Diabetes Healthy Schools, Healthy Families Mithila Jegathesan, M.D. Kate Avitabile, M.D.

What is Diabetes? A disease in which there are high levels of blood glucose in the body Glucose is the medical term for sugar It is the fuel the body uses to stay active, just like gas in a car

Why does diabetes happen? Normally, an organ called the pancreas produces a hormone called insulin Insulin controls the level of sugar in the body In diabetes the insulin does not control the sugar correctly

Type 1 Diabetes The body destroys the cells in the pancreas that usually make insulin There is no insulin in the body to control the levels of sugar Insulin must be injected into the person to control the levels of sugar

Type 1 Diabetes Usually happens in children and young adults May be “in their genes” No way to prevent or cure this type of diabetes yet

Type 2 Diabetes At the beginning the pancreas is able to produce insulin to control the sugar But the other cells in the body, like the muscles, cannot respond to this insulin The pancreas tries to produce more and more insulin but the organs cannot respond This is called “insulin resistance”

Type 2 Diabetes The pancreas eventually gets tired out and cannot produce any more insulin The body’s sugar levels are uncontrolled Some people need medications to decrease the level of sugar in the body Other people may eventually need insulin injections

Who often gets Type 2 Diabetes? Older age - adult and young adult cases Overweight or obese people Women who had diabetes during pregnancy People who do not exercise often Some races and ethnicities –African American –Hispanic/Latinos –Native Americans –Some Asians May run in families

Gestational Diabetes Diabetes in pregnant women May go away after the baby is born But some women with this type of diabetes may be more likely to develop permanent diabetes after pregnancy Can cause problems for the baby including heart and lung problems and problems with the baby’s sugar

Who may get diabetes of pregnancy? Obese women Women with family members with diabetes More common in African Americas, Hispanic/Latina Americans, and Native Americans

Body Parts Affected by Diabetes Eyes –Diabetes causes the blood vessels of the back of the eye called the retina to grow too much –This may cause the retina to separate from the back of the eye –This may lead to permanent blindness –Some people may have surgery to remove these blood vessels

Body Parts Affected by Diabetes Kidneys –Diabetes causes the blood vessels of the kidneys to become weak –This may lead to leaking of important proteins into the urine –These important proteins are lost from the body

Body Parts Affected by Diabetes Kidneys –Loss of proteins may lead to swelling of the feet and ankles –Kidney damage can also cause high blood pressure –Some people need kidney transplants

Body Parts Affected by Diabetes Heart –High sugar causes damage to the blood vessels that bring blood to the muscle of the heart –The vessels can become narrow –Blood cannot get to all parts of the heart –This may lead to chest pain, heart attacks, and possibly death

Body Parts Affected by Diabetes Other blood vessels –The vessels of the legs, ankles, and feet may be damaged by diabetes –This may lead to change in color, pain, and ulcers –Some diabetics need to have amputations

Body Parts Affected by Diabetes Nerves –The nerves of the feet are often damaged –This can cause changes in feeling as well as burning sensations in the feet –The nerves of the stomach and intestine can also be damaged and cause problems with digestion

Body Parts Affected by Diabetes Infections –Diabetics are more prone to getting infections –They may get very serious infections with fungi –The ulcers of the feet can become infected and spread to infection of the bone

What is Pre-Diabetes? A condition that may later develop into diabetes The levels of sugar in the blood are higher than normal but not as high as in diabetes

Who can get Pre-Diabetes? Adults Also children! As more and more children are overweight, more and more children are getting pre- diabetes

What are the signs of Pre- Diabetes? A person with pre-diabetes has high sugar on a blood test taken first thing in the morning, before eating anything The doctor may then test the blood after the person eats a sugary meal and the blood sugar is even higher

What are the signs of Pre- Diabetes? Acanthosis nigricans –Dark color of the skin on the back of the neck or under the armpits –May be seen in both light and dark skinned people –Sign of high levels of blood sugar –Especially important in finding children at risk of pre-diabetes and diabetes

Now for some GOOD NEWS!!

How can I prevent diabetes in myself and my children? Exercise –30 minutes per day or 3 times per week –Try walking more rather than taking the bus or subway –Take the stairs instead of the elevator –Try buying an exercise video to use at home –Find a friend to exercise with you!

How can I prevent diabetes in myself and my children? Eat healthy –Eat a diet low in fat, low in carbohydrates, and high in fiber –Limit fast food –Limit soda and juice –Parents’ examples help children form good habits!

How can I prevent diabetes in myself and my children? Lose weight –Obesity is a major risk factor for developing diabetes –Exercise and healthy eating can help you maintain a healthy weight and lower your risk of developing diabetes

How can I prevent diabetes in myself and my children? Decrease screen time –Instead of watching TV or playing video games with your kids, go for a walk or go to the park together –Cutting down TV time from 4 hrs a day to 2 hrs a day can decrease children’s risk of being overweight and developing pre- diabetes

How can I prevent diabetes in myself and my children? See your doctor for regular check-ups –Follow advice on how to lower blood pressure and cholesterol –Having diabetes along with obesity, high blood pressure, and high cholesterol increases your risk of heart and kidney disease

How can I prevent diabetes in myself and my children? Limit alcohol intake Ask your doctor for information about how you can stop smoking Dial 411 for other programs