1. Diabetes: The Modern Epidemic Roy Buchinsky, MD Director of Wellness

2. 9/18/2015University Hospitals Ahuja Medical Center2 Introduction Disorder of glucose utilization. Insufficient or no insulin- Type 1- 10% Increased resistance to insulin- Type 2-90% Elevated blood sugar levels. Complications

3. 9/18/2015University Hospitals Ahuja Medical Center3 Incidence

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6. 9/18/2015University Hospitals Ahuja Medical Center6 Type 1 Diabetes Immune system destroys pancreatic beta cells. Usually affects children and young adults. Insulin delivered via injection or pump. Risk factors includes genetic, autoimmune, or environmental.

7. 9/18/2015University Hospitals Ahuja Medical Center7 Type 2 Diabetes Mainly occurs in adults. 90-95% of all diabetes. Characterized by insulin resistance. Associated with obesity, family history, gestational diabetes, and race/ethnicity.

8. 9/18/2015University Hospitals Ahuja Medical Center8 Diagnosis: Clinical Asymptomatic Poly-dipsia, phagia, uria, Weight loss Visual disturbance Diabetic ketoacidosis

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10. 9/18/2015University Hospitals Ahuja Medical Center10 Diagnosis: Labs 1.Fasting bg > 126. 2.Sxs plus random bg > 200. 3.Abnormal GTT - bg > 200 2 hrs after load. 4.HbA1c > 6.5.

11. 9/18/2015University Hospitals Ahuja Medical Center11 Impaired Glucose Tolerance FBG 100-125 A1c 5.9-6.4 79 million adults in USA Increased risk for development of DM. –Annual re-screening. –Intensive lifestyle intervention.

12. 9/18/2015University Hospitals Ahuja Medical Center12 Metabolic Syndrome The Deadly Quartet Obesity Hypertension Increased blood sugar Elevated cholesterol

13. 9/18/2015University Hospitals Ahuja Medical Center13 Treatment Type 1- insulin delivered by pump or injection. –Daily or with meals Type 2- improved eating habits, increased exercise, weight loss, oral agents.

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15. 9/18/2015University Hospitals Ahuja Medical Center15 Complications Retinopathy Cardiovascular disease Peripheral neuropathy Nephropathy Peripheral vascular disease

16. 9/18/2015University Hospitals Ahuja Medical Center16 Prevention Increased exercise and a healthy diet. Treatment with metformin DPP- reduced risk of Type 2 DM by 58% over 3 years –Greater benefit in patients over 60.

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18. 9/18/2015University Hospitals Ahuja Medical Center18 Diet Recommendations Low glycemic index foods. 0 calorie or very low calorie drinks. Avoid sugary drinks like fruit punch and soda. Carbohydrate restriction

19. 9/18/2015University Hospitals Ahuja Medical Center19 Summary ↑incidence of diabetes 2 types of diabetes Prevention techniques Treatment options Complications

21. Thank You 9/18/2015University Hospitals Ahuja Medical Center21