What is Diabetes?Diabetes 101                                         Diabetes mellitus is a group of diseases           ...
What about people?                                Ethnic Groups over 20 years    Every 24 hours:                          ...
How Food is Digested                                                                       Diagnosing diabetes       1. Fo...
Type 2                                                 Type 2   90-95% of all diabetes cases   Onset is usually very slo...
Preventing Complications                               Preventing Complications                                           ...
Pre-diabetes—do we care?                     Pre-diabetes and Obesity?   Estimated 61 million people   Estimated 70% pro...
What can we do?                           What about exercise?                                             We need to mov...
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Diabetes 101-presentation

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Diabetes 101-presentation

  1. 1. What is Diabetes?Diabetes 101  Diabetes mellitus is a group of diseases characterized by high levels of blood Ginny Burns RN MEd CDE glucose resulting from defects in insulin production, insulin action or both.Why do we care? What Does This Mean? Diabetes is now recognized as20.8 million people one of the largest epidemics humanity has ever faced and Diagnosed 14.6 million a leading cause of death!!!! Undiagnosed 6.2 million 7% of the total population Estimated Costs of Diabetes?  Total cost: $132 billion 70% of people with  Direct Medical costs: $92 billion diabetes will die of cardiovascular disease.  Indirect costs: $40 billion 1
  2. 2. What about people? Ethnic Groups over 20 years Every 24 hours:  8.7% White New cases: 4,100  9.5% Hispanic Deaths: 810  13.3% Black Amputations: 230  27% SW Native Americans Kidney Failure: 120 Blindness: 55  21% of all Americans over age 60 What about Utah? 61% of all Hispanic/Latino  154,000 people in Utah have been diagnosed Americans born in  1 out of every 25 people in Utah have diabetes 2000 AD will have  Sixth leading cause of death in Utah and US DiabetesTypes of Abnormal Glucose? Types of Abnormal Glucose? 1. Type 1 diabetes---previously called  3. Gestational diabetes---a form of insulin-dependent diabetes (IDDM) or glucose intolerance that is diagnosed in juvenile-onset diabetes. some women during pregnancy. 2. Type 2 diabetes---previously called  4. Prediabetes---term used to non-insulin-dependent diabetes distinguish people who are at in (NIDDM) or adult-onset diabetes. increased risk for developing diabetes. 2
  3. 3. How Food is Digested Diagnosing diabetes 1. Food enters stomach  Fasting plasma 4. Pancreas releases insulin 5. Insulin unlocks glucose test (see receptors figure to the right) 6. Glucose enters cell  If fasting glucose test is positive, confirm results 3. Glucose enters bloodstream by repeating on a 2. Food is converted different day. into glucose Symptoms Type 1  Extreme thirst  5-10% of all diagnosed cases  Frequent urination  May be autoimmune, genetic or  Extreme hunger environmental  Blurry vision  Beta-cell destruction usually leading to  Unexplained weight loss absolute insulin deficiency  Tingling or numbness in the hands or feet  Onset usually abrupt in young but can Constant fatigue  be slow in older patients  Dry / irritated skin (above and beyond Utah standards)  Usually normal weight or slender  Wounds that are slow to heal What happens in Type 1 diabetes? Type 1 1. Food enters stomach 4. Pancreas cells produce no insulin Insulin is the medication that is used!!!!! 5. Glucose rises in blood Symlin, insulin pumps, glucose sensors 3. Glucose enters bloodstream 2. Food is converted into glucose 3
  4. 4. Type 2 Type 2 90-95% of all diabetes cases Onset is usually very slow Older age? Children? And Obesity Family history, history of gestational DM Depression? Complications are often present at diagnosis: retinopathy, neuropathy nephropathy What Happens in Type 2 diabetes?Type 2 Hypertension is most often present 1. Food enters stomach Cholesterol levels often abnormal 4. Pancreas releases too little 5. Insulin is less Medications: insulin effective oral diabetes medications, lipid 6. Less glucose enters cell lowering agents, hypertensive medications, pain medications for 3. Glucose enters bloodstream 2. Food is converted neuropathy, insulin, Byetta, Symlin into glucose 7. Glucose rises in bloodDiabetes Complications Diabetes Complications Cardiovascular Disease (CVD):  Eyes  2 to 4 times the risk of heart disease and Glaucoma, cataracts, retinopathy stroke compared with people without diabetes  Kidneys  Diabetes appears to particularly increase Nephropathy, renal failure the risk of CVD in women  Nerves  Major cause of death in all patients with Neuropathy, amputations DM  Gums and teeth 4
  5. 5. Preventing Complications Preventing Complications  Glycemic Control Developing self-management skills is at  Control the amount of sugars and carbohydrates the foundation of diabetes consumed management:  Aggressive Lipid Lowering  Lower the amount of “bad fats” in your diet  Self-monitoring of blood glucose  Management of Hypertension  Meal planning  Decrease blood pressure and find ways to manage  Exercise stress  Medication complianceGestational Diabetes? Gestational? Diabetes diagnosed in pregnancy  No known cause of gestational 2-5% of all pregnancies diabetes, but there are some ideas More common in obese women  Hormones from the placenta may block the action of the mothers insulin in her body More common if family hx of DM causing insulin resistance More frequent in African Americans,  The stress of the pregnancy may also Hispanic/Latino Americans and cause insulin resistance American Indians  Usually disappears after pregnancy  Risk for Type 2 diabetes later in lifeGestational? Gestational?Screening 24-26 wks.  Women have 20-50% chance of50gram glucose drink with blood draw 1 developing diabetes in the next 5-10 hour after drink. yrs.Positive if results are equal or greater It appears that the largest risk comes from weight!! than 140mg/dL Encourage normal body weight!!! 5
  6. 6. Pre-diabetes—do we care? Pre-diabetes and Obesity? Estimated 61 million people Estimated 70% progress to DM Are they connected? Lifestyle changes may prevent or delay the onset to DM YES!!! Complications begin when glucose levels are elevated!!!!Obesity 1990 Obesity in 2001Diabetes in 1990 Diabetes in 2001 6
  7. 7. What can we do? What about exercise?  We need to move, move, move, move, move, move, Make Lifestyle move and move some more!! changes!!!  About 1 hr every day should be the minimum. 10,000 steps is great!!!What about food? Diets? Or Just Healthy Eating?Mike Huckabee, Governor from Arkansas,  Eat Less said he lost several hundred pounds by  Decrease highly processed foods following the advice of his MD:  Increase fruits and vegetables Do not drink your carbohydrates“If is wasn’t a food 100  years ago, don’t eat it”!!!!!Questions? Twitter:@AskGinny Blog:http://askginnyaboutdiabetes. blogspot.com or askginny@utah.gov 7

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