What is Diabetes?
Dec 24, 2015
What is Diabetes?
Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Definition of Diabetes
Diabetes is a disease in which the body does not produce or properly use the hormone insulin.
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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Insulin and Blood Glucose
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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Focus on Blood Glucose
Insulin is required for uptake of glucose (“sugar”) from the blood into cells.
In diabetes, blood glucose levels rise because it can’t get from the blood into the cells.
Consistently high blood glucose causes many health problems.
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Types of Diabetes
Type 1 diabetes– Onset usually before age 30.– Absolute insulin deficiency.– Destruction of beta cells in pancreas.
Genetic predisposition Environmental factors Auto-immune response
– Dependence on exogenous insulin.
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Type 1 Diabetes: a message from the American Diabetes Association
Types of Diabetes
Type 2 diabetes– Most common in adults over age 40.– Increasing problem in children and
adolescents.– Genetic factor: family history.– Metabolic factor: insulin resistance.– Environmental factors: obesity, physical inactivity,
and poor dietary habits.
Take Charge of Your Diabetes, University of Florida IFAS Extension © 20107
Type 2 Diabetes: a message from the American Diabetes Association
Take Charge of Your Diabetes, University of Florida IFAS Extension © 20108http://professional.diabetes.org/ResourcesForProfessionals.aspx?cid=60378&typ=17
Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes:
The Situation
About 24 million Americans have type 2 diabetes.– About 6 million of these are undiagnosed.
– On average, diabetes is present for 6½ years before diagnosis.
– Usually diagnosed during routine medical exam.
About 57 million Americans are at high risk for diabetes.
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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes:
Risk Factors
Obesity Inactivity Family history
NOTE: About 20% of U.S. adults are obese and sedentary, putting them at high risk for type 2 diabetes.
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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes:
Disease Process
Progressive deterioration of glucose tolerance:Normal glucose tolerance
Impaired glucose tolerance (pre-diabetes)
Diabetes mellitus
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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes:
Health Complications
Chronic high blood glucose (hyperglycemia) can lead to:– Retinopathy (eye disease)
– Nerve damage and amputations
– Nephropathy (kidney disease)
– Stroke major cause of death
– Heart attack major cause of death
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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes:
Causes of Hyperglycemia
Insulin resistance Insulin secretory dysfunction
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Diagram of insulin crystals
Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes: Insulin Resistance
Decreased ability to use insulin. Part of a group of conditions called
the metabolic syndrome. Increases risk for atherosclerosis. Pancreas produces more insulin to attempt to
decrease blood glucose.
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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes: Insulin Secretory Dysfunction
Also called defective insulin secretion. Inability to produce enough insulin to
overcome insulin resistance.
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Insulin Resistance and Defective Insulin Secretion
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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes:
The Metabolic Syndrome
Condition exists when person has at least three the following:– Hyperglycemia
– Low level of blood high density lipoprotein cholesterol (HDL)
– Central obesity
– High blood triglycerides
– High blood pressure
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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes:
Treatment Approach
Best defenses against health complications: WEIGHT LOSS and PHYSICAL ACTIVITY!
Best approach is concurrent management of:– Blood glucose– Blood pressure– Blood lipids– Body weight– Physical activity
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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes: Diabetes Management Plan
To reduce risk of complications by achieving optimal:
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blood glucose
blood pressure
blood lipids
Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Tighter Control Improves Health Outcomes
Two major and several smaller research studies over 20 years.
Type 1 and type 2 diabetes studied. Subjects with tightly controlled
blood glucose decreased risk of complications.
Even small improvement in A1C decreased risk!
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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
TCYD Participants Decrease A1C
Pilot of TCYD in three Florida counties. Participants increased knowledge, improved
lifestyle behaviors, and monitored blood glucose regularly.
Average A1C decreased from 7.2% to 6.2%. Average systolic blood pressure decreased from
142 mmHg to 133 mmHg. You can do it too!
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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes: Treatment Goals
Blood glucose– Fasting blood glucose: 70 to 130 mg/dl
– Postprandial (2 hrs after first bite of meal or snack): less than 180 mg/dl
– Hemoglobin A1C: less than 7%
NOTE: Your physician may suggest more or less stringent goals.
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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes: Treatment Goals
Blood Lipids– LDL cholesterol: less than 100 mg/dl– HDL cholesterol: over 40 mg/dl (men)
over 50 mg/dl (women)– Triglycerides: less than 150 mg/dl
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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes: Treatment Goals
Blood Pressure
– Under 130/80 mmHg
NOTE: Your physician may suggest a more stringent goal.
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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Type 2 Diabetes:
Treatment Plan
Proper nutrition Weight management Regular physical activity Medication, if needed
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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010
Living Well With Type 2 Diabetes
The path to living well includes:
Acceptance
Education
Motivation
Commitment
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Prepared by:
Nancy Gal, Extension Agent IVMarion County - University of Florida IFAS Extension
Linda Bobroff, Professor and Extension Nutrition SpecialistUniversity of Florida
Updated 2010
What is Diabetes?