What is Diabetes Definition of Diabetes is a
What is Diabetes?
Definition of Diabetes is a disease in which the body does not produce or properly use the hormone insulin. 2 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Insulin and Blood Glucose http: //professional. diabetes. org/resourcesforprofessionals. aspx? cid-60378&typ=17 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010 3
Focus on Blood Glucose l Insulin is required for uptake of glucose (“sugar”) from the blood into cells. l In diabetes, blood glucose levels rise because it can’t get from the blood into the cells. l Consistently high blood glucose causes many health problems. 4 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Types of Diabetes l Type 1 diabetes – – – Onset usually before age 30. Absolute insulin deficiency. Destruction of beta cells in pancreas. l l l – Genetic predisposition Environmental factors Auto-immune response Dependence on exogenous insulin. 5 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 1 Diabetes: a message from the American Diabetes Association http: //professional. diabetes. org/Resources. For. Professionals. aspx? cid=60378&typ=17 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010 6
Types of Diabetes l Type 2 diabetes – – – Most common in adults over age 40. Increasing problem in children and adolescents. Genetic factor: family history. Metabolic factor: insulin resistance. Environmental factors: obesity, physical inactivity, and poor dietary habits. 7 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes: a message from the American Diabetes Association http: //professional. diabetes. org/Resources. For. Professionals. aspx? cid=60378&typ=17 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010 8
Type 2 Diabetes: The Situation l l About 24 million Americans have type 2 diabetes. – About 6 million of these are undiagnosed. – On average, diabetes is present for 6½ years before diagnosis. – Usually diagnosed during routine medical exam. About 57 million Americans are at high risk for diabetes. 9 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes: Risk Factors l l l Obesity Inactivity Family history NOTE: About 20% of U. S. adults are obese and sedentary, putting them at high risk for type 2 diabetes. 10 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes: Disease Process l Progressive deterioration of glucose tolerance: Normal glucose tolerance Impaired glucose tolerance (pre-diabetes) Diabetes mellitus 11 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes: Health Complications l Chronic high blood glucose (hyperglycemia) can lead to: – Retinopathy (eye disease) – Nerve damage and amputations – Nephropathy (kidney disease) – Stroke major cause of death – Heart attack major cause of death 12 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes: Causes of Hyperglycemia l l Insulin resistance Insulin secretory dysfunction Diagram of insulin crystals 13 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes: Insulin Resistance l Decreased ability to use insulin. l Part of a group of conditions called the metabolic syndrome. l Increases risk for atherosclerosis. l Pancreas produces more insulin to attempt to decrease blood glucose. 14 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes: Insulin Secretory Dysfunction l l Also called defective insulin secretion. Inability to produce enough insulin to overcome insulin resistance. 15 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Insulin Resistance and Defective Insulin Secretion http: //professional. diabetes. org/Resources. For. Professionals. aspx? cid=60378&typ=17 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010 16
Type 2 Diabetes: The Metabolic Syndrome l Condition exists when person has at least three the following: – Hyperglycemia – Low level of blood high density lipoprotein cholesterol (HDL) – Central obesity – High blood triglycerides – High blood pressure 17 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes: Treatment Approach l l Best defenses against health complications: WEIGHT LOSS and PHYSICAL ACTIVITY! Best approach is concurrent management of: – – – Blood glucose Blood pressure Blood lipids Body weight Physical activity 18 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes: Diabetes Management Plan l To reduce risk of complications by achieving optimal: blood glucose blood lipids blood pressure 19 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Tighter Control Improves Health Outcomes l l Two major and several smaller research studies over 20 years. Type 1 and type 2 diabetes studied. Subjects with tightly controlled blood glucose decreased risk of complications. Even small improvement in A 1 C decreased risk! 20 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
TCYD Participants Decrease A 1 C l l l Pilot of TCYD in three Florida counties. Participants increased knowledge, improved lifestyle behaviors, and monitored blood glucose regularly. Average A 1 C decreased from 7. 2% to 6. 2%. Average systolic blood pressure decreased from 142 mm. Hg to 133 mm. Hg. You can do it too! 21 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes: Treatment Goals l Blood glucose – Fasting blood glucose: 70 to 130 mg/dl – Postprandial (2 hrs after first bite of meal or snack): less than 180 mg/dl – Hemoglobin A 1 C: less than 7% NOTE: Your physician may suggest more or less stringent goals. 22 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes: Treatment Goals l Blood Lipids – LDL cholesterol: HDL cholesterol: – Triglycerides: – less than 100 mg/dl over 40 mg/dl (men) over 50 mg/dl (women) less than 150 mg/dl 23 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes: Treatment Goals l Blood Pressure – Under 130/80 mm. Hg NOTE: Your physician may suggest a more stringent goal. 24 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes: Treatment Plan l l Proper nutrition Weight management Regular physical activity Medication, if needed 25 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Living Well With Type 2 Diabetes The path to living well includes: Acceptance Education Motivation Commitment 26 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Prepared by: Nancy Gal, Extension Agent IV Marion County - University of Florida IFAS Extension Linda Bobroff, Professor and Extension Nutrition Specialist University of Florida Updated 2010 What is Diabetes?
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