes)
may occur suddenly, and
include:
Urinating at night
(nocturnal enuresis)
Blurred vision
Numbness or tingling in
Frequent urination the hands or feet
Increased thirst Heavy or labored
Extreme hunger breathing
Unexplained weight loss Drowsiness or lethargy
Extreme weakness and
fatigue Fruity odor on the
breath
6. Juvenile Diabetes
The symptoms of Type 1 diabetes (juvenile
diabetes) may occur suddenly, and include:
• Frequent urination • Urinating at night (nocturnal
• Increased thirst enuresis)
• Extreme hunger • Blurred vision
• Numbness or tingling in the
• Unexplained weight hands or feet
loss • Heavy or labored breathing
• Extreme weakness • Drowsiness or lethargy
and fatigue • Fruity odor on the breath
7. Long-Term Effects of Diabetes
Type One on the Body’s Organs
Type 1 diabetes can have Type 1 diabetes, or juvenile diabetes,
long-term effects such as…
occurs mainly in children and young
1. Heart and Blood adults, but it can develop at any age.
Vessel Damage
According to the American Diabetes
2. Neuropathy Association, only 5 percent to 10
3. Nephropathy percent of people with diabetes have
4. Retinopathy Type 1. Type 1 diabetes develops when
5. Complications the body's immune system kills the
During Pregnancy pancreatic cells that are responsible
6. Peripheral Artery for producing insulin. (Nash, 2011)
Disease
8. Total Prevalence of Diabetes
Total: 25.8 million children and
adults in the United States—8.3% of
the population—have diabetes.
Diagnosed: 18.8 million people
Undiagnosed: 7.0 million people
Pre diabetes: 79 million people*
New Cases: 1.9 million new cases of
diabetes are diagnosed in people
aged 20 years and older in 2010.
9. Juvenile Diabetes Type 1
Demographics and Statistics
15,600 newly diagnosed between 2002 – 2005
3,600 newly diagnosed youth
Non-Hispanic white youth have the highest rates of new type 1 diabetes cases
Type 2 diabetes is rare among ages 10 but greater 10–19 years
U.S. minority populations have higher rates than non-Hispanic whites
rates of new cases are greater for type 2 than for type 1 diabetes in
Asian/Pacific Islander Americans, American Indian youths and non-Hispanic
black and Hispanic/Latino youth ages 10–19 years (Center For Disease Control
and Prevention, 2011)
The cost of diabetes was estimated at $174 billion total costs for diagnosed
diabetes in 2007 with $116 billion going towards direct medical costs. (National
10. Impact on Adult Client
Mentally and emotionally
depression
fatigue and stress.
Chemical imbalances with swinging moods
Physically
Heart Disease, Stroke, hypertension, blindness, eye
problems, kidney, nerve diseases, amputations, dental
diseases, spontaneous abortions and large babies for pregnant mothers
and acute life threatening events
Sexually
Erectile dysfunction (ADA,2012)
11. Impact on Adult Client
Access to Health care
The federal health care reform legislation has it that a
diagnosis of diabetes will no longer be a lawful reason to deny
health care
Insurance companies will not be allowed to limit benefits or drop
coverage when a person needs health care most
(American Diabetes Association, 2012)
Impact on Adult Client
Susceptibility to Substance abuse
People who suffer from diabetes may turn to alcohol or drugs in
order to ease the symptoms of depression.
Diabetics may develop a higher tolerance to alcohol (eHow
Health…Retrieved)
12. Impact on Adult Client
Prenatal care and childbearing.
major birth defects in 5% to 10% of pregnancies
spontaneous abortions in 15% to 20% of pregnancies
Occupational considerations and hazards.
Evaluation for employment
Evaluation for safety risks
Provision of accommodation (ADA,2009)
Ability to cope with stress.
fight-or-flight response is affected
Insulin is not always able to let the extra energy into the cells, so glucose piles up in
the blood.
Stress hormones that are designed to deal with short-term danger stay turned on for
a long time with long-term stress causing long-term high blood glucose levels
(ADA,2012)
13. Expected outcomes for adult client living with
Type 1 Diabetes
Client will :
Have a Balanced Nutrition: meeting the demands of the body and the necessary
requirements.
Will show signs of proper body image -client will not see self different from
peers .
Client will demonstrate compliance of restricted lifestyle: changes in diet,
dietary management , medication, insulin administration, exercise, and self-
monitoring of blood.
Adult client will show signs of prosperity verbalizing hope for the future and
expressing feelings.
Client will demonstrate knowledge of Diabetes and the disease process.
14. Education for adults with this condition.
Health Interventions
Health screening & HealthDetermine the diet and eating patterns
of patients and compare it with foods
promotion that can be spent on patients .
Client is able to identify the body for Collaborate with a dietitian.
signs of hypoglycemia or The client involves his/her family with
hyperglycemia. meal plans and healthy eating patterns.
Client is capable in Examination of blood sugar testing and
preventing/reducing the risk of
(self-monitoring.)
developing infection.
Insulin administrations and
Client complies with regular check-ups
treatments.
and exams to manage disease with
clients endocrinologist
Proper skin and foot care, checks skin
daily.
Yearly eye exams
Client exercises on a regular basis.
15. Resources
Community
Yuma Regional Medical Center Diabetes
Education Center
~ Offers 101 classes, support services for
clients and family members, Diabetes self-
management skills training, administration of
insulin, support groups
Kachina Building, 2451 S. Avenue A, Suite 104.
Yuma, Az 85364 - 928-336-7309
National
CDC Diabetes
Mission: To reduce the preventable burden of
diabetes through public health leadership,
partnership, research, programs, and policies
that translate science into practice
http://www.cdc.gov/diabetes
8am-8pm ET Monday-Friday Closed Holidays
cdcinfo@cdc.gov
1-800-CDC-INFO / 1-888-232-6348
16.
17. The United States of Diabetes:
Cost of Diabetes Challenges and Opportunities in
the Decade Ahead focuses on four
categories of potential cost
savings over the next 10 years:
•$174 billion: Total costs of 1. Lifestyle Intervention to
diagnosed diabetes in the Combat Obesity
United States in 2007 2. Early Intervention to Prevent
Pre diabetes from Becoming
•$116 billion for direct medical
Diabetes
costs
3. Diabetes Control through
•$58 billion for indirect costs Medication and Care
(disability, work Compliance Programs
loss, premature mortality) 4. Lifestyle Intervention
Strategies for Diabetes
Control
18. References
American Diabetes Association 2012 - retrieved
http://www.diabetes.org/advocate.our-priorities/health-care/
American Diabetes Association, 2012. Living with Diabetes - retrieved
http://www.diabetes.org/living-with-diabetes/complications/stress.html
Diabetes and Employment, 2009 retrieved
http://creativecommons.org/licences/by-nc-nd/3.0/
Centers for Disease Control and Prevention, 2011. National diabetes fact
Sheet retrieved - http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf
Relationship between Substance Abuse & Diabetes – retrieved eHow.com
retrieved http://www.ehow.com/facts6296744relationship-substance-abuse-
amp-diabetes.html#ixzz2C223/CYO
19. References
Type 1 diabetes 2010 prime group for JDRF, mar 2011 ()
http://www.jdrf.org/index.cfm?page_id=101982
Picture for slide 4: http://diabetes.webmd.com/ss/slideshow-type-1-diabetes-
overview
Association, A. D. (2012). Diabetes Statistics. Retrieved November 11, 2012, from
Diabetes Basics: http://www.diabetes.org/diabetes-basics/diabetes-statistics/
Nash, C. (2011, May 4). live strong. Retrieved November 11, 2012, from Long-Term
Effects of Diabetes Type One: http://www.livestrong.com/article/77488-
longterm-effects-diabetes-type-one/
Editor's Notes
Hi All. Welcome to our presentation on Juvenile Diabetes. I’m Leela and with me are my team members Gail, Patricia and Nicole. Today we would like to bring your attention to one of the most common form of diabetes faced by our growing/younger generations – Juvenile Diabetes. With the ever evolving world of the “Survival of the fittest” – most of us gets so dissolved in our day to day lives that we get little to no time at all to focus on our children's health. By the time the busy working parents gets home they are either too tired or just burned out form the day’s activities to jump into the kitchen for a healthy meal, well an exception is if you are a chef. But over all a majority of the adulthood life is overtaken by the financial burdens that we find it quiet easy to neglect our health but little do we know that our decisions in turn effects our kids. So most often than not, an easy way to replace the healthy meal approach is the junk food option – with an over indulgence could lead to something like juvenile diabetes.
Juvenile diabetes is a prolonged diseases that when affected can carry onto adulthood. Is there a permanent cure? The only answer to that question, thanks to the Canadian doctor Frederick Banting and his assistant Charles Best who discovered insulin – is currently the only way to bring down the dangerously high blood sugar levels (http://www.diabeteshealth.com/read/2008/12/17/715/the-history-of-diabetes/). Until the discovery of insulin most children diagnosed with the disease were expected to live less than a year
This is an auto immune disease in which a child’s or the individual’s pancreas stops producing insulin Insulin, a hormone, that enables the breakdown of sugar that aids in the ATP processes ultimately generating energy Insulin production deficiency generally occurs when the body’s immune system attacks and destroys the insulin producing cells in the pancreas cells the beta cells Generally speaking, the onset of this disease might not entirely be a diet dependant cause. However the real cause is yet to be determined.
Type 1 diabetes is a condition that generally causes high blood pressure levels and happens when the pancreas can not make insulin.Insulin is a hormone that helps convert sugar in cells into energyWith type 1, this process fails, and the sugar gets built up in blood leading to dangerous levels of toxicityAs mentioned previously, type 1 diabetes is an auto immune disease in which the pancreas fails to produce insulin thereby eliminating a cells ability to generate energy
Type 1 diabetes or Juvenile diabetes is an autoimmune disease. The person's pancreas stops producing insulin. Insulin is a hormone that enables the digestion of food to produce energy. Juvenile diabetes occurs when the body's immune system attacks and destroys the insulin-producing cells in the pancreas. Beta cells of the pancreas make the insulin. It is believed that both genetic factors and environmental triggers are involved in this disease. There is nothing to suggest that yourdiet or lifestyle can contribute to the disease. You can’t prevent the disease all you can do is treat it.
Type 1 diabetes or Juvenile diabetes is an autoimmune disease. The person's pancreas stops producing insulin. Insulin is a hormone that enables the digestion of food to produce energy. Juvenile diabetes occurs when the body's immune system attacks and destroys the insulin-producing cells in the pancreas. Beta cells of the pancreas make the insulin. It is believed that both genetic factors and environmental triggers are involved in this disease. There is nothing to suggest that yourdiet or lifestyle can contribute to the disease. You can’t prevent the disease all you can do is treat it.
1. Heart and blood vessels damage can include a heart attack, stroke, coronary artery disease, atherosclerosis (hardening of the arteries) and high blood pressure. According to the American Diabetes Association, 65 percent of people who have diabetes will die of some type of heart complication.2.Neuropathy isdamage to the nerves. Diabetic neuropathy leads to weakness, tingling, burning or numbness in the feet, legs, hands and arms. According to the Juvenile Diabetes Research Foundation, diabetic neuropathy affects more than 60 percent of Type 1 diabetics and is the most common cause of amputation (excluding accidents) in the United States.3. Nephropathy is damage to the kidneys. The kidneys are the filtering system for the body. When the nerves become damaged from excess sugar, it can lead to kidney damage or end-stage kidney disease. The Juvenile Diabetes Research Foundation says that one-third of Type 1 diabetes patients will develop diabetic nephropathy.4. Retinopathy is the progression of damage to the small blood vessels in the retina, leading to vision problems such as glaucoma, cataracts and impaired vision. The Juvenile Diabetes Foundation reports that people living with Type 1 diabetes for more than 20 years will show some signs of retinopathy. Twenty to 30 percent of Type 1 diabetics will develop an advanced form called proliferative retinopathy, which can cause blindness.5. Complications During Pregnancy can be when a mother and baby are at risk when the mother is diabetic because the need for insulin increases in both the mother and baby. Diabetes that is not controlled leads to an increased chance of preeclampsia (high blood pressure), miscarriage, stillbirth and birth defects. The American Diabetes Association recommends that pregnant women have a team of health-care providers who have experience in caring for pregnant women with diabetes. The team should include an obstetrician, a pediatrician or a neonatologist, a registered dietitian and a diabetes educator.6. Peripheral Artery Disease or (PAD) develops when blood vessels in the legs become narrow due to fatty deposits, resulting in decreased circulation to legs and feet. PAD increases the chances of stroke or heart attack. According to the American Diabetes Association, one in three diabetics older than 50 has developed PAD. Most people do not show any signs or symptoms; however, some people may experience pain when walking, or have cold feet and lower legs, numbness or tingling in the lower legs and sores on the foot or leg that are slow to heal. (Nash, 2011)
More than 50 percent of Americans could have diabetes or prediabetes by 2020 at a cost of $3.35 trillion over the next decade if current trends continue, according to new analysis by UnitedHealth Group's (NYSE: UNH) Center for Health Reform & Modernization, but there are also practical solutions for slowing the trend.New estimates show diabetes and pre diabetes will account for an estimated 10 percent of total health care spending by the end of the decade at an annual cost of almost $500 billion – up from an estimated $194 billion this year.
SEARCH for Diabetes in Youth is a multicenter study funded by the CDC and the National Institute of Health to examine diabetes—type 1 and type 2—among children and adolescents in the United States. SEARCH findings for the communities studied include the following:During 2002–2005, 15,600 youth were newly diagnosed with type 1 diabetes, and 3,600 youth were newly diagnosed with type 2 diabetes annually.Among youth ages younger than 10 years, the rate of new cases was 19.7 per 100,000 each year for type 1 diabetes and 0.4 per 100,000 for type 2 diabetes. Among youth ages 10 years or older, the rate of new cases was 18.6 per 100,000 each year for type 1 diabetes and 8.5 per 100,000 for type 2 diabetes.Non-Hispanic white youth had the highest rates of new cases of type 1 diabetes—24.8 per 100,000 per year among those younger than 10 years and 22.6 per 100,000 per year among those ages 10–19 years.Type 2 diabetes was extremely rare among youth ages younger than 10 years. While still infrequent, rates were greater among youth ages 10–19 years than in younger children, with higher rates among U.S. minority populations than in non-Hispanic whites.Among non-Hispanic white youth ages 10–19 years, the rate of new cases was higher for type 1 than for type 2 diabetes. For Asian/Pacific Islander Americans and American Indian youth ages 10–19 years, the opposite was true—the rate of new cases was greater for type 2 than for type 1 diabetes. Among non-Hispanic black and Hispanic/Latino youth ages 10–19 years, the rates of new cases of type 1 and type 2 diabetes were similar.
Clinical depression often affects those who suffer from diabetes. Depression can cause fatigue and stress. People who suffer from diabetes may turn to alcohol or drugs in order to ease the symptoms of depression. Erectile dysfunction is one of the complications that come with diabetes. It can cause medical complications that affect the ability to work, spend time with family and friends, sexual functioning and overall quality of life.
Once the provisions of the law are fully in place, people with diabetes can no longer be denied insurance or forced to pay more for coverage simply because they have diabetes. Insurance companies will not be allowed to limit benefits or drop coverage when a person needs health care most. Adiagnosis of diabetes will no longer be a lawful reason to deny health care, ending the current system that sanctions such discrimination.
Individuals with diabetes can and do serve as highly productive members of the workforce and reasonable accommodations shouldbe made toallow people with diabetes to effectively perform the vast majority of jobs. The effects of diabetes vary from person to person, so employers must consider each person's capacities and needs on an individual basis. People with diabetes should always be evaluated individually with the assistance of experienced diabetes health care professionals. The requirements of the specific job and the individual's ability to perform that job, with or without reasonable accommodations, always need to be considered.
Reasons for health screening of diabetes patientsHeart disease and stroke • Heart disease is the leading cause of diabetes-related deaths. • Adults with diabetes have heart disease death rates 2-4 times higher than adults without diabetes. • The risk for stroke is 2-4 times higher in people with diabetes. • About 65% of deaths among people with diabetes are due to heart disease and stroke. 2. High blood pressure • About 73% of adults with diabetes have blood pressure greater than or equal to 130/80 or use prescription medication for higher pressure. 3. Blindness • Diabetes is the leading cause of new cases of blindness in adults 20 to 74 years old. • Diabetic retinopathy causes between 12,000 and 24,000 new cases of blindness each year. 4. Kidney disease • Diabetes is the leading cause of end-stage renal disease, accounting for about 44% of new cases. 5. Nervous system disease • About 60% to 70% of people with diabetes have mild to severe forms of nervous system damage which often includes impaired sensation or pain in the feet or hands, slowed digestion of food in the stomach, carpal tunnel syndrome, and other nerve problems. • Severe forms of diabetic nerve disease are a major contributing factor of lower extremity amputations. 6. Amputations • More than 60% of nontraumatic lower limb amputations in the United States occur among people with diabetes. 7. Dental disease • Periodontal disease is more common among people with diabetes. • Almost one third of people with diabetes have severe periodontal disease. 8. Complications of pregnancy • Poorly controlled diabetes before conception and during the first trimester can cause major birth defects in 5% to 10% of pregnancies and spontaneous abortions in 15% to 20 % of pregnancies. 9. Other complications • People with diabetes are more susceptible to other illnesses such as pneumonia and influenza than people who do not have diabetes. (http://ddsn.sc.gov/providers/manualsandguidelines/Documents/HealthCareGuidelines/Diabetes.pdf)Health InterventionsDiet management includes education about how to adjust the timing, size, frequency, and composition of meals so as to avoid hypoglycemia or postprandial hyperglycemia. All patients on insulin should have a comprehensive diet plan, created with the help of a professional dietitian, that includes the following:A daily caloric intake prescriptionRecommendations for amounts of dietary carbohydrate, fat, and proteinInstructions on how to divide calories between meals and snacks
Community ResourcesOffered in Yuma, ArizonaDiabetes classes 101This informative, two-hour class is open to anyone who wants to learn about the basic skills needed to control Type 2 diabetes. The class is taught by Certified Diabetes Educators who give an overview of Type 2 diabetes, the medications used to control diabetes, meal planning and healthy behaviors that can help patients avoid complications.National : CDCGoalsPrevent diabetes.Prevent complications, disabilities, and burden associated with diabetes.Eliminate diabetes-related health disparities.Maximize organizational capability to achieve DDT goals.PrioritiesIncrease diabetes preventive behaviors.Improve the access to effective lifestyle interventions.Enhance and improve community and environmental strategies to prevent diabetes.Improve the health behavior and self management practices of people with diabetes.Enhance and improve the access and delivery of effective preventive health care services.Enhance and improve community and environmental strategies to support people with diabetes.Improve the science of health and health care disparities related to diabetes.Prioritize and disseminate public health strategies to eliminate disparities.Build DDT capacity for communication, evaluation, marketing, policy, and partner
Resources:CDC - About Us - Diabetes DDT. (n.d.). Centers for Disease Control and Prevention. Retrieved November 14, 2012, from http://www.cdc.gov/diabetes/about/index.htm#2national, t. o., diagnosed, b., not., & state., i. e. (n.d.). Diabetes in the US | GDS Publishing. Healthcare Management Online | GDS Publishing. Retrieved November 14, 2012, from http://www.executivehm.com/news/diabetes-in-the-us/
1.Lifestyle Intervention to Combat Obesity: There is an opportunity to reduce the number of people who would develop prediabetes or diabetes by nearly 10 million Americans, through public health initiatives and the wider use of wellness programs to combat obesity.2. Early Intervention to Prevent Pre diabetes from Becoming Diabetes: Evidence from randomized controlled trials and UnitedHealth Group’s own experience demonstrates that the use of community-based intervention programs – such as the UnitedHealth Group Diabetes Prevention Program (DPP) in partnership with the Y – could reduce the number of people with pre diabetes who convert to diabetes by an additional 3 million. The DPP is based on the original U.S. Diabetes Prevention Program, funded by the National Institutes of Health (NIH) and the CDC, which demonstrated that with lifestyle changes and modest weight reduction, individuals with pre diabetes can prevent or delay the onset of the disease by 58 percent.3. Diabetes Control through Medication and Care Compliance Programs: Better management of diabetes through improved medication and care compliance programs can help control the disease and reduce complications, such as UnitedHealth Group’s Diabetes Control Program (in partnership with community pharmacists).4. Lifestyle Intervention Strategies for Diabetes Control: The wider use of public-private partnerships to develop the infrastructure to scale nationally the promising of learning to the Look AHEAD Trial. (Association, 2012)