By: Manuela Belda SISD 24534. Prevalence of total diabetes in the United States, all ages -- United States, 2002 Total: 18.2 million people--6.3 percent.

By: Manuela BeldaSISD 24534

Prevalence of total diabetes in the United States, all ages -- United States, 2002 Total:

18.2 million people--6.3 percent of the population--have diabetes. Undiagnosed: 5.2 million people

Diabetes was the sixth leading cause of death listed on U.S. death certificates in 2000. diabetes contributed to 213,062 deaths.

Cost of diabetes in the United States, 2002 Total (direct and indirect): $132 billion

What is diabetes??

•Diabetes mellitus – commonly referred to as diabetes – is a chronic illness that affects the metabolism

•Diabetes – “sweat urine”

•Characterized by too much glucose (a type of sugar) in the blood. = Hyperglycemia

•Results from defects in insulin production, action or both.

•There are two main types: One and Two

Glucose – simple sugar Function:

Provides fuel for cells to function

Insulin –hormone produced by beta cells in the pancreas

Function: works as a key that opens the cells for glucose to

enter. Regulates glucose levels in the blood

5%-10% of all diagnosed cases of diabetes Also known as juvenile diabetes mellitus or insulin

dependent diabetes mellitus [IDDM] Autoimmune disease: Risk factors

Genetics Exposure to viral infections and other environmental

toxins Who is at risk:

Lean, young individuals however there are adults that present the same disease – latent autoimmune diabetes in adults [LADA]

Treatment - insulin

1) Food enters the system and is digested in to simpler units, [one being glucose]

2) Glucose enters the blood stream

3) Insulin is produced by the pancreas and is released into the blood stream.

4) Insulin binds to the cell allowing glucose to enter

1) Food enters the system and is digested in to simpler units, [one being glucose]

2) Glucose enters the blood stream

3) Insulin is produced by the pancreas and is released into the blood stream.

4) Insulin binds to the cell allowing glucose to enter

1) Food enters the system and is digested in to simpler units, [one being glucose]

2) Glucose enters the blood stream

3) Little or no insulin is produced by the pancreas and is released into the blood stream.

4) Glucose accumulates in the bloodstream.

90%-95% of all diagnosed cases Commonly known as adult onset diabetes

mellitus or non-insulin dependent diabetes mellitus [NIDDM]

The cells of the body lack sensitivity to insulin

Type 2 diabetes mellitus is first treated with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugars, oral medications are used.. Increase the insulin output by the pancreas Decrease the amount of glucose released from the liver Increase the sensitivity (response) of cells to insulin Decrease the absorption of carbohydrates from the

intestine

South Carolina Prevalence Data

Income Prevalence %

Less than $15,000

15.7

$15,000-24,999 10.7

$25,000-34,999 9.0

$35,000-49,000 6.9

$50,000+ 4.5

Other problems that may occur:

Heart disease and stroke High blood pressure Nervous system disease Dental disease Complication in pregnancy Atherosclerotic trouble Kidney failure Blindness Chronic pain Proteins may be knocked out Too much/too little insulin

Some symptoms: •Frequent urination •Increased fatigue •Excessive thirst •Irritability •Extreme hunger •Blurry vision •Unusual weight loss

How does How does stressstress affect affect this disease?this disease?

During acute stress:Epinephrine released

Liver

Increased Gluconeogenesis

IncreasedGlycogenolysis

Increased Blood glucose

Decreased Glycogen synthesis

Increased lypolysis of triglycerides

Increased circulating free

fatty acids

Pancreas

Decreased insulin

Increased glucagon

Decreased glucose uptake in skeletal

muscle and peripheral tissues

Cortisol

Liver

Increased gluconeogenesis

Increased blood

glucose

Promotes lipolysis in extremities

During chronic stress:

More glucose and fatty acids in the blood stream They gum up in the wrong places glucocorticoids promote insulin resistance in fat

cells Fat cells release another hormone that promote

insulin resistance in other tissues [muscle and liver]

What factors are What factors are stressfulstressful for for

individuals with individuals with diabetes??diabetes??

In children: Family conflict and dysfunction

Predictive of adherence difficulty Family support, cohesion and organization

Better adherence and metabolic control Patient-physician relationship

Those who discontinue tend to be in poorer health

Depression and anxiety is associated with poor management of the disease

Alienated, opportunistic, and explosive temperaments were in poorer glucose control

Beliefs: [about symptoms, severity of disease, vulnerability to negative consequences treatment benefits and costs, perceived ability to successfully perform self-care tasks] – self efficacy

Following a prescribed diet Following a prescribed diet and set mealtimesand set mealtimes

Monitoring blood glucose Monitoring blood glucose levelslevels

Making sure to eat and Making sure to eat and exerciseexercise

Taking medications [1 to 4 Taking medications [1 to 4 insulin shots daily]insulin shots daily]

Pricking one’s finger for Pricking one’s finger for testing glucose levelstesting glucose levels

time consuming and irritatingtime consuming and irritating Having to stop smoking and Having to stop smoking and

consuming alcoholconsuming alcohol

The diagnosis usually comes as a The diagnosis usually comes as a shock and is a stressor in and of shock and is a stressor in and of itselfitself Psychosocial impact:Psychosocial impact:

Depression / anxiety / social withdrawalDepression / anxiety / social withdrawal Fear of hypoglycemia (low blood Fear of hypoglycemia (low blood

sugars)sugars) Feeling of guilt and shame when Feeling of guilt and shame when

hyperglycemia occurshyperglycemia occurs Fears of future medical Fears of future medical

complicationscomplications Feeling of being different Feeling of being different Feeling of dependence and Feeling of dependence and

vulnerabilityvulnerability

Coping with diabetes

•Role of perception•Control and self efficacy•Relationship between coping styles and health outcomes in youths with type I diabetes•Avoidance coping – “tell yourself that the problem is not important” – try to stay away from home as much as possible•Ventilation coping – “blame others” – get angry about it

Tara W. Strine: -study

People with diabetes that suffer from any sort of depression or emotional problems are more likely to smoke to ease off their tensions Have high cholesterol High blood pressure Avoid exercise – running, calisthenics, golf,

gardening or walking – leading to obesity They tend to experience 4 or more of 5 major

risk factors for heart diseasehttp://www.hindustantimes.com/news/181_986616,00500020.htm