Harold Schnitzer Diabetes Health Center. Finally Some Good News About Diabetes- Delaying/Preventing Diabetes in Those at High Risk!

Transcription

1 Harold Schnitzer Diabetes Health Center Finally Some Good News About Diabetes- Delaying/Preventing Diabetes in Those at High Risk!

2 If Only It Was This Easy.

3 Activity Diet Nation

4 Objectives At the End of This Discussion You Will Be Able To: List the number of Americans with diabetes as well as those at risk for developing type 2 diabetes Discuss the results from the original Diabetes Prevention Program research study Locate an Oregon based Diabetes Prevention Program, or consider establishing one in your community Begin lowering your risk today!

5 Normal Metabolism- Food Carbohydrate that you eat is broken down and absorbed into the blood stream as glucose (blood sugar) Carbohydrate Blood Sugar

6 Normal Metabolism- Insulin

7 How Insulin Works Insulin acts like a key that opens the door to your cells so that glucose can enter the cell from your blood. Cell with adequate Insulin Cell without adequate Insulin

8 Normal Metabolism Most of the diabetes seen in adults is caused by a resistance to the insulin that is produced by the body

9 Abnormal Metabolism- Insulin Resistance Most of the diabetes seen in adults is caused by a resistance to the insulin that is produced by the body

10 Types of Diabetes Type 1 Diabetes- Pancreas no longer makes insulin (auto-immune condition). Type 2 Diabetes- Combination of insulin resistance and less insulin being made. Caused by genetic and lifestyle factors. Pre-Diabetes = Pre type 2 diabetes. Caused by genetic and lifestyle factors.

11 How do You Know You Have Diabetes?

12 On the Horizon Diabetes = 29 million Pre-Diabetes = 86 million 35% of US adults 15-30% develop diabetes within 5 years if no action is taken CDC: A Snapshot of Diabetes in the United States, 2014.

13 How Did We Get Here? Approximately 80%- 90% of people with type 2 diabetes are overweight or obese In the United States, approximately 68% of adults are considered overweight or obese Obesity is the primary risk factor for developing type 2 diabetes.

14 Obesity & Diabetes Risk 1994 Obesity (BMI 30 kg/m 2 ) Diabetes Centers for Disease Control and Prevention: National Diabetes Surveillance System. Available online at: Accessed 10/3/2011.

15 Diabetes Prevention Program Research Question- Does a lifestyle intervention or treatment with a diabetes drug prevent or delay the onset of diabetes?

16 Diabetes Prevention Program Study Population 3200 American adults with prediabetes 45% of population from minority groups (American Indian, Hispanic, African American, Asian, Pacific Islander) Average Age = 51 Mean Body Mass Index (BMI) = 34 (>30 = obese)

17 Diabetes Prevention Program Study Interventions Lifestyle Reduced calories, low-fat diet 150 minutes of exercise per week (30 minutes of walking 5 days per week) Weight loss goal = 7% of body weight Metformin (Diabetes Drug) 850 milligrams 2 times per day Placebo (No Intervention)

18 Diabetes Prevention Program Study Results Lifestyle Risk for developing diabetes decreased by 58% Metformin (Diabetes Drug) Risk for developing diabetes decreased by 31%

19 HBO Weight of the Nation

20 What You Can Start Doing Today! What you can do to reduce your risk Eat well-balanced, reduced calorie, low-fat meals. Accumulate at least 30 minutes of physical activity on at least 5 days of the week. If you are overweight, try to reduce your weight by 5-7%.

21 A Little Weight Loss Goes a Long Way! Moderate weight loss (7% of body weight) is associated with decreased insulin resistance, improved measures of blood sugar, better blood lipid levels and improved blood pressure. Diabetes Care, 36 (1): , 2013.

22 Weight Management- What Works Physical Activity + Calorie Intake = Weight Management Eating 100 fewer calories per day can result in a 10-pound weight loss in one year.

23 Practical Weight Management Tips Eat less of everything except vegetables Vegetables are composed of water, fiber, vitamins, minerals and phytonutrients Vegetable calories are poorly assimilated Increasing vegetable intake helps to lower calorie intake from other foods

24 Suggested Calories for Weight Loss Female < 5 4 = 1200 calories > 5 5 = 1500 calories Male < 5 9 = 1800 calories > 5 10 = 2000 calories

25 Practical Weight Management Tips Don t drink your calories Liquid kcals are not filling 12 oz OJ = 180 calories 12 oz of regular coke = 140 calories 12 oz of beer = 150 calories Pint = 200 calories Imperial Pint = 250 calories 4 oz wine = 100 calories 1.5 oz liquor = 100 calories

26 Practical Weight Management Tips Avoid deep fried foods Deep frying adds unneeded calories 1 tsp of oil = 40 calories 4 oz Chicken breast, fried = 266 calories 4 oz Chicken breast, grilled = 136 calories

27 Keeping track of your food There s an app for that!

28 Physical Activity Exercise is Medicine Physical Activity- General Benefits Decreased risk of coronary artery disease Improved blood sugar levels Decreased risk of developing high blood pressure Decreased feelings of depression and anxiety Helps to build and maintain healthy bones, muscles, and joints Helps to control weight * Consult with your doctor before starting any exercise program.

29 Exercise is Medicine Physical Activity- How Much? Aerobic 150 minutes per week moderate-intensity (30 minutes 5 days per week) 75 minutes per week vigorous-intensity (25 minutes 3 days per week) Muscle Strengthening Workout involving all major muscle groups two or more days per week 2008 Physical Activity Guidelines for Americans, US Department of Health & Human Services

30 Exercise is Medicine Physical Activity- Moderate Vs Vigorous Intensity Moderate (150 minutes per week) mets i.e.- walking at 3.0 mph = 3.3 mets Vigorous (75 minutes per week) 6.0 mets or more i.e.- running at 4.5 mph = 6 mets

31 Exercise is Medicine Physical Activity FITT Principle Frequency: Aim for at least 5 days a week Intensity: Talk test Type: Aerobic exercise burns calories and improves blood sugar, blood pressure and blood lipids Time: 30 minutes; can be done in intervals

32 Eligible National DPP Participants Overweight Adults: Limited to persons ages 18 years and older with a BMI of 24 or greater (Asian Americans: 22 or greater) Prediabetes: Prediabetes identified through blood test (Fasting blood sugar, A1C, or Oral Glucose Tolerance Test) OR history of gestational diabetes OR screen positive for prediabetes based on National Diabetes Prevention Program Risk Test

33 CDC Risk Test Baby > 9 lbs. Sibling or parent with diabetes At risk height/weight chart Under 65 and get little to no exercise Age

34 National Diabetes Prevention Program How it Works Lifestyle Coach works with groups of participants to reduce their risk by: Losing weight through healthy eating (5-7 % of starting weight) Increasing physical activity (avg. 150 minutes per week) Learning to identify and address barriers to healthy eating and physical activity Lifestyle Coach does not have to be a healthcare professional!

35 National Diabetes Prevention Program How it Works Relies on self-monitoring, goal setting, group process 1 year program First 6 months: 16 sessions, usually held weekly Second 6 months: monthly sessions over 6-8 months

36 Key Strategies of the Lifestyle Change Program Regular group sessions Weekly, then monthly Group dynamics Goal setting and tracking Weight loss Physical activity Eating (fat grams, calories) Regular weigh-ins, weight charting Self-monitoring of weight, food and physical activity

37 National Diabetes Prevention Program Content- 1 st 16 weeks of program Skills 1. Welcome 2. Be a Fat and Calorie Detective 3. Three Ways to Eat Less Fat and Fewer Calories 4. Healthy Eating 5. Move Those Muscles 6. Being Active: A Way of Life 7. Tip the Calorie Balance Controlling the external environment 8. Take Charge of What s Around You 9. Problem Solving 10. Four Keys to Healthy Eating Out Psychological and emotional 11. Talk Back to Negative Thoughts 12. The Slippery Slope of Lifestyle Change 13. Jump Start Your Activity Plan 14. Make Social Cues Work for You 15. You Can Manage Stress 16. Ways to Stay Motivated

38 Curriculum

39 Participant Food and Activity Tracker

40 Lifestyle Coach Mantras You Bite it, You Write it! You lick it, you log it You Drink it, You Ink it!

41 What Tools are Needed? Program provides: Scale for weigh-ins at each session Participants acquire: (recommended) Bathroom scale Food and Activity Trackers Participant Notebook Fat and Calorie Counter (recommended) Tools for weighing and measuring food Suitable shoes for physical activity

42 Diabetes Prevention in Oregon DPP in Action

43 National Diabetes Prevention Program Now Available to Eastern Oregon and Salem Area OEBB Members! 1 Year Program 16 weekly sessions 8 monthly maintenance sessions Group delivery of program to help participants achieve: 7% weight loss 150 minutes of physical activity Cost is covered by your benefits package!

44 Diabetes Prevention in Oregon Find a Program Tillamook Lincoln Clatsop Polk Benton Multnomah Clackamas Marion Linn Hood River Wasco Jefferson Sherman Morrow Gilliam Wheeler Umatilla Grant Union Baker Wallowa Diabetes Prevention Program Coming soon Lane Deschutes Crook No program Coos Douglas Harney Malheur Lake Klamath Curry Josephine Jackson

45 A CHANGE FOR LIFE

46 Preventing Diabetes- It Takes a Village

47 Questions? Kathy Hayden Don Kain