Diabetes mellitus (DM) is a common, chronic, metabolic syndrome characterized by hyperglycemia as a cardinal biochemical feature. The major forms of diabetes are classified according to those caused by deficiency of insulin secretion due to pancreatic β-cell damage (type 1 DM, or T1DM) and those that are a consequence of insulin resistance occurring at the level of skeletal muscle, liver, and adipose tissue, with various degrees of β-cell impairment (type 2 DM, or T2DM). T1DM is the most common endocrine-metabolic disorder of childhood and adolescence, with important consequences for physical and emotional development. Individuals with T1DM confront serious lifestyle alterations that include an absolute daily requirement for exogenous insulin, the need to monitor their own glucose level, and the need to pay attention to dietary intake. Morbidity and mortality stem from acute metabolic derangements and from long-term complications (usually in adulthood) that affect small and large vessels resulting in retinopathy, nephropathy, neuropathy, ischemic heart disease, and arterial obstruction with gangrene of the extremities. The acute clinical manifestations are due to hypoinsulinemic hyperglycemic ketoacidosis. Autoimmune mechanisms are factors in the genesis of T1DM; the long-term complications are related to metabolic disturbances (hyperglycemia).
Type 1 Diabetes Mellitus
Formerly called insulin-dependent diabetes mellitus (IDDM) or juvenile diabetes, T1DM is characterized by low or absent levels of endogenously produced insulin and dependence on exogenous insulin to prevent development of ketoacidosis, an acute life-threatening complication of T1DM. The natural history includes 4 distinct stages: (1) preclinical β-cell autoimmunity with progressive defect of insulin secretion, (2) onset of clinical diabetes, (3) transient remission “honeymoon period,” and (4) established diabetes associated with acute and chronic complications and decreased life expectancy. The onset occurs predominantly in childhood, with median age of 7-15 yr, but it may present at any age. The incidence of T1DM has steadily increased in many parts of the world, including Europe and the USA. T1DM is characterized by autoimmune destruction of pancreatic islet β cells. Both genetic susceptibility and environmental factors contribute to the pathogenesis. Susceptibility to T1DM is genetically controlled by alleles of the major histocompatibility complex (MHC) class II genes expressing human leukocyte antigens (HLAs). It is also associated with autoantibodies to islet cell cytoplasm (ICA), insulin (IAA), antibodies to glutamic acid decarboxylase (GADA or GAD65), and ICA512 (IA2). T1DM is associated with other autoimmune diseases such as thyroiditis, celiac disease, multiple sclerosis, and Addison disease. There is some suggestion that high dietary intake of omega-3 polyunsaturated fatty acids and vitamin D supplementation in early childhood decreases the incidence of autoi
Diabetes, often referred to by doctors as diabetes mellitus, describes a group of metabolic diseases in which the person has high blood glucose, either because insulin production is not enough, or because the body's cells do not react properly to insulin, or both. Patients with high blood sugar will typically experience polyuria (frequent urination), they will become more and more thirsty (polydipsia) and hungry (polyphagia).
There are mainly 3 types of Diabetes.
1. Type 1 Diabetes.
2. Type 2 Diabetes
3. Gestational Diabetes
Diabetes Mellitus type 1 major comorbidity now days.
Insulin injection being the major treatment Diabetes Mellitus.
Some other drugs used to treat the Diabetes Mellitus are Tablet Metformin 500 mg and other hypoglycemic drugs.
Diabetes Mellitus and Hypertension how they are interlinked.
Diabetes mellitus (DM) is a common, chronic, metabolic syndrome characterized by hyperglycemia as a cardinal biochemical feature. The major forms of diabetes are classified according to those caused by deficiency of insulin secretion due to pancreatic β-cell damage (type 1 DM, or T1DM) and those that are a consequence of insulin resistance occurring at the level of skeletal muscle, liver, and adipose tissue, with various degrees of β-cell impairment (type 2 DM, or T2DM). T1DM is the most common endocrine-metabolic disorder of childhood and adolescence, with important consequences for physical and emotional development. Individuals with T1DM confront serious lifestyle alterations that include an absolute daily requirement for exogenous insulin, the need to monitor their own glucose level, and the need to pay attention to dietary intake. Morbidity and mortality stem from acute metabolic derangements and from long-term complications (usually in adulthood) that affect small and large vessels resulting in retinopathy, nephropathy, neuropathy, ischemic heart disease, and arterial obstruction with gangrene of the extremities. The acute clinical manifestations are due to hypoinsulinemic hyperglycemic ketoacidosis. Autoimmune mechanisms are factors in the genesis of T1DM; the long-term complications are related to metabolic disturbances (hyperglycemia).
Type 1 Diabetes Mellitus
Formerly called insulin-dependent diabetes mellitus (IDDM) or juvenile diabetes, T1DM is characterized by low or absent levels of endogenously produced insulin and dependence on exogenous insulin to prevent development of ketoacidosis, an acute life-threatening complication of T1DM. The natural history includes 4 distinct stages: (1) preclinical β-cell autoimmunity with progressive defect of insulin secretion, (2) onset of clinical diabetes, (3) transient remission “honeymoon period,” and (4) established diabetes associated with acute and chronic complications and decreased life expectancy. The onset occurs predominantly in childhood, with median age of 7-15 yr, but it may present at any age. The incidence of T1DM has steadily increased in many parts of the world, including Europe and the USA. T1DM is characterized by autoimmune destruction of pancreatic islet β cells. Both genetic susceptibility and environmental factors contribute to the pathogenesis. Susceptibility to T1DM is genetically controlled by alleles of the major histocompatibility complex (MHC) class II genes expressing human leukocyte antigens (HLAs). It is also associated with autoantibodies to islet cell cytoplasm (ICA), insulin (IAA), antibodies to glutamic acid decarboxylase (GADA or GAD65), and ICA512 (IA2). T1DM is associated with other autoimmune diseases such as thyroiditis, celiac disease, multiple sclerosis, and Addison disease. There is some suggestion that high dietary intake of omega-3 polyunsaturated fatty acids and vitamin D supplementation in early childhood decreases the incidence of autoi
Diabetes, often referred to by doctors as diabetes mellitus, describes a group of metabolic diseases in which the person has high blood glucose, either because insulin production is not enough, or because the body's cells do not react properly to insulin, or both. Patients with high blood sugar will typically experience polyuria (frequent urination), they will become more and more thirsty (polydipsia) and hungry (polyphagia).
There are mainly 3 types of Diabetes.
1. Type 1 Diabetes.
2. Type 2 Diabetes
3. Gestational Diabetes
Diabetes Mellitus type 1 major comorbidity now days.
Insulin injection being the major treatment Diabetes Mellitus.
Some other drugs used to treat the Diabetes Mellitus are Tablet Metformin 500 mg and other hypoglycemic drugs.
Diabetes Mellitus and Hypertension how they are interlinked.
Prediabetes and Diabetes: Are you at risk?Summit Health
Learn how the four healthy pillars of managing diet, exercise, sleep habits, and stress can significantly reduce your chance of developing prediabetes or progressing from prediabetes to diabetes.
The Diabetic coma is one the most dangerous and again emergent case experienced during dental care delivery. Actually it mistreated and aggravated-diabetic cases resulting coma, that is categorized into Hypoglycemic coma, Diabetic ketoacidosis and Hyperosmolar coma.
Prediabetes and Diabetes: Are you at risk?Summit Health
Learn how the four healthy pillars of managing diet, exercise, sleep habits, and stress can significantly reduce your chance of developing prediabetes or progressing from prediabetes to diabetes.
The Diabetic coma is one the most dangerous and again emergent case experienced during dental care delivery. Actually it mistreated and aggravated-diabetic cases resulting coma, that is categorized into Hypoglycemic coma, Diabetic ketoacidosis and Hyperosmolar coma.
Learn how acupuncture can help diagnose, treat, and prevent certain conditions and diseases, including chronic pain, asthma, allergies, insomnia, hot flashes and stress. Our acupuncturist will demonstrate acupuncture and describe how the ancient techniques can be used with traditional medicine to help you maintain wellness.
Are you age 40 years or older and finding it difficult to lose weight? Learn how your age, menopause and hormones can affect weight loss. Find out about strategies that can help you maintain a healthy weight.
Everything You Ever Wanted To Know About Your Child's NutritionSummit Health
New and experienced parents are invited to join us and learn about good nutrition and healthy dietary habits that can help children achieve and maintain a healthy weight for life!
Fixed tackling sports concussions head onSummit Health
Athletes (and non athletes as well) are increasingly reporting concussions to parents, coaches, and school nurses. How can you recognize a concussion? We will review the diagnosis and treatments for concussions, review dangers of multiple concussions and discuss the use of computerized neuropsychological testing prior to “return to play”.
Our patient accounts staff answers to frequently asked billing questions at Summit Medical Group. Topics include bringing your insurance card to all medical visits, the ABC's of co-pays, deductibles and co-insurance, and the difference between in-network and out-of-network services.
High blood pressure can get away from you, but
there’s plenty you can do to rein it in. Find out the
difference it can make to lose those extra pounds
and tweak your diet, as well as how to get the most
from your medications.
Keeping your child with diabetes out of the hospital prewebinar materialStephen Ponder
This slide deck is material for preparation for the August 19th 2014 Webinar by the same title to be presented at 7:30-9:00PM Central Standard Time in the USA. To register for the webinar go to
https://baylorscottandwhiteevent.webex.com/mw0307l/mywebex/default.do?siteurl=baylorscottandwhiteevent
Pediatric Talk: Managing Arthritis During the Holidays - Dr. Marla Guzman - ...Summit Health
While holiday celebrations and activities are great fun, it’s also a disruptor to the daily routine. Our expert will share tips to help you navigate holiday season stressors to minimize your child’s risk of a potential flare-up. This virtual event is hosted by the Arthritis Foundation.
Safety and Success in a Post-Pandemic Society - Daniela Accurso, MD, MPH - 7...Summit Health
The Covid-19 Pandemic has been a health crises that we have been fighting for the last year and a half. Dr. Accurso’s presentation is focused on reviewing how far we have come as a society and to address the questions, health concerns, and important precautions we need to take as we integrate ourselves back into a healthy community.
Melanoma: Prevention, Detection and Treatment - Stephanie Badalamenti, MD - L...Summit Health
Sun safety needs to start at an early age, and continue throughout life, in order to reduce the risk for skin cancer. Learn about prevention and ways to reduce your risk, screening for skin cancer and innovations in treatments.
Melanoma: Prevention, Detection and Treatment - Stephanie Badalamenti, MD - L...Summit Health
Sun safety needs to start at an early age, and continue throughout life, in order to reduce the risk for skin cancer. Learn about prevention and ways to reduce your risk, screening for skin cancer and innovations in treatments.
Shoulder Pain Relief: Common Rotator Cuff Injuries & Treatment Options - And...Summit Health
If you are experiencing shoulder pain, a rotator cuff tear could be the issue. Learn about how, and why, rotator cuff tears happen, how the condition and severity is diagnosed, and the non-surgical and surgical treatment options available.
My Knee Hurts! A Look at Joint Pain in Children - Marla Guzman, MD - 1.12.2021Summit Health
Is your child complaining of joint pain? Learn about concerning symptoms and when to seek medical advice. Our expert discusses the various causes of joint pains in children, how a pediatric rheumatologist evaluates musculoskeletal complaints, and available treatment options.
Mildred “Mitch” Bentler, MA, RD, CSP, CDE, presented a virtual lecture at on diabetes prevention. According to Ms. Bentler,
“A combination of small changes can really make an impact on lowering your blood sugar. Increasing physical activity and adopting healthier eating habits can go a long way to reducing your diabetes risk.”
Why Does My Stomach Ache? - Dennis Han, MD, Gastroenterologist - Morristown &...Summit Health
Do you have stomach issues which are bothering you and you can't figure out why? Learn about conditions that could be causing abdominal pain or discomfort at this virtual program. Our expert will discuss different conditions such as: Irritable Bowel Syndrome; Inflammatory Bowel Disease; Celiac Disease and other conditions that require a gluten-free diet; and GERD (Reflux). He will explain the differences between these various conditions, how they are diagnosed, and treatment options available. Hosted by Morristown & Morris Township Public Library.
Know Your Numbers and What They Mean for Your Overall Health - Madison Public...Summit Health
What does your blood pressure, BMI, cholesterol, blood sugar and vitamin levels tell you about your health? Our expert will discuss how these numbers tell a story, and why it’s important to understand what that story means to your overall health. Dr. Im-Imamura will also share tips for helping you get these numbers where they should be, and how increasing physical activity and improving nutrition are key factors that can impact those numbers in a good way.
Presented as part of the Madison Public Library Virtual Seminar Series.
Understanding Knee Arthritis and Cartilage Disorders - Maurice M. Pine Free P...Summit Health
Many people suffer from pain, swelling, stiffness, and loss of knee function as a result of knee arthritis. Our expert will discuss the causes, symptoms, and nonsurgical and surgical treatment options available. Hosted by Maurice M. Pine Free Public Library.
Pulmonologist, Jenny Kim, MD, FCCP of our Sleep Disorders Center partnered with the Livingston Health Department to present, Can’t Sleep? The ABCs of Your ZZZs to the community. During the session, Dr. Kim discussed tips for improving sleep and treatment options for common sleep disorders.
Christina Lavner, RDN, Nutrition Services, presented Healthy Eating for Cancer Survivorship, as the second session of our Now What? A Cancer Survivorship Speaker Series for patients wanting to learn more about nutrition that will benefit them during and after treatment. Be sure to check out upcoming presenters in this series and pass the word on to any patients you think would be interested in the information. The next presentation in this series is November 16, Coping with Treatment Side Effects, presented by Constance Gore, RN-APN
Guide to Eating an Anti-Inflammatory Diet Virtual Lecture - Christina Lavner,...Summit Health
An anti-inflammatory diet, along with exercise, can yield many health benefits, such as improved symptoms of many chronic conditions, reduced cancer risk, and a lower risk of obesity, heart disease, and diabetes. Learn more about this healthy way of eating and how to get started.
While most common in teens, the onset of acne can be troubling at any age. Depending on its severity, acne can cause emotional distress and scar the skin. The earlier you start treatment, the lower your risk of such problems. Learn about the causes of acne and effective treatment options for adolescents and adults.
Living a Heart Healthy Life - Liliana Cohen - West Orange Public Library - 2....Summit Health
Learn how to make healthy choices that impact heart health, the typical mistakes to avoid, and how to recognize the signs and symptoms of a heart attack.
Heart of the Matter - Ali Ahmad, MD, FACC - Livingston Library - 1.6.2020Summit Health
Heart disease is the leading killer of adults nationwide and it carries a significant morbidity for the population at risk. Learn about traditional and non-traditional risk factors associated with coronary artery disease, and how to modify your risk and prevent heart disease. Also, learn about how heart disease affects different ethnic backgrounds, particularly the high-risk groups, such as South Asians.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
2. Diabetes: You Are Not Alone
Centers for Disease Control and Prevention. 2011. http://www/cdc/gov/diabetes/pubs/pdf
ndfs_2011.pdf. Accessed March 7, 2011.
3. What Are Different Kinds of Diabetes?
Body doesn’t make
Body doesn’t
enough insulin or can’t
make insulin
use insulin properly
Diagnosed during Steroids, cystic
pregnancy fibrosis
ADA. Diabetes Care. 2011;34 (Suppl 1):S11-S61.
4. Who Is Most Likely
to Have Type 2
Diabetes?
• Overweight
• Not physically active
• High blood pressure
• 45 years or older
• Diabetes during pregnancy
• Diabetes in the family
or having a baby more than
• Some ethnic groups 9 pounds
ADA. Diabetes Care. 2011;34(Suppl 1):S11-S61.
5. How Does Your Doctor
Know That You Have
Diabetes?
• A1C blood test of 6.5% or higher*
• Blood sugar of 126 mg/dL or more after not eating for at least
8 hours*
• Oral glucose tolerance test of 200 mg/dL or higher*
• High blood sugar symptoms and blood sugar of 200 mg/dL or
more when tested at any time
• Prediabetes: A1C of 5.7% - 6.4% or blood sugar of 100-125
mg/dL after not eating*
*May need to be repeated to be sure.
ADA. Diabetes Care. 2011;34(Suppl 1):S11-S61.
6. What Are Some
Symptoms of Very High
Blood Sugar?
• Urinating often • Weight loss
• More thirsty or hungry • Increased infections
than usual
• Blurry vision
ADA. Diabetes Care. 2011;34(Suppl 1):S62-S69.
7. Low Blood Sugar (Hypoglycemia)
What can How do you Does everyone
cause it? feel? feel the same?
• Too little food or • Hungry • People have
carbohydrates different
• Angry/tense
• Skipped or symptoms
• Sick to stomach
delayed meals • Some people
• Light-headed have no
• More active than
• Clammy/sweaty/ symptoms at all
usual
pale
• Too much insulin
or too many • Shaky
diabetes pills • Tired
ADA. Diabetes A to Z (6th edition). American Diabetes Association, Alexandria, VA 2010; 15-16.
8. Treating Low Blood Sugar
Check your The Rule of 15 Fast-acting
blood sugar sugars
• Eat or drink 15g
• Is it in your carbs • ½ cup fruit juice
target range? or regular soda
• Wait 15 minutes
• If you can’t and check blood • 4 or 5 hard
check your sugar candies
blood sugar,
• If still low, eat • 3 glucose
treat it anyway
another 15g carbs tablets
• If you’re low,
follow the Rule • Check again after
of 15 15 minutes
ADA. Hypoglycemia - Planet D. 2010. http://www.diabetes.org/living-with-diabetes/parents-and-
kids/planet-d/new-to-diabetes/hypoglycemia.html Accessed April 16, 2011.
10. How Does Food Turn Into Energy?
• Certain foods (carbohydrates) break
down into sugar during digestion1
• Sugar enters bloodstream1
• Rising sugar level in blood causes
pancreas to release insulin2
• Insulin moves sugar from blood to the
cells where it is used for energy1,2
• Carbohydrates make blood sugar go up
and insulin makes blood sugar go Pancreas
down2
Schaefer EJ et al. J Nutr. 2009;139:1257S-1262S.2 Kahn RC, Saltiel AR. In: Joslin’s Diabetes
1
Mellitus. 14th ed. Lippincott Williams & Wilkins; 2005:145-168.
11. Create Your
Plate • Draw imaginary line across
center of plate
• On one side, cut again so there
are 3 sections
• Fill largest section with non-
starchy vegetables
• Fill one small section with
starchy foods
• Fill the other small section with
protein
• Add 8-oz non-fat or low-fat
milk and fruit
ADA. Diabetes A to Z (6th edition). American Diabetes Association, Alexandria, VA. 2010;125-126.
12. cup 1
Portion Control: It’s Easy!
• Eating healthy food is important, but
so is eating the right amounts
3 oz.
• Start by weighing and measuring
your food to learn what the right
portion size looks like
• After that, use your hands as
measuring tools*
• Your fist = 1 cup
• Your palm = 3 ounces 1 oz.
• Your thumb = 1 ounce
*Hand sizes vary. Estimates are based on the size of a small hand. They are intended to be
guides only.
Diabetes America. Nutrition measuring and portion control in diabetes. 2011.
http://www.diabetesamerica.com/da-nutrition_measuring.cfm. Accessed March 13, 2011.
13. Know Your Serving Size
Servings per
Nutrients Container
Saturated Fat and Trans Fat
Cholesterol
Carbohydrates (Carbs) Sodium
Fiber
ADA. Diabetes A to Z (6th edition). American Diabetes Association, Alexandria, VA. 2010;67.
14. Keep Track of Your Carbohydrates
*
• Starches (bread, cereal,
rice, pasta)
• Starchy vegetables
(corn, peas, potatoes,
dry beans)
• Fruit and fruit juice
• Milk and yogurt
• Sugary foods
• Sweets
* These foods turn to sugar in your body
ADA. Diabetes A to Z (6th edition). American Diabetes Association, Alexandria, VA. 2010;125.
15. Protein-Rich Foods
• Meat*
• Poultry
• Fish
• Cheese, cottage cheese
• Eggs
* Choose lean cuts of baked or broiled
meat, such as chicken or fish.
ADA. Diabetes A to Z (6th edition). American Diabetes Association, Alexandria, VA. 2010;87,126.
16. Get the Facts on Fats
• Saturated fat: Bacon, butter, sour
cream
• Unsaturated fat:
• Monounsaturated fat - olive oil,
canola oil, peanut oil
• Polyunsaturated fat - corn oil,
safflower oil
• Trans fat: unsaturated fats that raise
cholesterol
ADA. Diabetes A to Z (6th edition). American Diabetes Association, Alexandria, VA. 2010;85.
17. Let’s Move
• Stay healthy
• Control blood sugar
• Improve heart health
• Manage weight
• Aim for at least 150
minutes of moderate
physical activity each
week
ADA. Diabetes Care. 2011;34(Suppl 1):S11-S61.
18. Take 3 Steps to Be
More Active 1
2
Recommended Amount of Exercise:
At least 2.5 hours/week
• Step 1: Talk to your doctor
• Step 2: Choose your activity
• Step 3: Set a goal
1
ADA. Diabetes Care. 2011;34(Suppl 1):S11-S61. 2ADA. Be active, but how? 2010.
http://www.diabetes.org/food-and-fitness/fitness/fitness-management/be-active-but-how.html.
Accessed January 4, 2011.
If you have diabetes, you are not alone. One out of every 12 Americans – nearly 26 million persons - has diabetes. Reference Centers for Disease Control and Prevention. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf Accessed March 7, 2011.
Diabetes is characterized by chronically elevated blood sugar. In patients with type 1 diabetes, production of insulin by the pancreas is completely absent. Patients with type 2 diabetes have increased blood sugar because of a defect in the ability of the pancreas to secrete insulin or a defect in the ability to use insulin (ie, insulin resistance). Another less common type of diabetes is only diagnosed during pregnancy and is called gestational diabetes. The fourth type of diabetes is a catch-all that includes diabetes caused by specific events, such as a genetic defect in beta-cell function or insulin action, pancreatic diseases (eg, cystic fibrosis), and exposure to certain drugs or chemicals. Reference ADA. Standards of medical care in diabetes – 2011. Diabetes Care . 2011;34(Suppl 1):S11-S61.
The American Diabetes Association (ADA) has identified risk factors that are associated with the development of diabetes. The likelihood of developing type 2 diabetes can increase in people with certain risk factors. Two very common risk factors are being overweight and physically inactive. Having high blood pressure, with readings of 140/90 mmHg or greater, or taking medication for high blood pressure also increases the risk of developing type 2 diabetes. Other risk factors, which cannot be changed, are growing older, having a family member with diabetes, belonging to certain ethnic groups (eg, African Americans, Mexican Americans, native Hawaiians), being pregnant, and having a baby weighing more than 9 pounds. Reference ADA. Standards of medical care in diabetes – 2011. Diabetes Care . 2011;34(Suppl 1):S11-S61.
Your doctor can determine if you have diabetes several different ways. The first test is called the A1C, which the American Diabetes Association (ADA) recommends as a diagnostic test for diabetes. The A1C test tells your doctor how high (or low) your blood sugar has been over the past several months. According to the ADA, persons with an A1C value of 6.5% or greater are considered to have diabetes. Another measurement is called fasting plasma glucose – or FPG. An FPG of 126 mg/dL or greater indicates that a person has diabetes. When you take this test, you do not eat for at least 8 hours, which is why it is often taken in the morning before breakfast. A third test is called the oral glucose tolerance test – or OGTT – in which your blood sugar is measured after you drink a mixture of sugar and water. Persons with blood sugar levels of 200 mg/dL or greater two hours after drinking the sugar mixture have diabetes. A fourth way that your doctor can tell if you have diabetes is if you have symptoms of high blood sugar and a blood sugar level of 200 mg/dL or more. The results of your tests may not show that you have diabetes, but the results may be high enough to indicate that you have prediabetes. Persons with prediabetes are at increased risk of developing full-blown diabetes sometime in the future. You have prediabetes if you A1C test is 5.7% to 6.4% or if you have a blood sugar level of 100-125 mg/dL or more after not eating for at least 8 hours. Unless you have symptoms of high blood sugar or a blood sugar level of 200 mg/dL or more, your diagnostic tests for diabetes and prediabetes should be repeated to be sure that there is no laboratory error. Reference ADA. Standards of medical care in diabetes – 2011. Diabetes Care . 2011;34(Suppl 1):S11-S61.
There are some tell-tale signs of very high blood sugar levels. 1 Having to urinate frequently, being more thirsty or hungry than usual, having blurry vision, losing weight unexpectedly, and being more prone to infections than usual are all signs of very high blood sugar. 1 Diabetes is different in every person. Not everyone with diabetes will have these symptoms. Some people have different symptoms, and some don’t have any symptoms at all. 1 In fact, many people with diabetes do not even suspect that they have the disease. 2 Persons with type 1 diabetes usually have very noticeable symptoms of high blood sugar, which helps their doctor make a diagnosis quickly. 2 However, type 2 diabetes often is not diagnosed until complications occur, and as many as one out of every four persons with type 2 diabetes does not know they have it. 2 References 1 ADA. Diagnosis and classification of diabetes mellitus. Diabetes Care . 2011;34(Suppl 1):S62-S69. 2 ADA. Standards of medical care in diabetes – 2011. Diabetes Care . 2011;34(Suppl 1):S11-S61.
Low blood sugar, also called hypoglycemia, happens when your blood sugar is too low. It is something that people with diabetes need to be prepared to treat. You might get low blood sugar if you ate too little food or carbohydrates or skipped or delayed meals or snacks. Low blood sugar can also happen if you are more active than usual or take too much insulin or too many diabetes pills. With low blood sugar, you may feel weak or tired, hungry, dizzy or shaky, nervous or upset, sweaty, like your heart is beating too fast, or like your vision is blurry. The signs and symptoms of low blood sugar may become less noticeable after a person has had diabetes for a while. Some signs and symptoms might be so subtle that it is hard to react to them in time. Having signs and symptoms of low blood sugar without realizing it is called "hypoglycemic unawareness.“ Ask your diabetes care team what low blood sugar is for you. For most people, it is less than 70 mg/dL. Check your blood sugar right away if you have any symptoms of low blood sugar. If your blood sugar is low, or if you think your blood sugar is low but you cannot check at that time, eat or drink something high in sugar right away, such as 4 ounces (1/2 cup) of regular fruit juice, 4 ounces (1/2 cup) of regular soda pop (not diet), or glucose tablets. Reference ADA. Diabetes A to Z (6th edition). American Diabetes Association, Alexandria, VA. 2010;15-16.
People with diabetes need to be prepared to treat low blood sugar. If you feel like you are low, check your blood sugar right away. If your blood sugar is below your target range, follow the Rule of 15. If you cannot check your blood sugar, play it safe and treate it anyway. The Rule of 15 is a simple and easy to remember way to treat low blood sugar: Eat or drink something with 15 grams of carbohydrate Wait 15 minutes and check your blood sugar again If your blood sugar is still low, eat or drink another 15 g of carbohydrates Check again after 15 minutes Keep some fast-acting carbohydrates on hand just in case your blood sugar becomes low. Some fast-acting carbohydrates are: One-half cup of fruit juice or regular soda; do not use diet soda 4 or 5 hard candies; chocolate is not a good choice because it contains fat, which doesn’t give you the burst of sugar that you need 3 glucose tablets Reference ADA. Hypoglycemia - Planet D. 2010. http://www.diabetes.org/living-with-diabetes/parents-and-kids/planet-d/new-to-diabetes/hypoglycemia.html Accessed April 16, 2011.
Now let’s talk about using what you’ve learned about diabetes to stay healthy.
The food we eat is used by our bodies as fuel to stay healthy and keep going. 1 This animation shows how a certain type of food – carbohydrate – is broken down into sugar. You may sometimes hear sugar referred to as glucose. Glucose travels from the stomach into the blood. 1 Once in the blood, we call this fuel blood sugar – or blood glucose. Increasing levels of sugar in the bloodstream cause the pancreas to release insulin into the blood. 2 Insulin helps move the sugar from the blood to the inside of the cells so it can be used as energy. 1,2 Carbohydrates make blood sugar increase, and insulin (and other important substances not shown here) makes blood sugar decrease. 2 References 1 Schaefer EJ, Gleason JA, Dansinger ML. Dietary fructose and glucose differentially affect lipid and glucose homeostasis. J Nutr . 2009;139:1257S-1262S. 2 Kahn RC, Saltiel AR. The molecular mechanism of insulin action and the regulation of glucose and lipid metabolism (Chapter 9). In: Joslin’s Diabetes Mellitus . 14th ed. Lippincott Williams & Wilkins; 2005:145-168.
There is a simple way to choose healthy foods in the right portion sizes: it is called the ‘plate method’ of diabetes meal planning. The plate method allows you to spread the amount of carbohydrates that you eat evenly over your daily meals and snacks. By using the plate method, you will be your way to managing your blood sugar. It is easy to create a plate of healthy food with the right portions: Draw a picture of a typical dinner plate Split the plate in half and then split one of the sections in 2 Fill the big section with nonstarchy vegetables, like spinach or broccoli Put starchy foods, like whole wheat bread or rice, in one of the small sections Put protein-containing foods, like meat, chicken, or eggs, in the other small section Add one 8-ounce glass of skim milk and a serving of fruit. Reference ADA. Diabetes A to Z (6th edition). American Diabetes Association, Alexandria, VA. 2010;125-126.
Eating healthy food is important, but so is eating the right amounts. Start by weighing and measuring your food to be familiar with what the right portion size looks like. Although all hands are different, a general rule is that your fist equals one cup, your palm equals 3 ounces, and your thumb equals one ounce. Reference Diabetes America. Nutrition measuring and portion control in diabetes. 2011. http://www.diabetesamerica.com/da-nutrition_measuring.cfm Accessed March 13, 2011.
One important part of taking charge of your diabetes is learning about the food that you eat. Food labels are a great source of information about the carbohydrates, fats, cholesterol, sodium, and fiber in a serving of that food. It is important that you carefully read the Nutrition Facts label. The number of calories, fat, carbohydrates, and other nutrients shown on the label are for a specific serving of that food. Many food containers have more than one serving. So in the example shown on this slide, the serving size is one cup and there are 2.5 servings in the container. That means that one cup of that food contains 150 calories. However, because there are 2.5 servings in the container, if you eat the entire container, you will be eating 375 calories and corresponding amounts of fat, carbohydrates, and the other nutrients. Reference ADA. Diabetes A to Z (6th edition). American Diabetes Association, Alexandria, VA. 2010;67.
Carbohydrate counting – or carb counting - is another way to manage your diabetes. Your body changes carbohydrates into sugar faster than proteins or fats, and it is the carbohydrates in your diet that are responsible for the increases and decreases in your blood sugar levels. The carbohydrate counting method of diabetes meal planning is simple: you keep track of the number of carbohydrates that you eat in each meal. Don’t worry about counting food that is mostly protein and fat because these types of foods contain very few carbohydrates. If you take insulin to control your blood sugar, carb counting will help you adjust your dose of insulin because you will be aware of how many carbohydrates you have eaten in each meal. If you do not take insulin, “carb counting” will help you learn to space your carbohydrates over the course of the day and better manage your blood sugar. Reference ADA. Diabetes A to Z (6th edition). American Diabetes Association, Alexandria, VA. 2010;125.
A healthy diet includes protein, which is found in foods from both animals and plants. According to the American Diabetes Association, a healthy meal plan will include about 6 ounces of meat or meat substitutes. Your dietician will recommend that you choose protein from foods that are low in fat, calories, and cholesterol. Meats, eggs, cheese, and cottage cheese are high-protein foods, but they may also be high in fat and calories. For healthy eating, you should try to choose lean cuts of meat (baked or broiled) and low-fat dairy products. Healthy choices of protein-rich foods are chicken (without skin), fish, shellfish, beans, peas, lentils, grains, nuts, and seeds. Reference ADA. Diabetes A to Z (6th edition). American Diabetes Association, Alexandria, VA. 2010;87,126.
Your healthy eating plan should consist of meals and snacks that are low in saturated fat. There are three types of fat: saturated fat, unsaturated fat, and trans fat. Saturated fats will increase your cholesterol levels. Cholesterol is found only in foods from animal sources, such fatty cuts of meat and high-fat dairy products, like butter or sour cream. Unsaturated fats are found in foods from plants. Some unsaturated fats will help you reduce your cholesterol. Some foods that contain monounsaturated fats are olive oil, canola oil, peanut oil, avocados, and almonds. Polyunsaturated fats are found in foods, such as corn oil, safflower oil, cottonseed oil, sunflower oil, and avocados. Trans fats are a type of unsaturated fat that are particularly unhealthy because they can increase your cholesterol. Check the labels on your food to see if it contains trans fat and if so, the healthy choice is to choose another type of food. Reference ADA. Diabetes A to Z (6th edition). American Diabetes Association, Alexandria, VA. 2010;85.
According to the American Diabetes Association, regular exercise will help you stay healthy and can improve your blood sugar control, reduce your risk for heart disease, and help you lose weight. Your diabetes team may suggest that you try to do at least 150 minutes of moderate-intensity exercise each week. Reference ADA. Standards of medical care in diabetes – 2011. Diabetes Care . 2011;34(Suppl 1):S11-S61.
Because diabetes is associated with an increased risk of heart disease or other diabetes-related complications, you must see your physician before beginning an exercise regimen. 1 One great way to get started is to identify activities that you enjoy. Work with your diabetes team to find activities that burn calories (eg, walking) as well as activities that build muscle (eg, walking with light weights). 1 Begin slowly by exercising for 10 minutes three times a week, then increase the duration of each exercise session, then increase the number of exercise sessions each week. 1 Find a partner or join an exercise group to make exercising social and more fun. 1 The American Diabetes Association recommends that persons with diabetes get at least 2.5 hours of moderate-intensity aerobic exercise each week. 2 Don’t feel that if you can’t exercise for 30 minutes at a time, you should quit. Ten minutes here and there for a total of 30 minutes may be more practical for some people. 1 Find times throughout the day to increase your level of activity. For example, you can find a parking spot farther away from the grocery store, take the stairs instead of the elevator, and get up to change the television channel rather than using the remote. 1 References 1 ADA. Be active, but how? 2010. http://www.diabetes.org/food-and-fitness/fitness/fitness-management/be-active-but-how.html. Accessed January 4, 2011. ADA. 2 Standards of medical care in diabetes – 2011. Diabetes Care . 2011;34(Suppl 1):S11-S61.
Please ask the attendees if they have any questions at this time.