Preventing diabetes

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Via Christi Women's Connection presentation on preventing diabetes held May 13, 2014.

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Preventing diabetes

  1. 1. Preventing DiabetesPreventing Diabetes Dany Zayour, MDDany Zayour, MD Via Christi ClinicVia Christi Clinic Diabetes and Endocrinology CenterDiabetes and Endocrinology Center
  2. 2. Why talk about Diabetes?Why talk about Diabetes?  26 million americans (11.3%) have diabetes26 million americans (11.3%) have diabetes  7 million do not know it7 million do not know it  2 new million cases diagnosed each year2 new million cases diagnosed each year  79 million americans have prediabetes79 million americans have prediabetes  37 million (15%) will have diabetes in 201537 million (15%) will have diabetes in 2015  1 in 3 adults will have diabetes in 20501 in 3 adults will have diabetes in 2050
  3. 3. What is prediabetes?What is prediabetes?
  4. 4. What is prediabetes?What is prediabetes?  Blood sugar is higher than normal but not asBlood sugar is higher than normal but not as high as diabeteshigh as diabetes  Touch of sugarTouch of sugar  Mild diabetesMild diabetes  Prediabetes is likely to progress to diabetes in 10Prediabetes is likely to progress to diabetes in 10 years or lessyears or less  Already started complicationsAlready started complications
  5. 5. How do I know if I have prediabetes?How do I know if I have prediabetes?
  6. 6. SymptomsSymptoms  No signs or symptomsNo signs or symptoms  Darkened areas of skin called acanthosis nigricansDarkened areas of skin called acanthosis nigricans  Signs of diabetesSigns of diabetes  Increased thirstIncreased thirst  Frequent urinationFrequent urination  FatigueFatigue  Blurred visionBlurred vision  Recurrent infectionRecurrent infection  Tingling and numbnessTingling and numbness  Cuts and bruises that are slow to healCuts and bruises that are slow to heal
  7. 7. What increases my risk for diabetesWhat increases my risk for diabetes and should I get tested?and should I get tested?
  8. 8. What increases the risk of diabetes?What increases the risk of diabetes?  Overweight or obese (BMI above 25)Overweight or obese (BMI above 25)  Extra weight in your bellyExtra weight in your belly  Not physically activeNot physically active  SmokingSmoking  Family history of type 2 diabetesFamily history of type 2 diabetes  Gestational diabetes or baby more than 9 lbsGestational diabetes or baby more than 9 lbs  PCOSPCOS  Sleep fewer than 6 hrs or more than 9 hrs per daySleep fewer than 6 hrs or more than 9 hrs per day  Race: african american, asian, HispanicRace: african american, asian, Hispanic
  9. 9. Are there any blood tests to diagnose prediabetes?Are there any blood tests to diagnose prediabetes?
  10. 10. Blood tests to diagnose prediabetesBlood tests to diagnose prediabetes  Fasting glucoseFasting glucose  8 hrs fast8 hrs fast  BS 100-125 mg/dlBS 100-125 mg/dl  Glucose tolerance testGlucose tolerance test  Drink sugary solutionDrink sugary solution  BS 2 hrs after that 140-199BS 2 hrs after that 140-199  Hemoglobin A1c or HbA1cHemoglobin A1c or HbA1c  HbA1c 5.7-6.4%HbA1c 5.7-6.4%
  11. 11. A1C eAGA1C eAG %% mg/dlmg/dl 66 126126 6.56.5 140140 77 154154 7.57.5 169169 88 183183 8.58.5 197197 99 212212 9.59.5 226226 1010 240240 HbA1c and average glucose
  12. 12. ADA Diagnostic Criteria:ADA Diagnostic Criteria: Normal, Diabetes, and Pre-diabetesNormal, Diabetes, and Pre-diabetes Clinical Practice Recommendations 2010Clinical Practice Recommendations 2010 ParameterParameter NormalNormal DiabetesDiabetes Pre-diabetesPre-diabetes MethodMethod 11 Fasting PlasmaFasting Plasma GlucoseGlucose (mg/dl)(mg/dl) <100<100 ≥≥126126 100–125100–125 No caloric intakeNo caloric intake for at least 8 hfor at least 8 h 22 2-h plasma2-h plasma glucose onglucose on OGTT (mg/dl)OGTT (mg/dl) <140<140 ≥≥200200 140–199140–199 WHO method: 75WHO method: 75 g glucose loadg glucose load 33 RandomRandom plasma glucoseplasma glucose (mg/dl)(mg/dl) <140<140 ≥≥200200 -- with classicwith classic symptomssymptoms of hyperglycemiaof hyperglycemia or crisisor crisis 44 A1CA1C %% <5.7<5.7 ≥≥6.56.5 5.7 – 6.45.7 – 6.4 NGSP certifiedNGSP certified methodmethod standardized tostandardized to the DCCT assaythe DCCT assay
  13. 13. What is the treatment of prediabetes?What is the treatment of prediabetes?
  14. 14. Reducing risk of DiabetesReducing risk of Diabetes  Losing 7% (5-10%) of body weightLosing 7% (5-10%) of body weight  Decrease risk by 58%Decrease risk by 58%  11% per year of prediabetes develop diabetes in11% per year of prediabetes develop diabetes in the first 3 yearsthe first 3 years
  15. 15. DietDiet  DietDiet  Low in fatLow in fat  High in fibersHigh in fibers  Focus on fruits, vegetables and whole grainsFocus on fruits, vegetables and whole grains  VarietyVariety
  16. 16. Physical activityPhysical activity  30-60 minutes daily 5 days a week ( there are 1440 min in a day)30-60 minutes daily 5 days a week ( there are 1440 min in a day)  Brisk daily walkingBrisk daily walking  Ride your bikeRide your bike  DancingDancing  Low impact aerobic classLow impact aerobic class  SwimmingSwimming  Exercise while sittingExercise while sitting  Use stairsUse stairs  Park away from entrancePark away from entrance
  17. 17. MedicationsMedications  MetforminMetformin  ActosActos  AcarboseAcarbose  GLP-1 agonistsGLP-1 agonists
  18. 18. Alternative medicineAlternative medicine  CinnamonCinnamon  ChromiumChromium  GinsengGinseng  Prickly pear cactusPrickly pear cactus  SoySoy  SteviaStevia  GymnemaGymnema
  19. 19. THANK YOUTHANK YOU

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