Diabetes: The Basics

Presented By: Shahid Nawaz

Researcher

King Saud University,

Riyadh,KSU

People have diabetes

because….

(1)The insulin their body makes doesn’t work right or

(2)Their body doesn’t make

enough insulin.

Insulin takes the glucose from

blood into cells.Insulin takes the glucose from

blood into cells.

People have diabetes because….

.

.

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.

How Does Insulin Work?

Energy for Our Bodies

• Energy comes mostly from the glucose in the foods we eat.

• Blood takes the glucose to our cells.• The pancreas makes insulin, which unlocks the cells

so the glucose can get in.• Extra glucose is stored as fat or in the liver for use if

needed later.

• Energy comes mostly from the glucose in the foods we eat.

• Blood takes the glucose to our cells.• The pancreas makes insulin, which unlocks the cells

so the glucose can get in.• Extra glucose is stored as fat or in the liver for use if

needed later.

                                                                                                                     

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.

Why Isn’t 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.

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.

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 Peoples. greater occurrence of obesity sedentary lifestyles

How You Diagnosed With Diabetes?

The ADA redefined it’s criteria for diagnosing diabetes.

<110 mg/dl is normal fasting blood glucose. 110 – 126 mg/dl is impaired fasting glucose. >126 mg/dl (fasting blood glucose) is used

to diagnose diabetes.

What Are The Symptoms?

Polyphasia - excessive eating Polyurea - excessive urination Polydypsia - excessive fluid intake Blurred vision Poor wound healing Irritability

Short Term Complications

• People who have diabetes can have life-threatening short-term complications. They must try to avoid complications, but also be prepared to treat them if they happen:

– High blood sugar or hyperglycemia – Low blood sugar or hypoglycemia – High ketones or diabetic ketoacidosis

Long Term Complications

• Too much glucose in the blood damages the lining of the vessels that carry the blood.

• Blood vessels all over the body get damaged.

• The damage causes the body organs not to work well.

What Problems Does Blood Vessel Damage Cause?

• Heart and blood vessel damage can lead to high blood pressure, strokes and heart attacks.

• Kidney damage can lead to kidney failure and the need for dialysis and kidney transplant.

• Eye damage can lead to blindness.• Nerve damage can lead to tingling, numbness and

pain in hands and feet. • Nerve damage can also cause problems with the

digestive system.

What Problems Does Blood Vessel Damage Cause?

• Foot damage can lead to infections and need for amputation of toes, feet or legs.

• Skin and mouth damage can lead to gum disease, infections and loss of teeth.

• Bone damage can lead to osteoporosis and broken bones.

• Brain damage can lead to dementia.

In Order To Be Diagnosed With Diabetes:

Person must have symptoms of diabetes Plasma glucose >200 Fasting blood glucose of >126 mg/dl

2-hour plasma glucose >200 mg/dl on oral glucose tolerance test

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) Was diagnosed with gestational diabetes or delivered a baby

whose birth weight >9 lbs. Hypertension HDL level <40(men) <50(women) or triglycerides >250 Found to have impaired glucose tolerance or impaired

fasting on a previous test.

I’ve 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.

Diabetes Complications

Kidney Heart Nerve damage Feet/skin Eye/Vision Teeth/Gums

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.

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.

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.

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.

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.

Hyperglycemia

High blood sugar Not enough insulin Too much food Too little exercise

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 >8% indicates action is needed.

Treatment Goals

The main goal is to normalize blood sugar. Realistic goals for diabetics are 70-140 mg/dl before meals, <180 mg/dl after and a glycosolated hemoglobin (HgA1C) within 1% of normal.

Need good blood glucose control to avoid complications.

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).

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.

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

What Is A Healthy Diet?

• Make healthy food choices.– More fruits and vegetables of many colors.– More whole grains.– Fish 2-3 times a week.– Only lean meat or chicken without skin.– Low-fat or non-fat dairy products.– Drink water instead of sugary or carbonated

drinks.– Decrease snack foods that are high calorie and

fat.– Watch portion sizes.– Cook with liquid oils and decrease fats in your

diet.

How to Eat A Healthy Diet

– Practice portion control so you don’t eat too much. (examples of portion sizes)

– Avoid eating fast food, prepared foods and unhealthy snacks.

Exercise

• Physical activity: – Gets you moving!!– Decreases insulin resistance of the

cells!

• Being physically fit has three parts:– Strength– Endurance– Flexibility

Exercise

• Especially beneficial in type II diabetes.

• Promotes weight loss• Increases insulin sensitivity.• Must also be aware of medication

and intake to prevent hypoglycemia.

Benefits of Exercise

• Strengthens heart, muscles, bones.• Helps insulin work better (decreases

insulin resistance).• Improves blood circulation.• Keeps joints flexible.

Benefits of Exercise

• Decreases: – Blood glucose-less damage to vessels– Blood pressure-less risk of stroke– Cholesterol-less risk of heart attack and

stroke– Stress- less risk of depression.

Methods of Carbohydrate Control

There are many new methods of controlling diabetes, these are still the two most common.

• Exchange Lists• Carbohydrate counting- Very basic,

allows a little more freedom and variety.

Grains and MoreDiabetics should have 6 or more servings of grains, beans and starchy vegetables per day. Choose whole-grain foods that are nutritious and high in fiber, such as whole grain bread or crackers, bran cereal and brown rice. Beans can be another good source of fiber. Don't use white flour when cooking, instead look for whole wheat or whole grain alternatives.

Eating right is just one of the ways to manage your diabetes. Exercise and regular diabetic testing are other elements to live a healthy lifestyle

Sources

American Diabetes Association Diabetes.org