1. 12a PowerPoint ® Lecture Outlines prepared by Dr. Lana Zinger, QCC  CUNY Copyright © 2011 Pearson Education, Inc. FOCUS ON Your Risk for Diabetes

2. Copyright © 2011 Pearson Education, Inc. Your Risk for Diabetes Diabetes currently affects 23.6 million Americans. Since 1980, incidence has increased over 50 percent among U.S adults. Diabetes is up by almost 70 percent among those in their thirties. 7.8 percent of the population has some form of diabetes. Approximately 225,000 people die each year from diabetes- related complications. It is the sixth leading cause of death in the United States today.

3. Copyright © 2011 Pearson Education, Inc. Percentage of Adults with Diagnosed Diabetes

4. Copyright © 2011 Pearson Education, Inc. What Is Diabetes?  Diabetes Mellitus Disease characterized by a persistently high level of sugar (glucose) in the blood Pancreas fails to produce enough insulin or the body fails to use insulin effectively Hyperglycemia—high blood glucose levels seen in diabetes

5. Copyright © 2011 Pearson Education, Inc. What Is Diabetes?  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—hormone secreted by the pancreas and required by body cells for the uptake and storage of glucose

6. Copyright © 2011 Pearson Education, Inc. Diabetes: What It Is and How It Develops

7. Copyright © 2011 Pearson Education, Inc. What Is Diabetes?  Types of Diabetes Type 1 diabetes Type 2 diabetes Gestational diabetes

8. Copyright © 2011 Pearson Education, Inc. What Is Diabetes?  Type 1 Diabetes Is an Immune Disorder Autoimmune disease Without insulin, cells cannot take up glucose, and blood glucose levels become permanently elevated. Formally called juvenile diabetes Symptoms include persistent hunger, weight loss, excessive thirst, frequent urination, and fatigue Require daily insulin injections or infusions and careful monitoring of diet and exercise levels

9. Copyright © 2011 Pearson Education, Inc. What Is Diabetes?  Type 2 Diabetes Is a Metabolic Disorder Accounts for 90 to 95 percent of all diabetes cases Either the pancreas does not make sufficient insulin or body cells are resistant to its effects (insulin resistance). 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.

10. Copyright © 2011 Pearson Education, Inc. What Is Diabetes?  Type 2 Diabetes Nonmodifiable risk factors Increased age Certain ethnicities (Native Americans and African Americans) Genetic factors Biological factors

11. Copyright © 2011 Pearson Education, Inc. What Is Diabetes? Modifiable risk factors Decrease body weight Increase level of physical activity Increase sleep Decrease level of stress  Type 2 Diabetes

12. Copyright © 2011 Pearson Education, Inc. What Is Diabetes?  Gestational Diabetes Develops during Pregnancy A state of high blood glucose that is first recognized in a woman during pregnancy Occurs in 3 to 8 percent of all pregnancies Women with gestational diabetes have a significantly increased risk of progressing to type 2 diabetes 5 to 10 years after giving birth. Increased risk of birth-related complications, damage to the fetus, and possible fetal death

13. Copyright © 2011 Pearson Education, Inc. What Is 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 25 percent of the adult population A ticking time bomb; if it’s not “defused,” diabetes will eventually strike

14. Copyright © 2011 Pearson Education, Inc. What Is Diabetes and What Causes It?  Pre-Diabetes 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 5 times more likely to develop type 2 diabetes than a person without the syndrome.

15. Copyright © 2011 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

16. Copyright © 2011 Pearson Education, Inc. What Are the Symptoms of Diabetes?  Diabetes Has Severe Complications Diabetic ketoacidosis Cardiovascular disease Kidney disease Amputations Eye disease and blindness Flu and pneumonia-related deaths Tooth and gum disease

17. Copyright © 2011 Pearson Education, Inc. Complications of Uncontrolled Diabetes Include Amputation and Eye Disease

18. Copyright © 2011 Pearson Education, Inc. What Are the Symptoms of Diabetes?  Blood Tests Are Used to Diagnose and Monitor Diabetes Fasting plasma glucose test (FPG) Oral glucose tolerance test (OGTT) Hemoglobin A1C test

19. Copyright © 2011 Pearson Education, Inc. How Is Diabetes Treated?  Lifestyle Changes Can Improve Glucose Levels Weight Loss Recommended goal is to lose 5 to 10 percent of current weight Adopting a Healthy Diet Whole grains Coffee Fatty fish Increasing Physical Fitness The Diabetes Prevention Program recommends 30 minutes of physical activity 5 days a week

20. Copyright © 2011 Pearson Education, Inc. How Is Diabetes Treated?  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.

21. Copyright © 2011 Pearson Education, Inc. How Is Diabetes Treated?  Insulin Injections May Be Necessary Essential for those with type 1 diabetes Essential 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.

22. Copyright © 2011 Pearson Education, Inc. How Is Diabetes Treated?  Diabetes Care Can Be Expensive On average, health care costs for diabetics are $15,000 to $25,000 higher per year than for healthy patients. The direct and indirect costs of treating diabetes in the United States total $174 billion per year. The costs related to undiagnosed diabetes are unknown.

23. Copyright © 2011 Pearson Education, Inc. What Can You Do to Prevent Pre-Diabetes? Consider your risk factors. If you are at high risk, talk to your health care provider about diabetes screening. If you are overweight, lose weight. Exercise. Consume a low fat, low sodium, high fiber diet.