1. Diabetes By Frank Ngo Chris Jones

2. Diabetes There are 3 types of diabetes There are 3 types of diabetes Mellitus (type I & II) Mellitus (type I & II) What is it? What is it? Symptoms Symptoms Treatments Treatments Complications Complications Insipidus Insipidus What is it? What is it? Symptoms Symptoms Treatments Treatments Complications Complications

3. Diabetes Mellitus (type I & II) What is it? What is it? Type I diabetes, usually diagnosed among children and young adults, is the type of diabetes where the pancreas produces little or no insulin. (Diabetes Type I) Type I diabetes, usually diagnosed among children and young adults, is the type of diabetes where the pancreas produces little or no insulin. (Diabetes Type I) (Diabetes Type I) (Diabetes Type I) Type II diabetes, usually diagnosed in older adults, is the type of diabetes where the pancreas either doesn’t produce enough insulin or the cells of body are less responsive to insulin. (Diabetes Type II) Type II diabetes, usually diagnosed in older adults, is the type of diabetes where the pancreas either doesn’t produce enough insulin or the cells of body are less responsive to insulin. (Diabetes Type II)(Diabetes Type II)(Diabetes Type II) Insulin is a hormone used by the body to convert sugars (glucose), starches and other foods into energy needed for daily life. Insulin is a hormone used by the body to convert sugars (glucose), starches and other foods into energy needed for daily life. Type I & II diabetes can be inherited from genes. A family history of diabetes can significantly increase the risk of developing diabetes Type I & II diabetes can be inherited from genes. A family history of diabetes can significantly increase the risk of developing diabetes Type I & II diabetes results in persistent hyperglycemia where blood sugar levels in the blood fall above 150mg (normal levels fall between 70mg and 150mg). Inversely, hypoglycemia is where blood sugar levels in the blood fall below 70mg Type I & II diabetes results in persistent hyperglycemia where blood sugar levels in the blood fall above 150mg (normal levels fall between 70mg and 150mg). Inversely, hypoglycemia is where blood sugar levels in the blood fall below 70mg

4. Diabetes Mellitus (type I & II) Symptoms Symptoms Increased thirst and frequent urination: Increased thirst and frequent urination: As excess sugar builds up in your bloodstream, fluid is pulled from your tissues. This may leave you thirsty. As a result, you may drink — and urinate — more than usual. As excess sugar builds up in your bloodstream, fluid is pulled from your tissues. This may leave you thirsty. As a result, you may drink — and urinate — more than usual. Extreme hunger: Extreme hunger: Without enough insulin to move sugar into your cells, your muscles and organs become depleted of energy. This triggers intense hunger that may persist even after you eat. Without insulin, the sugar in your food never reaches your energy-starved tissues. Without enough insulin to move sugar into your cells, your muscles and organs become depleted of energy. This triggers intense hunger that may persist even after you eat. Without insulin, the sugar in your food never reaches your energy-starved tissues. Weight loss: Weight loss: Despite eating more than usual to relieve hunger, you may lose weight — sometimes rapidly. Without the energy sugar supplies, your muscle tissues and fat stores may simply shrink. Despite eating more than usual to relieve hunger, you may lose weight — sometimes rapidly. Without the energy sugar supplies, your muscle tissues and fat stores may simply shrink. Fatigue: Fatigue: If your cells are deprived of sugar, you may become tired and irritable. If your cells are deprived of sugar, you may become tired and irritable. Blurred vision: Blurred vision: If your blood sugar level is too high, fluid may be pulled from your tissues — including the lenses of your eyes. This may affect your ability to focus clearly. If your blood sugar level is too high, fluid may be pulled from your tissues — including the lenses of your eyes. This may affect your ability to focus clearly.

5. Diabetes Mellitus (type I & II) Treatments Treatments For type I diabetes, a person needs to take daily injections of insulin as prescribed by the doctor For type I diabetes, a person needs to take daily injections of insulin as prescribed by the doctor For type II diabetes, a person needs to take medication before every meal as prescribed by the doctor For type II diabetes, a person needs to take medication before every meal as prescribed by the doctor Medications Medications Sulfonylurea & Meglitinide are two drug classifications that stimulate the beta cells of the pancreas to release more insulin. Some common drug names are Diabinese, Glucotrol, Glynase, Prandin, and Starlix Sulfonylurea & Meglitinide are two drug classifications that stimulate the beta cells of the pancreas to release more insulin. Some common drug names are Diabinese, Glucotrol, Glynase, Prandin, and Starlix Biguanide lower blood glucose levels primarily by decreasing the amount of glucose produced by the liver. Common drug name (Glucophage) Biguanide lower blood glucose levels primarily by decreasing the amount of glucose produced by the liver. Common drug name (Glucophage)

6. Diabetes Mellitus (type I & II) Treatments (continued) Treatments (continued) For both types of diabetes, it is important to maintain a balanced diet that usually avoids sweets and leans more towards organic and natural foods. Along with a balanced diet, daily exercise will decrease chances to develop complications For both types of diabetes, it is important to maintain a balanced diet that usually avoids sweets and leans more towards organic and natural foods. Along with a balanced diet, daily exercise will decrease chances to develop complications For both types of diabetes, it is imperative that a person monitor and maintain blood glucose levels with a glucometer For both types of diabetes, it is imperative that a person monitor and maintain blood glucose levels with a glucometer

7. Diabetes Mellitus (type I & II) Complications Complications Heart disease Heart disease Diabetes carries an increased risk for heart attack, stroke, and complications related to poor circulation Diabetes carries an increased risk for heart attack, stroke, and complications related to poor circulation Kidney disease Kidney disease Diabetes can damage the kidneys, which not only can cause them to fail, but can also make them lose their ability to filter out waste products. This is called nephropathy Diabetes can damage the kidneys, which not only can cause them to fail, but can also make them lose their ability to filter out waste products. This is called nephropathy Eye impairments Eye impairments Diabetes can cause eye problems and may lead to blindness. People with diabetes do have a higher risk of blindness than people without diabetes. Early detection and treatment of eye problems can save your sight Diabetes can cause eye problems and may lead to blindness. People with diabetes do have a higher risk of blindness than people without diabetes. Early detection and treatment of eye problems can save your sight Skin disease Skin disease Diabetes can cause skin problems such as bacterial infections, fungal infections, and itching. Other skin problems happen mostly or only to people with diabetes. These include diabetic dermopathy, necrobiosis lipoidica diabeticorum, diabetic blisters, and eruptive xanthomatosis Diabetes can cause skin problems such as bacterial infections, fungal infections, and itching. Other skin problems happen mostly or only to people with diabetes. These include diabetic dermopathy, necrobiosis lipoidica diabeticorum, diabetic blisters, and eruptive xanthomatosis

8. Diabetes Insipidus What is it? What is it? Diabetes Insipidus is a disorder in which there is an abnormal increase in urine output, fluid intake and often thirst Diabetes Insipidus is a disorder in which there is an abnormal increase in urine output, fluid intake and often thirst Urine output is increased because it is not concentrated normally. Consequently, instead of being a yellow color, the urine is pale, colorless or watery in appearance and the measured concentration (osmolality or specific gravity) is low Urine output is increased because it is not concentrated normally. Consequently, instead of being a yellow color, the urine is pale, colorless or watery in appearance and the measured concentration (osmolality or specific gravity) is low The most common type of DI is caused by a lack of vasopressin, a hormone that normally acts upon the kidney to reduce urine output by increasing the concentration of the urine. This type of DI is usually due to the destruction of the back or "posterior" part of the pituitary gland where vasopressin is normally produced The most common type of DI is caused by a lack of vasopressin, a hormone that normally acts upon the kidney to reduce urine output by increasing the concentration of the urine. This type of DI is usually due to the destruction of the back or "posterior" part of the pituitary gland where vasopressin is normally produced

9. Diabetes Insipidus Symptoms Symptoms Urinary frequency Urinary frequency Nocturia (frequent awakening at night to urinate) Nocturia (frequent awakening at night to urinate) Enuresis (involuntary urination during sleep or "bedwetting") Enuresis (involuntary urination during sleep or "bedwetting") Extreme Thirst Extreme Thirst Absence of high blood and/or urine sugar Absence of high blood and/or urine sugar

10. Diabetes Insipidus Treatments Treatments Controlling fluid balance and preventing dehydration Controlling fluid balance and preventing dehydration Check weight daily and maintain a record Check weight daily and maintain a record Wear a medical identification bracelet or neck pendant that indicates your medical problem and the medications you take Wear a medical identification bracelet or neck pendant that indicates your medical problem and the medications you take Medications Medications Vasopressin or desmopressin acetate, modified synthetic forms of antidiuretic hormone, may be taken as a nasal spray several times a day, to maintain a normal urine output Vasopressin or desmopressin acetate, modified synthetic forms of antidiuretic hormone, may be taken as a nasal spray several times a day, to maintain a normal urine output

11. Diabetes Insipidus Complications Complications Electrolyte imbalance (especially low sodium or potassium deficiency) Electrolyte imbalance (especially low sodium or potassium deficiency) Either of these can cause heartbeat irregularity, fatigue and congestive heart failure Either of these can cause heartbeat irregularity, fatigue and congestive heart failure Severe dehydration Severe dehydration Muscle weakness Muscle weakness Weight loss Weight loss Rapid heart rate Rapid heart rate

12. Teaching Strategies Increased awareness of the benefits and challenges of physical activity for students with diabetes will aid the PE instructor in helping the student balance the demands of exercise and glucose control PE guidelines for students with diabetes Pages 15 & 16

13. References Websites Websites American Diabetes Association American Diabetes Association American Diabetes Association American Diabetes Association MedicineNet MedicineNet MedicineNet Articles Articles Kollipara, Sobha (MD) & Warren-Boulton, Elizabeth (MSN, RN); “Diabetes and Physical Activity in School” Kollipara, Sobha (MD) & Warren-Boulton, Elizabeth (MSN, RN); “Diabetes and Physical Activity in School”