What is diabetes? Community Health Education Lecture Series November 18, Cara L. Kilroy, ANP-BC

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1 What is diabetes? Community Health Education Lecture Series November 18, 2014 Cara L. Kilroy, ANP-BC

2 About Diabetes Total prevalence of diabetes Total: 25.8 million children and adults in the United States 8.3% of the population have diabetes. Diagnosed: 18.8 million people Undiagnosed: 7.0 million people Prediabetes: 79 million people* Under 20 years of age About 1 in every 400 children and adolescents has diabetes Diabetes is the sixth deadliest disease in the U.S

3 What is diabetes? Diabetes is a chronic illness in which the body does not produce insulin (type 1) or does not produce enough insulin or properly use it (type 2) Insulin is vital for everyday life because it converts sugar, starches, or other food into energy DIABETES HAS NO CURE.

4 What is diabetes? Diabetes means a person has too much sugar (glucose) in their blood Glucose is needed by the body for energy Insulin is a hormone that is made in the pancreas and works like a key to a door Insulin opens the door of the cells of our body allowing glucose to go from the bloodstream into the cells where it is then used for energy If there is not enough insulin, or if the insulin can not open the door to the cell, the glucose levels rise in the blood

5 GLUCOSE METABOLISM

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7 Importance of glucose and insulin Glucose One of the simplest forms of sugar Stored in our cells (muscle, fat, liver) to be used for energy Insulin Hormone that helps the body use glucose for energy Produced in the pancreas by beta cells

8 Diabetes Mellitus Type 1 Diabetes Prediabetes Type 2 Diabetes

9 Type 1 Diabetes

10 Type 1 diabetes Occurs when the pancreas does not produce insulin Requires multiple doses of insulin every day via injection Accounts for 5-10% of all cases of diabetes and is the most prevalent type of diabetes among young children and adolescents Type 1 diabetes can not be prevented.

11 What is the cause of type 1 diabetes? The cause of type 1 diabetes is believed to be: Genetics the genes that come from mom and dad Self-allergy or autoimmune disease when the body attacks a part of itself The environment in which we live coming into contact with a virus or chemical

12 Prediabetes

13 What is prediabetes? Prediabetes blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes puts you at a higher risk for developing type 2 diabetes and cardiovascular disease

14 Preventing the development of type 2 diabetes For some people with prediabetes, early treatment can actually return blood glucose levels to the normal range. Research shows that you can lower your risk for type 2 diabetes by 58% by: Losing 7% of your body weight (or 15 pounds if you weigh 200 pounds) Exercising moderately 30 minutes per day, five days per week

15 Healthy Eating Nutrition is the process of providing and/or obtaining food necessary for health and growth Food is the fuel for our bodies Our bodies need carbohydrates, proteins, and fats How do we know what good nutrition is? Balanced plate

16 Balanced Plate

17 Healthy Eating Make half of your plate vegetables and fruits Make at least half of your grains whole Switch to fat-free or low-fat milk and milk products Vary your protein choices: lean meats, poultry, beans, nuts Cut back on sodium and empty calories from solid fats and added sugars

18 Type 2 diabetes

19 Type 2 diabetes Occurs when the pancreas does not produce enough insulin or uses insulin improperly Increased type 2 diagnoses among children and adolescents in the U.S. African Americans and Hispanic/Latino Americans are at higher risk Managed with diet and other healthy living choices, oral medication, or insulin shots Type 2 diabetes may be prevented.

20 What is the cause of type 2 diabetes? The cause of type 2 diabetes is believed to be: Genetics the genes that come from mom and dad The environment in which we live Being overweight Not getting enough exercise

21 Symptoms of Diabetes

22 Symptoms of type 1 and type 2 diabetes Frequent urination Unusual thirst Extreme hunger Unusual weight loss Extreme fatigue and irritability Recurring infections difficulty healing Tingling/numbness in hands and feet

23 Diagnosis of Diabetes

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25 Treatment

26 Treatment of diabetes Type 1 diabetes: Exercise and healthy eating plan Daily blood sugar checks using a meter Medication: Insulin injections Insulin pump therapy Type 2 diabetes: Exercise and healthy eating plan Daily blood sugar checks using a meter Medication: Oral medication Non-insulin injections Insulin injections

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28 Treatment Goals

29 Hemoglobin A1c The hemoglobin A1C test gives you a picture of your average blood glucose (blood sugar) control for the past 2 to 3 months Should be monitored at least twice a year by your provider

30 Hemoglobin A1c Goals American Diabetes Association (ADA) 7.0% or less Estimated average glucose = 154mg/dL American Association of Clinical Endocrinologists (AACE) 6.5% or less Estimated average glucose = 169mg/dL

31 Possible long-term complications Heart disease Stroke Kidney disease (Nephropathy) Eye complications Nerve disease (Neuropathy) Amputations These chronic complications may occur overtime, especially if blood sugars are not well controlled.

32 Diabetes Complications and Control Trial HbA1c and Relative Risk of Diabetic Complications 15 Relative Risk of Complications AACE recommendation is 6.5% Average US HbA1c Range % Eye disease Kidney disease Nerve damage * HbA1c Skyler, J: Endo Met Cl N Am, vol 25, 2, p , June Adapted from DCCT Research Group: NEJM 1993;329: Minshall M, et al. Clin Ther. 2005;27:

33 Questions?