1. Click to edit Master title style DiabetesDiabetes

2.  Diabetes is a condition in which the body cannot change sugars and starches (carbohydrates) into energy.  This happens when the body cannot make enough insulin or cannot use the insulin it makes.  As a result, extra sugar in the blood can lead to damage in the blood vessels, eyes, kidneys, heart, and nerves. Source CDC, 2012 What is Diabetes ?

3. Click to edit Master title style  Type 1 diabetes is a condition in which the body makes no insulin or so little insulin that the body cannot change blood sugar into energy.  Type 1 diabetes usually develops during childhood or adolescence, before a woman gets pregnant. Source CDC, 2012 Three common types of diabetes:

4. Click to edit Master title style  Type 2 diabetes is a condition in which the body makes too little insulin or cannot use the insulin it makes to change blood sugar into energy.  Type 2 diabetes often occurs after childbearing age, although it is becoming more common for childbearing- aged women to develop type 2 diabetes. Source CDC, 2012

5. Click to edit Master title style  Gestational diabetes is a type of diabetes that is first diagnosed in a pregnant woman.  Gestational diabetes is a type of diabetes that is first diagnosed in a pregnant woman.  Out of every 100 pregnant women in the U.S., two to ten will have gestational diabetes.  Gestational diabetes usually goes away after pregnancy, but if it does not go away, it is known as type 2 diabetes.  Many women who have had gestational diabetes will develop type 2 diabetes later Source CDC, 2012

6. Click to edit Master title style Symptoms and Pathogenesis

7. Click to edit Master title style  Diabetes symptoms vary depending on how high your blood sugar is elevated. Some people, especially those with pre-diabetes or type 2 diabetes, may not experience symptoms initially.  In type 1 diabetes, however, symptoms tend to come on quickly and be more severe. Source Mayo Clinic 2012

8. Click to edit Master title style  Some of the signs and symptoms of type 1 and type 2 diabetes include: Increased thirst Increased thirst Frequent urination Frequent urination Extreme hunger Extreme hunger Unexplained weight loss Unexplained weight loss Source Mayo Clinic, 2012

9. Click to edit Master title style  Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that happens when there's not enough insulin) Fatigue Fatigue Blurred vision Blurred vision Slow-healing sores Slow-healing sores Mild high blood pressure Mild high blood pressure Frequent infections, such as gum or skin infections and vaginal or bladder infections Frequent infections, such as gum or skin infections and vaginal or bladder infections Source Mayo Clinic, 2012

10. Click to edit Master title style  Although type 1 diabetes can develop at any age, it typically appears during childhood or adolescence.  Type 2 diabetes, the most common type, can develop at any age and is often preventable. Source Mayo Clinic, 2012

11. Click to edit Master title style Gestational diabetes

12. Click to edit Master title style  A woman with gestational diabetes whose blood sugar stays high has an increased chance of: Preeclampsia (high blood pressure, protein in urine, increased swelling) Preeclampsia (high blood pressure, protein in urine, increased swelling) Preterm birth (baby born before 37 weeks) Preterm birth (baby born before 37 weeks) C-section C-section Source CDC, 2012

13. Click to edit Master title style Gestational diabetes

14. Click to edit Master title style  In a woman with preexisting diabetes (which includes type 1 and type 2), blood sugar that remains high can trigger or worsen certain health problems, including: High blood pressure High blood pressure Preeclampsia Preeclampsia Kidney disease Kidney disease Nerve damage Nerve damage Heart disease Heart disease Blindness Blindness Source CDC, 2012

15. Click to edit Master title style  Also, a woman with preexisting diabetes whose blood sugar remains high has an increased chance of: Miscarriage Miscarriage Preterm birth Preterm birth Stillbirth Stillbirth C-section C-section Source CDC, 2012

16. Click to edit Master title style Source Mayo Clinic, 2012 How can diabetes affect baby’s health?

17. Click to edit Master title style  Blood sugar that remains high in a woman with gestational diabetes can cause her baby to grow very large (about 9 pounds or more).  Being very large makes it hard for the baby to be born through the birth canal and can cause nerve damage to the baby’s shoulder during birth. Source CDC, 2011

18. Click to edit Master title style  A very large baby has an increased chance of being overweight or obese later in life.  Being overweight or obese increases the chance of also having diabetes later in life. Source CDC, 2011

19. Click to edit Master title style  Blood sugar that remains high in a pregnant woman with type 1 or type 2 diabetes can cause her baby to have the following health problems: Birth defects, especially of the brain, spine, and heart Birth defects, especially of the brain, spine, and heart Increased birth weight Increased birth weight Nerve damage to the shoulder during delivery Nerve damage to the shoulder during delivery Low blood sugar after birth Low blood sugar after birth Increased chance of overweight, obesity, and/or diabetes later in life Increased chance of overweight, obesity, and/or diabetes later in life Source CDC, 2011

20. Click to edit Master title style ComplicationsComplications

21.  Long-term complications of diabetes develop gradually.  The longer you have diabetes (and the less controlled your blood sugar) the higher the risk of complications.  Eventually, diabetes complications may be disabling or even life-threatening. Source Mayo Clinic, 2012

22. Click to edit Master title style  Possible complications include: Cardiovascular disease : if you have diabetes, you are more likely to have heart disease or stroke. Cardiovascular disease : if you have diabetes, you are more likely to have heart disease or stroke. Nerve damage (neuropathy): Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in the legs. This can cause tingling, numbness, burning or pain, lost of all sense of feeling in the affected limb, nausea, vomiting, diarrhea or constipation and erectile dysfunction for men. Nerve damage (neuropathy): Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in the legs. This can cause tingling, numbness, burning or pain, lost of all sense of feeling in the affected limb, nausea, vomiting, diarrhea or constipation and erectile dysfunction for men. Source Mayo Clinic, 2012

23. Click to edit Master title style Kidney damage (nephropathy): diabetes can damage the kidneys delicate filtering system causing severe damage can lead to kidney failure or irreversible end-stage kidney disease, requiring dialysis or a kidney transplant. Kidney damage (nephropathy): diabetes can damage the kidneys delicate filtering system causing severe damage can lead to kidney failure or irreversible end-stage kidney disease, requiring dialysis or a kidney transplant. Eye damage (retinopathy): diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Eye damage (retinopathy): diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Foot damage: nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. (e.g. toe, foot or even leg amputation). Foot damage: nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. (e.g. toe, foot or even leg amputation). Source Mayo Clinic, 2012

24. Click to edit Master title style Skin and mouth conditions : diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections. Skin and mouth conditions : diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections. Brain problems : recent research suggests that high blood sugar levels may increase the risk of Alzheimer's disease in people who have type 2 diabetes and a certain gene linked to the development of Alzheimer's disease. Brain problems : recent research suggests that high blood sugar levels may increase the risk of Alzheimer's disease in people who have type 2 diabetes and a certain gene linked to the development of Alzheimer's disease. Cancer: people with diabetes have a higher risk of some cancers. Cancer: people with diabetes have a higher risk of some cancers. Source Mayo Clinic, 2012

25. Click to edit Master title style Source Mayo Clinic, 2012 Complications of gestational diabetes

26. Click to edit Master title style  Most women who have gestational diabetes deliver healthy babies.  However, untreated or uncontrolled blood sugar levels can cause problems for you and your baby.  Complications in your baby can occur as a result of gestational diabetes. Source Mayo Clinic, 2012

27. Click to edit Master title style  Excess growth: very large babies are more likely to require a C-section birth.  Low blood sugar: Sometimes babies of mothers with gestational diabetes develop low blood sugar (hypoglycemia) shortly after birth because their own insulin production is high. Source Mayo Clinic, 2012

28. Click to edit Master title style  Respiratory distress syndrome : If your baby is delivered early, respiratory distress syndrome (a condition that makes breathing difficult) is possible. Babies who have respiratory distress syndrome may need help breathing until their lungs become stronger.  Jaundice : although jaundice usually isn't a cause for concern, careful monitoring is important. Source Mayo Clinic, 2012

29. Click to edit Master title style  Type 2 diabetes later in life: babies of mothers who have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.  Death: untreated gestational diabetes can result in a baby's death either before or shortly after birth. Source Mayo Clinic, 2012

30. Click to edit Master title style  Complications in you can also occur as a result of gestational diabetes:  Preeclampsia: this condition is characterized by high blood pressure and excess protein in the urine, and swelling in the legs and feet. Preeclampsia can lead to serious or even life-threatening complications for both mother and baby. Source Mayo Clinic, 2012

31. Click to edit Master title style  Subsequent gestational diabetes : once you've had gestational diabetes in one pregnancy, you're more likely to have it again with the next pregnancy. You're also more likely to develop diabetes (typically type 2 diabetes) as you get older.  Pre-diabetes may develop into type 2 diabetes. Source Mayo Clinic, 2012

32. Click to edit Master title style  Complications of pre-diabetes Pre-diabetes may develop into type 2 diabetes. Source Mayo Clinic, 2012

33. Click to edit Master title style Source Mayo Clinic, 2012 CausesCauses

34. Click to edit Master title style  To understand diabetes, one must first understand how glucose is normally processed in the body.  Glucose is a main source of energy for the cells that make up your muscles and other tissues.  Glucose comes from two major sources: the food you eat and your liver. Source Mayo Clinic, 2012 How glucose normally works How glucose normally works

35. Click to edit Master title style  During digestion, sugar is absorbed into the bloodstream.  Normally, sugar then enters cells, with the help of insulin.  The hormone insulin comes from the pancreas, a gland located just behind the stomach. Source Mayo Clinic, 2012 How glucose normally works How glucose normally works

36. Click to edit Master title style  When you eat, your pancreas secretes insulin into your bloodstream.  As insulin circulates, it acts like a key, unlocking microscopic doors that allow sugar to enter your cells. Insulin lowers the amount of sugar in your bloodstream.  As your blood sugar level drops, so does the secretion of insulin from your pancreas. Source Mayo Clinic, 2012 How glucose normally works How glucose normally works

37. Click to edit Master title style  Your liver acts as a glucose storage and manufacturing center.  When you haven't eaten in a while your liver releases stored glucose to keep your glucose level within a normal range. Source Mayo Clinic, 2012 How glucose normally works How glucose normally works

38. Click to edit Master title style  In type 1 diabetes, your immune system attacks and destroys your insulin-producing cells in the pancreas leaving the body with little or no insulin.  Instead of being transported into your cells, sugar builds up in your bloodstream.  Type 1 is thought to be caused by a combination of genetic susceptibility and environmental factors, though exactly what those factors are is still unclear. Source Mayo Clinic, 2012 Causes of type 1 diabetes Causes of type 1 diabetes

39. Click to edit Master title style  In pre-diabetes (which can lead to type 2 diabetes) and in type 2 diabetes, your cells become resistant to the action of insulin, and your pancreas is unable to make enough insulin to overcome this resistance.  Instead of moving into your cells, sugar builds up in your bloodstream. Source Mayo Clinic, 2012 Causes of pre-diabetes and type 2 diabetes Causes of pre-diabetes and type 2 diabetes

40. Click to edit Master title style  Exactly why this happens is uncertain, although as in type 1 diabetes, it's believed that genetic and environmental factors play a role in the development of type 2.  Being overweight is strongly linked to the development of type 2 diabetes, but not everyone with type 2 is overweight. Source Mayo Clinic, 2012 Causes of pre-diabetes and type 2 diabetes Causes of pre-diabetes and type 2 diabetes

41. Click to edit Master title style  During pregnancy, the placenta produces hormones to sustain your pregnancy.  These hormones make your cells more resistant to insulin.  As your placenta grows larger in the second and third trimesters, it secretes more of these hormones — making it even harder for insulin to do its job. Source Mayo Clinic, 2012 Causes of gestational diabetes Causes of gestational diabetes

42. Click to edit Master title style  Normally, your pancreas responds by producing enough extra insulin to overcome this resistance.  But sometimes your pancreas can't keep up. When this happens, too little glucose gets into your cells and too much stays in your blood: this is gestational diabetes. Source Mayo Clinic, 2012 Causes of gestational diabetes Causes of gestational diabetes

43. Click to edit Master title style ComplicationsComplications

44.  Mental illness is a leading cause of disability.  Aside from reducing your overall quality of life, untreated mental illness can cause severe emotional, behavioral and physical health problems.  Mental illness can also cause legal and financial problems. Source Mayo Clinic, 2012

45. Click to edit Master title style  Complications linked to mental illness include: Unhappiness and decreased enjoyment of life Unhappiness and decreased enjoyment of life Family conflicts Family conflicts Relationship difficulties Relationship difficulties Social isolation Social isolation Substance abuse Substance abuse Source Mayo Clinic, 2012

46. Click to edit Master title style  Complications linked to mental illness include: Missed work or school, or other problems related to work or school Missed work or school, or other problems related to work or school Heart disease and other medical conditions Heart disease and other medical conditions Poverty Poverty Homelessness Homelessness Suicide Suicide Source Mayo Clinic, 2012

47. Click to edit Master title style EpidemiologyEpidemiology

48. Source: 2007–2009 National Health Interview Survey estimates projected to the year 2010.

49. Click to edit Master title style Source: 2007–2009 National Health Interview Survey.

50. Click to edit Master title style Age-Adjusted Incidence of Diagnosed Diabetes per 1,000 Population Aged 18–79 Years, by Sex, United States, 1980–2010

51. www.cdc.gov/diabetes County-level Estimates of Diagnosed Diabetes among Adults aged ≥ 20 years: United States 2009 Percent

52. www.cdc.gov/diabetes County-level Estimates of Diagnosed Diabetes among Adults aged ≥ 20 years: United States 2009 Age-adjusted percent

53. www.cdc.gov/diabetes County-level Estimates of Diagnosed Diabetes among Adults aged ≥ 20 years: United States 2009 Percent Quartiles 0 - 8.9 9.0 - 10.4 10.5 – 11.9 > 12.0

54. www.cdc.gov/diabetes County-level Estimates of Diagnosed Diabetes among Adults aged ≥ 20 years: United States 2009 Age-adjusted percent Quartiles 0 - 7.7 7.8 - 9.0 9.1 - 10.6 > 10.7

55. www.cdc.gov/diabetes County-level Estimates of Diagnosed Diabetes among Adults aged ≥ 20 years: United States 2009 Number

56. www.cdc.gov/diabetes County-level Estimates of Diagnosed Diabetes among Adults aged ≥ 20 years: United States 2009 Percent Number

57. www.cdc.gov/diabetes County-level Estimates of Diagnosed Diabetes among Adults aged ≥ 20 years: United States 2009 Age-adjusted ranks based on age-adjusted percent of diabetes

58. Click to edit Master title style Source MDH 2011 HIV/AIDS in M Minnesota : Annual Review Overview of Mental Health in Minnesota

59. Click to edit Master title style  Each year, more than 26,000 Minnesotans are newly diagnosed with diabetes.  Diabetes is the sixth leading cause of death in Minnesota.  The prevalence of diagnosed diabetes in Minnesota increased from 3.1% of the adult population in 1995 to 5.7% in 2006 Source MDH, 2012

60. Click to edit Master title style Risk factors

61. Click to edit Master title style  Risk factors for diabetes depend on the type of diabetes. Source Mayo Clinic, 2012

62. Click to edit Master title style  Risk factors for type 1 diabetes Source Mayo Clinic, 2012 Risk factors for type 1 diabetes  Although the exact cause of type 1 diabetes is unknown, genetic factors likely play a role.  Your risk of developing type 1 diabetes increases if you have a parent or sibling who has type 1 diabetes.  Environmental factors, such as exposure to a viral illness, also likely play some role in type 1 diabetes.

63. Click to edit Master title style  Risk factors for type 1 diabetes Source Mayo Clinic, 2012 Risk factors for type 1 diabetes Other factors that may increase your risk include:  The presence of damaging immune system cells (auto- antibodies). Sometimes family members of people with type 1 diabetes are tested for the presence of diabetes auto-antibodies.  If you have these auto-antibodies, you have an increased risk of developing type 1 diabetes. But, not everyone who has these auto-antibodies develops type 1.

64. Click to edit Master title style  Risk factors for type 1 diabetes Source Mayo Clinic, 2012 Risk factors for type 1 diabetes  Dietary factors.  Dietary factors.  A number of dietary factors have been linked to an increased risk of type 1 diabetes, such as low vitamin D consumption; early exposure to cow's milk or cow's milk formula; or exposure to cereals before 4 months of age or after 7 months of age.  However, none of these factors has been shown to cause type 1 diabetes.

65. Click to edit Master title style  Risk factors for type 1 diabetes Source Mayo Clinic, 2012 Risk factors for type 1 diabetes  Race. Type 1 diabetes is more common in whites than in other races.  Geography. Certain countries, such as Finland and Sweden, have higher rates of type 1 diabetes.

66. Click to edit Master title style  Risk factors for type 1 diabetes Source Mayo Clinic, 2012 Risk factors for pre-diabetes and type 2 diabetes  Researchers don't fully understand why some people develop pre-diabetes and type 2 diabetes and others don't.  It's clear that certain factors increase the risk, however, including: Weight. The more fatty tissue you have, the more resistant your cells become to insulin. Weight. The more fatty tissue you have, the more resistant your cells become to insulin.

67. Click to edit Master title style  Risk factors for type 1 diabetes Source Mayo Clinic, 2012 Risk factors for pre-diabetes and type 2 diabetes Inactivity. The less active you are, the greater your risk. Physical activity helps you control your weight, uses up glucose as energy and makes your cells more sensitive to insulin. Exercising less than three times a week may increase your risk of type 2 diabetes. Inactivity. The less active you are, the greater your risk. Physical activity helps you control your weight, uses up glucose as energy and makes your cells more sensitive to insulin. Exercising less than three times a week may increase your risk of type 2 diabetes. Family history. Your risk increases if a parent or sibling has type 2 diabetes. Family history. Your risk increases if a parent or sibling has type 2 diabetes.

68. Click to edit Master title style  Risk factors for type 1 diabetes Source Mayo Clinic, 2012 Risk factors for pre-diabetes and type 2 diabetes Race. Although it's unclear why, people of certain races — including blacks, Hispanics, American Indians and Asians — are at higher risk. Race. Although it's unclear why, people of certain races — including blacks, Hispanics, American Indians and Asians — are at higher risk. Age. Your risk increases as you get older. This may be because you tend to exercise less, lose muscle mass and gain weight as you age. But type 2 diabetes is increasing dramatically among children, adolescents and younger adults. Age. Your risk increases as you get older. This may be because you tend to exercise less, lose muscle mass and gain weight as you age. But type 2 diabetes is increasing dramatically among children, adolescents and younger adults.

69. Click to edit Master title style  Risk factors for type 1 diabetes Source Mayo Clinic, 2012 Risk factors for pre-diabetes and type 2 diabetes Gestational diabetes. If you developed gestational diabetes when you were pregnant, your risk of developing pre-diabetes and type 2 diabetes later increases. Gestational diabetes. If you developed gestational diabetes when you were pregnant, your risk of developing pre-diabetes and type 2 diabetes later increases. Polycystic ovary syndrome. For women, having polycystic ovary syndrome — a common condition characterized by irregular menstrual periods, excess hair growth and obesity — increases the risk of diabetes. Polycystic ovary syndrome. For women, having polycystic ovary syndrome — a common condition characterized by irregular menstrual periods, excess hair growth and obesity — increases the risk of diabetes.

70. Click to edit Master title style Source Mayo Clinic, 2012 Risk factors for pre-diabetes and type 2 diabetes High blood pressure. Having blood pressure over 140/90mm Hg is linked to an increased risk of type 2 diabetes. High blood pressure. Having blood pressure over 140/90mm Hg is linked to an increased risk of type 2 diabetes. Abnormal cholesterol levels. If you have low levels of high-density lipoprotein (HDL), or "good," cholesterol, your risk of type 2 diabetes is higher. Abnormal cholesterol levels. If you have low levels of high-density lipoprotein (HDL), or "good," cholesterol, your risk of type 2 diabetes is higher. High levels of triglycerides. High level of triglyceride increases your risk of diabetes increases. High levels of triglycerides. High level of triglyceride increases your risk of diabetes increases.

71. Click to edit Master title style Source Mayo Clinic, 2012 Risk factors for gestational diabetes Risk factors for gestational diabetes  Any pregnant woman can develop gestational diabetes, but some women are at greater risk than are others. Risk factors for gestational diabetes include: Risk factors for gestational diabetes include: Age. Women older than age 25 are at increased risk. Age. Women older than age 25 are at increased risk. Family or personal history. Family or personal history. Weight. Being overweight before pregnancy increases your risk. Weight. Being overweight before pregnancy increases your risk. Race. women who are black, Hispanic, American Indian or Asian are more likely to develop gestational diabetes. Race. women who are black, Hispanic, American Indian or Asian are more likely to develop gestational diabetes.

72. Click to edit Master title style PreventionPrevention

73.  Keeping an ideal body weight and an active lifestyle may prevent type 2 diabetes.  There is no way to prevent type 1 diabetes.  To prevent complications of diabetes, visit your health care provider or diabetes educator at least four times a year. Source Mayo Clinic, 2012

74. Click to edit Master title style TreatmentTreatment

75.  There is no cure for diabetes.  Treatment involves medicines, diet, and exercise to control blood sugar and prevent symptoms and problems.