Transcript Slide 1

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for information
Diabetes ABCs
Contributed by Shawna Gornick-Ilagan, MS, RD, CWPC
Review Date 8/09 D-0549
Disclaimer
• This presentation should not substitute or
replace any medical advice prescribed by your
doctor
• The presentation is meant to provide you with
general health information to empower you
and your family to prevent or manage diabetes
Objectives
•
•
•
•
•
What is diabetes?
What are my risks of getting it?
How can I prevent diabetes?
How do I manage diabetes if I get it?
What do the ABCs stand for?
What Is Diabetes
• Diabetes is a condition in which the body is
unable to properly utilize blood sugar
Diabetes IQ Test
1. Every 24 hours:
a. More than 1000
diabetes
b. More than 2000
diabetes
c. More than 3000
diabetes
d. More than 4000
diabetes
adults are diagnosed with
adults are diagnosed with
adults are diagnosed with
adults are diagnosed with
Diabetes IQ Test
2. Every 24 hours:
a. About 10 children and adolescents
diagnosed with type 1 diabetes
b. About 20 children and adolescents
diagnosed with type 1 diabetes
c. About 30 children and adolescents
diagnosed with type 1 diabetes
d. About 40 children and adolescents
diagnosed with type 1 diabetes
are
are
are
are
Diabetes IQ Test
3. Every 24 hours:
a. 2 children and adolescents are diagnosed
with type 2 diabetes
b. 5 children and adolescents are diagnosed
with type 2 diabetes
c. 8 children and adolescents are diagnosed
with type 2 diabetes
d. 10 children and adolescents are diagnosed
with type 2 diabetes
Diabetes IQ Test
4. Every 24 hours:
a. Approximately
diabetes
b. Approximately
diabetes
c. Approximately
diabetes
d. Approximately
diabetes
50 people die from
100 people die from
150 people die from
200 people die from
Diabetes IQ Test
5. Every 24 hours:
a. 50 people with diabetes have a
nontraumatic lower-limb amputation
b. 100 people with diabetes have a
nontraumatic lower-limb amputation
c. 150 people with diabetes have a
nontraumatic lower-limb amputation
d. 200 people with diabetes have a
nontraumatic lower-limb amputation
Diabetes IQ Test
6. Every 24 hours:
a. About 30 people with diabetes develop
kidney failure
b. About 60 people with diabetes develop
kidney failure
c. About 90 people with diabetes develop
kidney failure
d. About 130 people with diabetes develop
kidney failure
Diabetes IQ Test
7. Every 24 hours:
a. Nearly 5 adults with diabetes go blind
b. Nearly 15 adults with diabetes go blind
c. Nearly 25 adults with diabetes go blind
d. Nearly 50 adults with diabetes go blind
Quiz derived from information found at
http://www.cec.gov/features/livingwithdiabetes/
Answer Key
• The correct answer for all questions— d.
• Over the years, high blood glucose
(hyperglycemia) damages nerves and blood
vessels, leading to complications such as:
– Heart disease
–
–
–
–
–
–
Stroke
Kidney disease
Blindness
Nerve problems
Gum infections
Amputation
What Are the
Symptoms?
• Some people do not have symptoms
• Other people have experienced these
symptoms:
–
–
–
–
–
–
Increased thirst
Increased urination
Weight loss without trying
Blurred vision
Increased hunger
Increased fatigue
Types of Diabetes
• The three types of diabetes:
– Type 1 (juvenile diabetes, insulin dependent:
5%-10%
– Type 2 (adult onset, noninsulin dependent):
90%-95%
– Gestational diabetes (diabetes during pregnancy):
2%-5%
• Prediabetes
– Centers for Disease Control estimates that 57 million
Americans age 20+ have prediabetes
Normal Process
Insulin
Diabetes: Type 1
Diabetes: Type 2
= Fat
Insulin
Diabetes: Type 2 (Over Time)
Type 1 Diabetes: Risk
Factors
• Family history of type 1 diabetes: 10%-15%
• Race: White people have a greater risk
• Presence of islet cell antibodies in the blood
Prevention
• Currently no way to prevent type 1 diabetes
• Can prevent or delay the development of
complications, such as:
– Vision, kidney, or heart failure
– Blood vessel and nerve diseases
• Prevention: Keep blood sugar near normal levels
Type 2 Diabetes: Risk
Factors
• Risk factors that you can not control:
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–
–
–
Family history
Age
Race
History of gestational diabetes
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Lose weight if overweight
Eat healthy and exercise
Quit smoking
Get treatment if you have prediabetes, high blood
pressure, or high cholesterol
• Risk factors that you can control:
Gestational Diabetes
• Stay at a healthy weight and do not gain too
much weight during pregnancy
• Exercise regularly to help keep your blood sugar
level within a safe range and to prevent
gestational diabetes
Weight Gain During
Pregnancy
Category
Weight Gain
Recommendations
If you began pregnancy at
a normal weight
25–35 pounds
If you began pregnancy
underweight
28–40 pounds
If you began pregnancy
overweight
15–25 pounds
If you are expecting twins
35–45 pounds
How Is It
Diagnosed?
• Fasting plasma glucose: Must fast for 8 hours or
more
Plasma Glucose
Results (mg/dL)
99 or below
100-125
126 or above
dL=deciliter, mg=milligram
Diagnosis
Normal
Prediabetes
Diabetes
Glucose Testing
Recommendations
• Blood glucose:
–
–
–
–
During a regular physical
Symptoms suggesting hyperglycemia or hypoglycemia
During pregnancy
Diabetic
• Starting at age 45 and every 3 years if normal
results
Prediabetes
Prediabetes
Is prediabetes the same as impaired
glucose tolerance or impaired fasting?
Yes: Doctors sometimes refer to this state of
elevated blood glucose levels as impaired
glucose tolerance or impaired fasting glucose
(IGT/IFG), depending on which test was used to
detect it
Source: American Diabetes Association. Frequently asked questions about pre-diabetes.
Available at: http://www.diabetes.org/pre-diabetes/faq.jsp. Accessed September 10, 2009.
Good News
• Type 2 diabetes is
preventable if you
catch it early and
make some
changes in your
lifestyle
85%-90% of Diabetes
Is Preventable
Preventable
Diabetes: Type
2
Insulin
Bad
News
• Type 2 diabetes is
a condition that
consumes your:
– Time
– Money
– Energy
How to Prevent Type 2
Diabetes
•
•
•
•
•
•
Maintaining a healthy weight
Increasing fruit and vegetable consumption
Increasing fiber intake
Decreasing fat intake
Exercising
Breastfeeding infants
– 20% less likely to have diabetes and high cholesterol
Tips to Maintain a
Healthy Weight
•
•
•
•
•
•
•
•
Do not drink calories
Eat slowly
Stay hydrated
Try the low-fat or nonfat version of foods
Change habits
Eat three meals each day
Focus on fruits and vegetables
Get enough fiber
Tips to Maintain a
Healthy Weight
Fruits and vegetables
• Canned or frozen
• Frozen grapes
• Prepackaged
• Microwaveable
• Low-fat dip
• 5 servings/day
Dietary fiber
• Beans
• Oatmeal
• Whole grain
– Pastas
– Cereals
– Breads
• Adults need 25-35
grams (g)/day; children
older than age 3 need
their age plus 5 g
(minimum
recommendation)
Source: Dwyer JT. Dietary fiber for children: how much? Pediatrics (serial online).
1995;96:1019-1022. Available at: http://www.diabetes.org/pre-diabetes/faq.jsp.
Accessed September 10, 2009
Exercise Regularly
• Exercise regularly to help raise your high-density
lipoprotein (HDL), the good cholesterol, and
lower your low-density lipoprotein (LDL), the
bad cholesterol
• Aim for 30 minutes of activity or more on most
days of the week
Decrease Saturated
and Trans Fats
Type of Harmful Fat
Food Source
Saturated fat
 Animal products, such as meat,
poultry, seafood, eggs, dairy
products, lard, and butter
 Coconut, palm, and other tropical
oils
Trans fat
 Partially hydrogenated vegetable
oils
 Commercial baked goods, such as
crackers, cookies, and cakes
 Fried foods, such as doughnuts
and French fries
 Shortening and margarine
Opt for Healthy Fats
Type of Healthy Fat
Food Source
Monounsaturated fat
 Olive oil, peanut oil, and canola
oil
 Avocados
 Nuts and seeds
Polyunsaturated fat
 Vegetable oils, such as
safflower, corn, sunflower, soy,
and cottonseed oils
 Nuts and seeds
Omega-3 fatty acids
 Fatty cold-water fish, such as
salmon, mackerel, and herring
 Flaxseeds and flax oil
 Walnuts
Know Where to Look
• Lose weight—calories
• Lower cholesterol—
saturated and trans
fats
• Manage glucose—total
carbohydrate
The Good News…
• By managing the ABCs of diabetes, people with
diabetes can reduce their risk of heart disease
and stroke
A stands for A1c
B stands for body mass index (BMI) and blood
pressure
C stands for cholesterol
A: Ask About Your A1c
• A1c measures average
blood glucose over the
last 3 months
• Get your A1c checked
at least twice/year
A1c
Average Blood
Reading
Sugar Level
6%
135 mg/dL
7%
170 mg/dL
8%
205 mg/dL
9%
240 mg/dL
10%
275 mg/dL
11%
310 mg/dL
12%
345 mg/dL
Healthy Plate Format
• One fourth plate starch
• One fourth plate meat
• One half plate
nonstarchy vegetables
• 8 fluid ounces of
reduced-fat milk
• One serving of fruit
Cereal or Grain
• 15 g of carbohydrate=one serving
• One cereal or grain serving is:
– One slide of bread
– One half of a hamburger bun
– ¾ cup (C) of unsweetened cereal
– ⅓ C cooked pasta
– 3 C popcorn
– ½ C cooked oatmeal
Fruit
• 15 g of carbohydrate=one serving
• One fruit serving is:
– ⅓ C of fruit juice
– ½ C of canned fruit
– One small piece of fruit, such as an apple
Milk or Dairy
• 15 g of carbohydrate=one serving
• One milk or dairy serving is:
– 1 C of milk
– 6 ounces of yogurt
Starch or Vegetables
• 15 g of carbohydrate=one serving
• One starch or vegetable serving is:
– ⅓ C of beans
– ½ C of corn or peas
– ½ C of mashed potatoes
Quick Reference Chart
for Eating With Diabetes
Number of Exchanges/Day for Various Calorie Levels
Calories
1200 1500 1800
Starch/Bread
5
8
10
Meat
4
5
7
Vegetable
2
3
3
Fruit
3
3
3
Milk
2
2
2
Fat
3
3
3
2000
11
8
4
3
2
4
2200
13
8
4
3
2
5
Source: University of Maryland Medical Center. Diabetes diet—diabetic exchange lists.
Available at: http://www.umm.edu/patiented/articles/what_general_guidelines_hearthealthy_diets_000042_5.htm. Accessed September 10, 2009.
B: BMI
• BMI is a number calculated from a person’s
weight and height
• Higher BMI values are associated with risk for
health problems
• BMI goal=less than 25
• More information at
http://www.cdc.gov/healthyweight/assessing/
bmi/
BMI
(kg/m2)
19
20
21
22
23
24
Normal Weight
Height
25
26
27
28
29
Increased Risk
30
35
40
High Risk
58
91
96
100
105
110
115
119
124
129
134
138
143
167
191
59
94
99
104
109
114
119
124
128
133
138
143
148
173
198
60
97
102
107
112
118
123
128
133
138
143
148
153
179
204
61
100
106
111
116
122
127
132
137
143
148
153
158
185
211
62
104
109
115
120
126
131
136
142
147
153
158
164
191
218
63
107
113
118
124
130
135
141
146
152
158
163
169
197
225
64
110
116
122
128
134
140
145
151
157
163
169
174
204
232
65
114
120
126
132
138
144
150
156
162
168
174
180
210
240
66
118
124
130
136
142
148
155
161
167
173
179
186
216
247
67
121
127
134
140
146
153
159
166
172
178
185
191
223
255
68
125
131
138
144
151
158
164
171
177
184
190
197
230
262
69
128
135
142
149
155
162
169
176
182
189
196
203
236
270
70
132
139
146
153
160
167
174
181
188
195
202
207
243
278
71
136
143
150
157
165
172
179
186
193
200
208
215
250
286
72
140
147
154
162
169
177
184
191
199
206
213
221
258
294
73
144
151
159
166
174
182
189
197
204
212
219
227
265
302
74
148
155
163
171
179
186
194
202
210
218
225
233
272
311
75
152
160
168
176
184
192
200
208
216
224
232
240
279
319
76
156
164
172
180
189
197
205
213
221
230
238
246
287
328
B: Beware of Your
Blood Pressure
• High blood pressure raises your risk for heart
attack, stroke, eye problems, and kidney disease
• Get your blood pressure checked at every visit
• Target blood pressure=less than 130/80
Key Steps for Lowering
Blood Pressure
•
•
•
•
•
•
Lose weight
Eat more fruits and vegetables
Reduce the amount of salt in diet
Lower alcohol intake
Quit smoking
Take blood pressure pills, if prescribed
– Many people require more than one pill
C: Check Your
Cholesterol
• Several kinds of blood fats:
– Total and LDL (“lousy”) cholesterol—can
narrow or block vessels
– HDL (“healthy”) cholesterol—helps remove
cholesterol deposits
– Triglycerides—can raise your risk for heart
attack/stroke
Know Your Numbers
Value
A1c
Goals
Less than 7
Blood pressure
Less than 130/80
Total cholesterol
Less than 200
LDL cholesterol
Less than 100
HDL cholesterol
Greater than 40 (men)
Greater than 50 (women)
Less than 150
Triglycerides