Focus On: Minimizing Your Risk for Diabetes © 2015 Pearson Education, Inc.

Learning Outcomes Differentiate among types of diabetes and identify common risk factors. Describe the main tests for, symptoms of, and complications associated with diabetes. Explain how diabetes can be prevented and treated. © 2015 Pearson Education, Inc.

Minimizing Your Risk for Diabetes The Centers for Disease Control and Prevention (CDC) estimates that 25.8 million people, 8.3 percent of the population, have diabetes. It is the fastest growing chronic disease in American history. Diabetes is the seventh leading cause of death, responsible for 225,000 deaths each year. The direct and indirect costs of treating diabetes in the U.S. total $245 billion. © 2015 Pearson Education, Inc.

What Is Diabetes? Diabetes is characterized by a persistently high level of sugar (glucose) in the blood. Another characteristic is the production of an unusually high volume of glucose-laden urine. Diabetes is derived from a Greek word meaning "to flow through" and mellitus, Latin for "sweet." Hyperglycemia—high blood glucose levels seen in diabetes © 2015 Pearson Education, Inc.

ABC News Video: Young Adults and Diabetes Discussion Questions Examine reasons more young adults are developing type 2 diabetes now than in previous generations. Should the government take more stringent guidelines to limit fast food restaurants from using ingredients (such as high fructose corn syrup) or offering large serving sizes that contribute to poor nutritional health among consumers? © 2015 Pearson Education, Inc.

Percentage of U.S. Population with Diagnosed Diabetes, 1958–2010 © 2015 Pearson Education, Inc.

What Is Diabetes? (cont.) In Healthy People, Glucose Is Taken Up Efficiently by Body Cells Carbohydrates from the foods are broken down into a monosaccharide called glucose. Liver and muscle cells store glucose as glycogen, then use it as needed to fuel metabolism, movement, and other activities. Pancreas—an organ located just beneath the stomach that secretes a hormone called insulin. Insulin—stimulates cells to take up glucose from the bloodstream and use it for immediate energy. © 2015 Pearson Education, Inc.

Type 1 Diabetes Type 1 Diabetes Is an Immune Disorder The individual's own immune system attacks and destroys the insulin-making cells in the pancreas. Risk increases with European ancestry, a genetic predisposition, and an environmental "insult" such as a viral infection. Daily insulin injections, or insulin infusion, are required for survival. Type 1 patients must monitor their diet and exercise levels. © 2015 Pearson Education, Inc.

Diabetes: What It Is and How It Develops © 2015 Pearson Education, Inc.

Type 2 Diabetes Type 2 Diabetes Is a Metabolic Disorder Accounts for 90–95 percent of all diabetes cases. Either the pancreas does not make sufficient insulin or body cells are resistant to its effects (insulin resistance). The liver's ability to self-regulate conversion of glucose into glycogen begins to fail, and blood levels of glucose gradually rise. Development of the Disease The overabundance of free fatty acids contributes to insulin resistance. As the progression to type 2 diabetes continues, pancreatic insulin-producing cells become exhausted from overwork, and damage occurs. © 2015 Pearson Education, Inc.

Risk Factors for Type 2 Diabetes Nonmodifiable Risk Factors Increased age Certain ethnicities (Native Americans and African Americans) Genetic factors Biological factors Modifiable Risk Factors Body weight Dietary choices Level of physical activity Sleep patterns Level of stress BMI of 25 or greater Waistline of 40 inches or more in males and 35 inches or more in females © 2015 Pearson Education, Inc.

Pre-diabetes Pre-diabetes can lead to type 2 diabetes A condition in which blood glucose levels are higher than normal, but not high enough to be classified as diabetes. Affects more than 35 percent of the adult population. Without significant lifestyle changes, approximately 30 percent of those with pre-diabetes will develop type 2 diabetes, but only 11 percent of those with pre-diabetes know it. © 2015 Pearson Education, Inc.

Metabolic Syndrome Prediabetes plays a role in metabolic syndrome Metabolic syndrome (MetS)—Cluster of six conditions linked to overweight and obesity Pre-diabetes and central adiposity appear to be the dominant factors for development of MetS. A person with MetS is five times more likely to develop type 2 diabetes than a person without the syndrome. © 2015 Pearson Education, Inc.

Gestational Diabetes Gestational diabetes develops during pregnancy A state of high blood glucose that is first recognized in a woman during pregnancy. Occurs in 4 percent of all pregnancies. Women with gestational diabetes have a significantly increased risk of progressing to type 2 diabetes. There is increased risk of birth-related complications, such as difficult labor, high blood pressure, high blood acidity, increased infections, and death. The fetus is also endangered: Risks include malformations of the heart, nervous system, and bones; respiratory distress; and excessive growth that can lead to birth trauma. © 2015 Pearson Education, Inc.

What Are the Symptoms of Diabetes? Thirst Excessive urination Weight loss Fatigue Nerve damage Blurred vision Poor wound healing and increased infections © 2015 Pearson Education, Inc.

Diabetes Can Have Severe Complications Diabetic ketoacidosis Cardiovascular disease Kidney disease Amputations Eye disease and blindness Flu and pneumonia-related deaths Tooth and gum disease © 2015 Pearson Education, Inc.

Complications of Uncontrolled Diabetes © 2015 Pearson Education, Inc.

Blood Tests to Diagnose and Monitor Diabetes Fasting Plasma Glucose Test (FPG) Patient is required to fast overnight, then blood is drawn and tested for glucose concentration. Oral Glucose Tolerance Test (OGTT) Patient is required to drink a liquid containing concentrated glucose, then blood is drawn 2 hours later and tested for glucose concentration. Hemoglobin A1C Test A regular blood glucose test done by a physician every 3 to 6 months. © 2015 Pearson Education, Inc.

Blood Glucose Levels in Pre-diabetes and Untreated Diabetes © 2015 Pearson Education, Inc.

How Is Diabetes Treated? Lifestyle Changes Can Improve Glucose Levels People with pre-diabetes can prevent or delay the development of type 2 diabetes up to 58 percent through lifestyle changes. Weight loss A loss of as little as 5–7 percent of current body weight and regular physical activity significantly lowers the risk of progressing to diabetes. Adopting a healthy diet Whole grains High-fiber foods Fatty fish Increased physical fitness Recommendation is 30 minutes of physical activity 5 days a week to reduce your risk of type 2 diabetes © 2015 Pearson Education, Inc.

How Is Diabetes Treated? (cont.) Oral medications and weight loss surgery can help Medications can Reduce glucose production by the liver Slow the absorption of carbohydrates from the small intestine Increase insulin production by the pancreas Increase the insulin sensitivity of cells People who have undergone gastric bypass surgery appear to have high rates of cure. Gastric bypass surgery risks include serious complications and death. © 2015 Pearson Education, Inc.

How Is Diabetes Treated? (cont.) Insulin injections may be necessary Essential for those with type 1 diabetes. Required for people with type 2 diabetes whose blood glucose levels cannot be adequately controlled with other treatment options Insulin cannot be taken in pill form because it is a protein and would be digested in the gastrointestinal tract. Most people use an insulin infusion pump. © 2015 Pearson Education, Inc.