1. Diabetes: The Basics
Presented By: Shahid Nawaz
Researcher
King Saud University,
Riyadh,KSU

2. People have diabetes because….
(1)The insulin their body makes
doesn’t work right or
(2)Their body doesn’t make
enough insulin.

3. Insulin takes the glucose from blood
into cells.
Insulin takes the glucose from blood
into cells.
People have diabetes because….

4. .
.
Insulin helps sugar move out of the blood and into
the cells.
Cells will not allow blood sugar in without insulin. -
this can cause a problem.
How Does Insulin Work?

5. Energy for Our Bodies
• Energy comes mostly from the glucose in the foods
we eat.
• Blood takes the glucose to our cells.
• The pancreas makes insulin, which unlocks the cells
so the glucose can get in.
• Extra glucose is stored as fat or in the liver for use if
needed later.
• Energy comes mostly from the glucose in the foods
we eat.
• Blood takes the glucose to our cells.
• The pancreas makes insulin, which unlocks the cells
so the glucose can get in.
• Extra glucose is stored as fat or in the liver for use if
needed later.

6. Types Of Diabetes
 Type I - body does not produce any insulin.
 Type II- body is not making enough or is losing
sensitivity to insulin made.
 Secondary - a consequence from another disease. For
example, pancreatitis or cystic fibrosis.
 Gestational Diabetes- diabetes during pregnancy.
 Impaired Glucose Tolerance- an intermediate between
normal and diabetes.

7. Why Isn’t The Body Making
Insulin?
 In people with Type I, the immune system
has made a big mistake.
 It attacks the beta cells and destroys them.
 In people with Type II, the pancreas is still
making insulin, just not enough to keep up,
or their bodies have become insulin
resistant.

8. Type I
 Usually diagnosed in children and young
adults.
 Must take daily insulin shots to stay alive.
 Type I accounts for 5-10% of the population
with diabetes.

9. Type II
 The most common form of the disease.
 Approximately 50% of men and 70% of
women are obese when diagnosed.
 Nearing epidemic proportions

increased number of older Peoples.

greater occurrence of obesity

sedentary lifestyles

11. How You Diagnosed With
Diabetes?
 The ADA redefined it’s criteria for
diagnosing diabetes.
 <110 mg/dl is normal fasting blood
glucose.
 110 – 126 mg/dl is impaired fasting
glucose.
 >126 mg/dl (fasting blood glucose) is used
to diagnose diabetes.

12. What Are The Symptoms?
 Polyphasia - excessive eating
 Polyurea - excessive urination
 Polydypsia - excessive fluid intake
 Blurred vision
 Poor wound healing
 Irritability

13. Short Term Complications
• People who have diabetes can have life-
threatening short-term complications. They must
try to avoid complications, but also be prepared
to treat them if they happen:
– High blood sugar or hyperglycemia
– Low blood sugar or hypoglycemia
– High ketones or diabetic ketoacidosis

14. Long Term Complications
• Too much glucose in the blood damages the
lining of the vessels that carry the blood.
• Blood vessels all over the body get damaged.
• The damage causes the body organs not to
work well.

15. What Problems Does Blood Vessel
Damage Cause?
• Heart and blood vessel damage can lead to high blood
pressure, strokes and heart attacks.
• Kidney damage can lead to kidney failure and the
need for dialysis and kidney transplant.
• Eye damage can lead to blindness.
• Nerve damage can lead to tingling, numbness and
pain in hands and feet.
• Nerve damage can also cause problems with the
digestive system.

16. What Problems Does Blood Vessel
Damage Cause?
• Foot damage can lead to infections and
need for amputation of toes, feet or legs.
• Skin and mouth damage can lead to gum
disease, infections and loss of teeth.
• Bone damage can lead to osteoporosis
and broken bones.
• Brain damage can lead to dementia.

17. In Order To Be Diagnosed
With Diabetes:
 Person must have symptoms of diabetes
 Plasma glucose >200
 Fasting blood glucose of >126 mg/dl
2-hour plasma glucose >200 mg/dl on oral glucose
tolerance test

18. Screening
 All patients at age 45 and older
 If the results are normal, repeat every 3 years
 Screen at a younger age if patient meets
following risk factors

Obesity

Inactive lifestyle

First degree relative with diabetes)

Was diagnosed with gestational diabetes or delivered a baby
whose birth weight >9 lbs.

Hypertension

HDL level <40(men) <50(women) or triglycerides >250

Found to have impaired glucose tolerance or impaired
fasting on a previous test.

19. I’ve Got Diabetes, Now What?
 After diagnosis, there is a great need
for education.
 A diabetic diet is no different from
the basic healthy eating plan.
 An activity goal is no different than a
basic healthy activity plan.

20. Diabetes Complications
 Kidney
 Heart
 Nerve damage
 Feet/skin
 Eye/Vision
 Teeth/Gums

21. Treatment Goals For Type II
 Achieve normal or near-normal blood
glucose levels.
 Prevent, delay or treat complications.
 Improve health through optimal
monitoring, nutrition and activity.

22. Blood Glucose Monitoring
 All diabetics must keep track of blood
glucose levels.
 This is the only way to know if the treatment
is effective.
 Gives the diabetic a good indication of what
affects their blood sugar level.
 Must check at least 2 times a day and four
times a day for at least 3 days a week.

23. Insulin
 Type I and sometimes Type II patients
need to be treated with insulin.
 There are more than 20 types.
 They differ in how they are made, how
they work in the body and their cost.

24. Hypoglycemia
 Hypoglycemia- low blood sugar
 Happens to everyone with diabetes
 Symptoms include shakiness, dizziness,
sweating, hunger, headache, pale skin,
sudden moodiness, clumsy or jerky
movements, difficulty paying attention,
and tingling sensations around mouth.

25. How To Treat Hypoglycemia
 Quickest way to raise blood glucose is with some
form of sugar.
 3 glucose tablets, 1/2 cup of fruit juice, 5-6 pieces
of candy.
 Wait 15-20 minutes and test blood sugar again.
 If hypoglycemia goes untreated, patient could get
worse and pass out.

26. Hyperglycemia
 High blood sugar
 Not enough insulin
 Too much food
 Too little exercise

27. Hemoglobin A1c
 A good indicator of blood glucose
control.
 Gives a % that indicates control over
the preceding 2-3 months.
 Performed 2 times a year.
 A hemoglobin of 6% indicates good
control and level >8% indicates action
is needed.

28. Treatment Goals
 The main goal is to normalize blood
sugar. Realistic goals for diabetics are
70-140 mg/dl before meals, <180
mg/dl after and a glycosolated
hemoglobin (HgA1C) within 1% of
normal.
 Need good blood glucose control to
avoid complications.

29. Physical Activity And
Diabetes
 Especially beneficial in type II diabetes.
 Possible improvement in blood glucose
control.
 Improved insulin sensitivity/lower
medication requirement.
 Reduction in body fat.
 Cardiovascular benefits.
 Stress reduction.
 Prevention of Type II diabetes (IGT).

30. Things To Consider
 Medication timing.
 Food intake timing.
 Recent illness or infection.
 Postpone exercise if glucose reading is below 100
mg/dl or above 250 mg/dl
 Consume 15g of carbs. per 60 min. of exercise.
 Keep a snack handy.
 Practice proper foot care.
 Carry medical identification.

31. How To Avoid Complications
 Control weight
 Eat a healthy well-balanced diet.
 Get regular exercise
 Have regular checkups
 Check feet everyday for cuts and blisters
 Do not smoke!
 Keep blood sugars normal
 Avoid the 2 common diabetic problems,
hypoglycemia and hyperglycemia

32. What Is A Healthy Diet?
• Make healthy food choices.
– More fruits and vegetables of many colors.
– More whole grains.
– Fish 2-3 times a week.
– Only lean meat or chicken without skin.
– Low-fat or non-fat dairy products.
– Drink water instead of sugary or carbonated drinks.
– Decrease snack foods that are high calorie and fat.
– Watch portion sizes.
– Cook with liquid oils and decrease fats in your diet.

34. How to Eat A Healthy Diet
– Practice portion control so you don’t eat too
much. (examples of portion sizes)
– Avoid eating fast food, prepared foods and
unhealthy snacks.

35. Exercise
• Physical activity:
– Gets you moving!!
– Decreases insulin resistance of the cells!
• Being physically fit has three parts:
– Strength
– Endurance
– Flexibility

36. Exercise
• Especially beneficial in type II diabetes.
• Promotes weight loss
• Increases insulin sensitivity.
• Must also be aware of medication and
intake to prevent hypoglycemia.

37. Benefits of Exercise
• Strengthens heart, muscles, bones.
• Helps insulin work better (decreases insulin
resistance).
• Improves blood circulation.
• Keeps joints flexible.

38. Benefits of Exercise
• Decreases:
– Blood glucose-less damage to vessels
– Blood pressure-less risk of stroke
– Cholesterol-less risk of heart attack and
stroke
– Stress- less risk of depression.

39. Methods of Carbohydrate Control
There are many new methods of controlling
diabetes, these are still the two most
common.
• Exchange Lists
• Carbohydrate counting- Very basic, allows a
little more freedom and variety.

40. Grains and More
Diabetics should have 6 or more servings of grains, beans and starchy vegetables per day.
Choose whole-grain foods that are nutritious and high in fiber, such as whole grain bread or
crackers, bran cereal and brown rice. Beans can be another good source of fiber. Don't use
white flour when cooking, instead look for whole wheat or whole grain alternatives.
Eating right is just one of the ways to manage your diabetes. Exercise and regular diabetic
testing are other elements to live a healthy lifestyle

41. Sources
 American Diabetes Association
 Diabetes.org