What is Diabetes?

Definition of Diabetes 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 3 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Focus on Blood Glucose Insulin is required for uptake of glucose (“sugar”) from the blood into cells. In diabetes, blood glucose levels rise because it can’t get from the blood into the cells. Consistently high blood glucose causes many health problems. 4 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Types of Diabetes Type 1 diabetes Onset usually before age 30. Absolute insulin deficiency. Destruction of beta cells in pancreas. 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/ResourcesForProfessionals.aspx?cid=60378&typ=17 6 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Types of Diabetes 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/ResourcesForProfessionals.aspx?cid=60378&typ=17 8 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Type 2 Diabetes: The Situation 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 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 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 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 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 Decreased ability to use insulin. Part of a group of conditions called the metabolic syndrome. Increases risk for atherosclerosis. 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 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/ResourcesForProfessionals.aspx?cid=60378&typ=17 16 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Type 2 Diabetes: The Metabolic Syndrome 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 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 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 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 A1C decreased risk! 20 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

TCYD Participants Decrease A1C Pilot of TCYD in three Florida counties. Participants increased knowledge, improved lifestyle behaviors, and monitored blood glucose regularly. Average A1C decreased from 7.2% to 6.2%. Average systolic blood pressure decreased from 142 mmHg to 133 mmHg. You can do it too! 21 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Type 2 Diabetes: Treatment Goals 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 A1C: 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 Blood Lipids LDL cholesterol: less than 100 mg/dl HDL cholesterol: over 40 mg/dl (men) over 50 mg/dl (women) Triglycerides: less than 150 mg/dl 23 Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Type 2 Diabetes: Treatment Goals Blood Pressure Under 130/80 mmHg 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 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?