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Diabetes: The Basics

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A diabetic diet is no different from the basic healthy eating plan. ... Gives the diabetic a good indication of what affects their blood sugar level. ... – PowerPoint PPT presentation

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Title: Diabetes: The Basics


1
Diabetes The Basics
  • Cornell Wellness Program

2
Diabetes- What Is It?
  • Body is not producing or has lost sensitivity to
    insulin.
  • Insulin is a hormone that allows sugars (glucose)
    to enter into each cell in your body.
  • Insulin is produced in the body by the pancreas.

3
Quick Review-Anatomy Of The Pancreas
  • A gland that lies behind the stomach
  • Produces three
  • hormones.
  • Its on the left side!

Image National Science Foundation
4
Insulin And The Other Hormones
  • Insulin- Hormone that lowers blood glucose.
  • Glucagon - Hormone that increases the amount of
    glucose in the blood when it is needed.
  • Somatostatin - Hormone that can suppress both
    glucagon and insulin when needed.

5
How Does Insulin Work?
  • A person normally secretes insulin in response to
    an elevated blood sugar level.
  • Insulin helps sugar move out of the blood and
    into the cells.
  • Cells will not allow blood sugar in without
    insulin. - this can cause a problem.

6
Types Of Diabetes
  • Type I - body does not produce any insulin.
  • Type II- body is not making enough or is losing
    sensitivity to insulin made.
  • Secondary - a consequence from another disease.
    For example, pancreatitis or cystic fibrosis.
  • Gestational Diabetes- diabetes during pregnancy.
  • Impaired Glucose Tolerance- an intermediate
    between normal and diabetes.

7
Why Isnt The Body Making Insulin?
  • In people with Type I, the immune system has made
    a big mistake.
  • It attacks the beta cells and destroys them.
  • In people with Type II, the pancreas is still
    making insulin, just not enough to keep up, or
    their bodies have become insulin resistant.

8
Type I
  • Usually diagnosed in children and young adults.
  • Must take daily insulin shots to stay alive.
  • Type I accounts for 5-10 of the population with
    diabetes.

9
Type II
  • The most common form of the disease.
  • Approximately 50 of men and 70 of women are
    obese when diagnosed.
  • Nearing epidemic proportions
  • increased number of older Americans
  • greater occurrence of obesity
  • sedentary lifestyles

10
What Are The Symptoms?
  • Polyphasia - excessive eating
  • Polyurea - excessive urination
  • Polydypsia - excessive fluid intake
  • Blurred vision
  • Poor wound healing
  • Irritability

11
How Are You Diagnosed With Diabetes?
  • In June 1997, the ADA redefined its criteria for
    diagnosing diabetes.
  • lt110 mg/dl is normal fasting blood glucose.
  • 110 126 mg/dl is impaired fasting glucose.
  • gt126 mg/dl (fasting blood glucose) is used to
    diagnose diabetes.

12
In Order To Be Diagnosed With Diabetes
  • Person must have symptoms of diabetes
  • Plasma glucose gt200
  • Fasting blood glucose of gt126 mg/dl
  • FBS, FBG, FPG, FG, FS
  • 2-hour plasma glucose gt200 mg/dl on oral glucose
    tolerance test
  • OGTT, GTT

13
Screening
  • All patients at age 45 and older
  • If the results are normal, repeat every 3 years
  • Screen at a younger age if patient meets
    following risk factors
  • Obesity
  • Inactive lifestyle
  • First degree relative with diabetes
  • High-risk ethnic group (African Americans, Native
    Americans, Asian Americans, Hispanics/Latinos and
    Pacific Islander heritage)
  • Was diagnosed with gestational diabetes or
    delivered a baby whose birth weight gt9 lbs.
  • Hypertension
  • HDL level lt40(men) lt50(women) or triglycerides
    gt250
  • Found to have impaired glucose tolerance or
    impaired fasting on a previous test.

14
Ive Got Diabetes, Now What?
  • After diagnosis, there is a great need for
    education.
  • A diabetic diet is no different from the basic
    healthy eating plan.
  • An activity goal is no different than a basic
    healthy activity plan.
  • So why bother?

15
Diabetes Complications
  • Kidney
  • Heart
  • Nerve damage
  • Feet/skin
  • Eye/Vision
  • Teeth/Gums

16
Treatment Goals For Type II
  • Achieve normal or near-normal blood glucose
    levels.
  • Prevent, delay or treat complications.
  • Improve health through optimal monitoring,
    nutrition and activity.

17
Blood Glucose Monitoring
  • All diabetics must keep track of blood glucose
    levels.
  • This is the only way to know if the treatment is
    effective.
  • Gives the diabetic a good indication of what
    affects their blood sugar level.
  • Must check at least 2 times a day and four times
    a day for at least 3 days a week.

18
Oral Medications 4 Types
  • Sulfonylurea-stimulates the body to make more
    insulin.
  • Metformin-lowers blood sugar by helping the
    insulin work better
  • Thiazolidinediones- increases muscle sensitivity
    to insulin.
  • Alpha-glucosidase inhibitors- slow the process of
    carbohydrate digestion.

19
Insulin
  • Type I and sometimes Type II patients need to be
    treated with insulin.
  • There are more than 20 types.
  • They differ in how they are made, how they work
    in the body and their cost.

20
Hypoglycemia
  • Hypoglycemia- low blood sugar
  • Happens to everyone with diabetes
  • Symptoms include shakiness, dizziness, sweating,
    hunger, headache, pale skin, sudden moodiness,
    clumsy or jerky movements, difficulty paying
    attention, and tingling sensations around mouth.

21
How To Treat Hypoglycemia
  • Quickest way to raise blood glucose is with some
    form of sugar.
  • 3 glucose tablets, 1/2 cup of fruit juice, 5-6
    pieces of candy.
  • Wait 15-20 minutes and test blood sugar again.
  • If hypoglycemia goes untreated, patient could get
    worse and pass out.

22
Hyperglycemia
  • High blood sugar
  • Not enough insulin
  • Too much food
  • Too little exercise

23
Hemoglobin A1c
  • A good indicator of blood glucose control.
  • Gives a that indicates control over the
    preceding 2-3 months.
  • Performed 2 times a year.
  • A hemoglobin of 6 indicates good control and
    level gt8 indicates action is needed.

24
Treatment Goals
  • The main goal is to normalize blood sugar.
    Realistic goals for diabetics are 70-140 mg/dl
    before meals, lt180 mg/dl after and a glycosolated
    hemoglobin (HgA1C) within 1 of normal.
  • Need good blood glucose control to avoid
    complications.

25
Physical Activity And Diabetes
  • Especially beneficial in type II diabetes.
  • Possible improvement in blood glucose control.
  • Improved insulin sensitivity/lower medication
    requirement.
  • Reduction in body fat.
  • Cardiovascular benefits.
  • Stress reduction.
  • Prevention of Type II diabetes (IGT).

26
Things To Consider
  • Medication timing.
  • Food intake timing.
  • Recent illness or infection.
  • Postpone exercise if glucose reading is below 100
    mg/dl or above 250 mg/dl
  • Consume 15g of carbs. per 60 min. of exercise.
  • Keep a snack handy.
  • Practice proper foot care.
  • Carry medical identification.

27
How To Avoid Complications
  • Control weight
  • Eat a healthy well-balanced diet.
  • Get regular exercise
  • Have regular checkups
  • Check feet everyday for cuts and blisters
  • Do not smoke!
  • Keep blood sugars normal
  • Avoid the 2 common diabetic problems,
  • hypoglycemia and hyperglycemia

28
Conclusion
  • For more informationwww.diabetes.org

29
Questions?
  • Contact the Wellness Program
  • 255-3886
  • wellness_at_cornell.edu
  • 303 Helen Newman Hall

30
Sources
  • American Diabetes Association
  • Diabetes.org
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