Nutrition411 Diabetes ABCs

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Where Health Care Professionals
Go for Information
Diabetes ABCs
Review Date 8/12
D-0549
Contributed by Shawna Gornick-Ilagan, MS, RD, CWPC
Updated by Nutrition411.com staff

2. Disclaimer
• This presentation should not substitute or replace any
medical advice prescribed by your doctor
• This presentation is meant to provide you with general
health information to empower you and your family to
prevent or manage diabetes

3. Objectives
• What is diabetes?
• What are my risks of getting it?
• How can I prevent diabetes?
• How do I manage diabetes if I get it?
• What do the ABCs stand for?

4. What Is Diabetes?
• Diabetes is a condition in which the body is unable to
properly utilize blood sugar

5. What’s Your
Diabetes
IQ?

6. Diabetes IQ Test
1. Every 24 hours:
a. More than 1000 adults are diagnosed with diabetes
b. More than 2000 adults are diagnosed with diabetes
c. More than 3000 adults are diagnosed with diabetes
d. More than 4000 adults are diagnosed with diabetes

7. 2. Every 24 hours:
a. About 10 children and adolescents are diagnosed
with type 1 diabetes
b. About 20 children and adolescents are diagnosed
with type 1 diabetes
c. About 30 children and adolescents are diagnosed
with type 1 diabetes
d. About 40 children and adolescents are diagnosed
with type 1 diabetes
Diabetes IQ Test
(cont’d)

8. 3. Every 24 hours:
a. Two children and adolescents are diagnosed with
type 2 diabetes
b. Five children and adolescents are diagnosed with
type 2 diabetes
c. Eight children and adolescents are diagnosed with
type 2 diabetes
d. Ten children and adolescents are diagnosed with
type 2 diabetes
Diabetes IQ Test
(cont’d)

9. 4. Every 24 hours:
a. Approximately 50 people die from diabetes
b. Approximately 100 people die from diabetes
c. Approximately 150 people die from diabetes
d. Approximately 200 people die from diabetes
Diabetes IQ Test
(cont’d)

10. 5. Every 24 hours:
a. 50 people with diabetes have a nontraumatic
lower-limb amputation
b. 100 people with diabetes have a nontraumatic
lower-limb amputation
c. 150 people with diabetes have a nontraumatic
lower-limb amputation
d. 200 people with diabetes have a nontraumatic
lower-limb amputation
Diabetes IQ Test
(cont’d)

11. 6. Every 24 hours:
a. About 30 people with diabetes develop kidney failure
b. About 60 people with diabetes develop kidney failure
c. About 90 people with diabetes develop kidney failure
d. About 130 people with diabetes develop kidney
failure
Diabetes IQ Test
(cont’d)

12. 7. Every 24 hours:
a. Nearly 5 adults with diabetes go blind
b. Nearly 15 adults with diabetes go blind
c. Nearly 25 adults with diabetes go blind
d. Nearly 50 adults with diabetes go blind
Quiz derived from information found at http://www.cdc.gov/features/livingwithdiabetes/.
Diabetes IQ Test
(cont’d)

13. • The correct answer for all questions— d.
• Over the years, high blood glucose (hyperglycemia)
damages nerves and blood vessels, leading to
complications such as:
– Heart disease
– Stroke
– Kidney disease
– Blindness
– Nerve problems
– Gum infections
– Amputation
Answer Key

14. • Some people do not have symptoms
• Other people have experienced these symptoms:
– Increased thirst
– Increased urination
– Weight loss without trying
– Blurred vision
– Increased hunger
– Increased fatigue
What Are the
Symptoms?

15. • The three types of diabetes:
– Type 1 (juvenile diabetes, insulin dependent: 5%–
10%)
– Type 2 (adult onset, noninsulin dependent):
90%–95%
– Gestational diabetes (diabetes during pregnancy):
2%–5%
• Prediabetes
– Centers for Disease Control and Prevention
estimates that 57 million Americans 20+ years of age
have prediabetes
Types of Diabetes

16. Normal
Process
Insulin

17. Diabetes: Type
1

18. Diabetes: Type 2
Insulin= Fat

19. Diabetes: Type 2 (Over
Time)

20. Type 1
Diabetes:
Risk Factors• Family history of type 1 diabetes: 10%–15%
• Race: White people have a greater risk
• Presence of islet cell antibodies in the blood
Prevention
• Currently no way to prevent type 1 diabetes
• Can prevent or delay the development of complications,
such as:
– Vision, kidney, or heart failure
– Blood vessel and nerve diseases
• Prevention: Keep blood sugar near normal levels

21. • Risk factors that you cannot control:
– Family history
– Age
– Race
– History of gestational diabetes
• Risk factors that you can control:
– Lose weight if overweight
– Eat healthy and exercise
– Quit smoking
– Get treatment if you have prediabetes, high blood
pressure, or high cholesterol
Type 2 Diabetes:
Risk Factors (cont’d)

22. Gestational
Diabetes• Stay at a healthy weight and do not gain too much weight
during pregnancy
• Exercise regularly to help keep your blood sugar level
within a safe range and to prevent gestational diabetes

23. Weight Gain
During Pregnancy
Category
Weight Gain
Recommendations
If you began pregnancy at
a normal weight
25–35 pounds
If you began pregnancy
underweight
28–40 pounds
If you began pregnancy
overweight
15–25 pounds
If you are expecting twins 35–45 pounds

24. How Is It Diagnosed?
• Fasting plasma glucose: Must fast for 8 hours or more
Plasma Glucose
Results (mg/dL)
Diagnosis
99 or below Normal
100–125 Prediabetes
126 or above Diabetes
dL=deciliter, mg=milligram

25. Glucose Testing
Recommendations
• Blood glucose:
– During a regular physical
– Symptoms suggesting hyperglycemia or hypoglycemia
– During pregnancy
– Diabetic
• Starting at age 45 and every 3 years if normal results

26. Prediabetes

27. Is prediabetes the same as impaired glucose tolerance or
impaired fasting?
Yes. Doctors sometimes refer to this state of elevated blood
glucose levels as impaired glucose tolerance or impaired
fasting glucose (IGT/IFG), depending on which test was used
to detect it.
Source: American Diabetes Association®
. Prediabetes FAQs. Available at: http://www.diabetes.org/pre-diabetes/faq.jsp.
Accessed August 5, 2012.
Prediabetes (cont’d)

28. Good News
• Type 2 diabetes is preventable
if you catch it early and make
some changes in your lifestyle

29. 85%–90% of Diabetes
Is Preventable
Preventable

30. Diabetes: Type 2 Insulin

31. Bad
News
• Type 2 diabetes is a condition
that consumes your:
– Time
– Money
– Energy

32. How to Prevent Type 2
Diabetes
• Maintain a healthy weight
• Increase fruit and vegetable consumption
• Increase fiber intake
• Decrease fat intake
• Exercise
• Breastfeed infants:
– 20% less likely to have diabetes and high cholesterol

33. Tips to Maintain a
Healthy Weight
• Do not drink calories
• Eat slowly
• Stay hydrated
• Try the low-fat or nonfat version of foods
• Change habits
• Eat three meals each day
• Focus on fruits and vegetables
• Get enough fiber

34. Tips to Maintain a
Healthy Weight (cont’d)
Fruits and vegetables
• Canned or frozen
• Frozen grapes
• Prepackaged
• Microwaveable
• Low-fat dip
• 5 servings/day
Dietary fiber
• Beans
• Oatmeal
• Whole grain
– Pastas
– Cereals
– Breads
• Adults need 25–35 grams
(g)/day; children older than
age 3 need their age plus 5
g (minimum
recommendation)
Source: Dwyer JT. Dietary fiber for children: how much? Pediatrics. 1995;96:1019-1022.

35. Exercise
Regularly
• Exercise regularly to help raise your high-density
lipoprotein (HDL), the good cholesterol, and lower your
low-density lipoprotein (LDL), the bad cholesterol
• Aim for 30 minutes of activity or more on most days of
the week

36. Decrease Saturated
and Trans Fats
Type of Harmful Fat Food Source
Saturated fat • Animal products, such as meat,
poultry, seafood, eggs, dairy
products, lard, and butter
• Coconut, palm, and other tropical
oils
Trans fat • Partially hydrogenated vegetable
oils
• Commercial baked goods, such
as crackers, cookies, and cakes
• Fried foods, such as doughnuts
and French fries
• Shortening and margarine

37. Opt for Healthy Fats
Type of Healthy Fat Food Source
Monounsaturated fat • Olive oil, peanut oil, and canola
oil
• Avocados
• Nuts and seeds
Polyunsaturated fat • Vegetable oils, such as safflower,
corn, sunflower, soy, and
cottonseed oils
• Nuts and seeds
Omega-3 fatty acids • Fatty cold-water fish, such as
salmon, mackerel, and herring
• Flaxseeds and flax oil
• Walnuts

38. Know Where to Look
• Lose weight—calories
• Lower cholesterol—
saturated fats and trans
fats
• Manage glucose—total
carbohydrate

39. The Good News
• By managing the ABCs of diabetes, people with
diabetes can reduce their risk of heart disease and stroke
A stands for A1c
B stands for body mass index (BMI) and blood
pressure
C stands for cholesterol

40. A: Ask About Your A1c
• A1c measures average
blood glucose over the last
3 months
• Get your A1c checked at
least twice/year
A1c
Reading
Average
Blood Sugar
Level
6% 126 mg/dL
7% 134 mg/dL
8% 183 mg/dL
9% 212 mg/dL
10% 240 mg/dL
11% 269 mg/dL
12% 298 mg/dL
Source: American Diabetes Association. Standards of medical care in diabetes–2012. Diabetes Care [serial online]. 2012;35(suppl
1);S11-S63. Available at: http://care.diabetesjournals.org/content/35/Supplement_1/S11.full.pdf+html. Accessed August 5, 2012.

41. Healthy Plate Format
• One fourth of plate starch
• One fourth of plate meat
• One half of plate
nonstarchy vegetables
• 8 fluid ounces of reduced-
fat milk
• One serving of fruit

42. Cereal or Grains
• 15 g of carbohydrate=one serving
• One cereal or grain serving is:
– One slide of bread
– One half of a hamburger bun
– ¾ cup (C) of unsweetened cereal
– ⅓ C cooked pasta
– 3 C popcorn
– ½ C cooked oatmeal

43. • 15 g of carbohydrate=one serving
• One fruit serving is:
– ⅓ C of fruit juice
– ½ C of canned fruit
– One small piece of fruit, such as an apple
Fruit

44. • 15 g of carbohydrate=one serving
• One milk or dairy serving is:
– 1 C of milk
– 6 ounces of yogurt
Milk or Dairy

45. Starch or
Vegetables
• 15 g of carbohydrate=one serving
• One starch or vegetable serving is:
– ⅓ C of beans
– ½ C of corn or peas
– ½ C of mashed potatoes

46. Quick Reference Chart
for Eating With Diabetes
Number of Exchanges/Day for Various Calorie Levels
Calories 1200 1500 1800 2000 2200
Starch/bread 5 8 10 11 13
Meat 4 5 7 8 8
Vegetables 2 3 3 4 4
Fruit 3 3 3 3 3
Milk 2 2 2 2 2
Fat 3 3 3 4 5
Source: University of Maryland Medical Center. Diabetes diet—diabetic exchange lists. Available at:
http://www.umm.edu/patiented/articles/what_general_guidelines_heart-healthy_diets_000042_5.htm. Accessed August 5, 2012.

47. B: BMI
• BMI is a number calculated from a person’s weight and
height
• Higher BMI values are associated with risk for health
problems
• BMI goal=less than 25
• More information is available at:
http://www.cdc.gov/healthyweight/assessing/bmi/

48. BMI
(kg/m2
)
19 20 21 22 23 24 25 26 27 28 29 30 35 40
Height Normal Weight Increased Risk High Risk
58 91 96 100 105 110 115 119 124 129 134 138 143 167 191
59 94 99 104 109 114 119 124 128 133 138 143 148 173 198
60 97 102 107 112 118 123 128 133 138 143 148 153 179 204
61 100 106 111 116 122 127 132 137 143 148 153 158 185 211
62 104 109 115 120 126 131 136 142 147 153 158 164 191 218
63 107 113 118 124 130 135 141 146 152 158 163 169 197 225
64 110 116 122 128 134 140 145 151 157 163 169 174 204 232
65 114 120 126 132 138 144 150 156 162 168 174 180 210 240
66 118 124 130 136 142 148 155 161 167 173 179 186 216 247
67 121 127 134 140 146 153 159 166 172 178 185 191 223 255
68 125 131 138 144 151 158 164 171 177 184 190 197 230 262
69 128 135 142 149 155 162 169 176 182 189 196 203 236 270
70 132 139 146 153 160 167 174 181 188 195 202 207 243 278
71 136 143 150 157 165 172 179 186 193 200 208 215 250 286
72 140 147 154 162 169 177 184 191 199 206 213 221 258 294
73 144 151 159 166 174 182 189 197 204 212 219 227 265 302
74 148 155 163 171 179 186 194 202 210 218 225 233 272 311
75 152 160 168 176 184 192 200 208 216 224 232 240 279 319
76 156 164 172 180 189 197 205 213 221 230 238 246 287 328

49. B: Beware of
Your Blood
Pressure• High blood pressure raises your risk for heart attack,
stroke, eye problems, and kidney disease
• Get your blood pressure checked at every visit
• Target blood pressure=less than 130/80

50. Key Steps for Lowering
Blood Pressure
• Lose weight
• Eat more fruits and vegetables
• Reduce the amount of salt in diet
• Have lower alcohol intake
• Quit smoking
• Take blood pressure pills, if prescribed:
– Many people require more than one pill

51. C: Check Your
Cholesterol
• Several kinds of blood fats:
– Total and LDL (“lousy”) cholesterol—can narrow or
block vessels
– HDL (“healthy”) cholesterol—helps remove cholesterol
deposits
– Triglycerides—can raise your risk for heart
attack/stroke

52. Know Your Numbers
Value Goals
A1c Less than 7
Blood pressure Less than 130/80
Total cholesterol Less than 200
LDL cholesterol Less than 100
HDL cholesterol Greater than 40 (men)
Greater than 50 (women)
Triglycerides Less than 150