Alam na ng langgam, Alam mo ba

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Alam na ng langgam, Alam mo ba?

• Recognizing the Signs and Symptoms of Diabetes

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Diabetes Mellitus Increasing Prevalence of
Diagnosed Cases
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Diabetes MellitusHealth Impact of the Disease
Diabetes is the no. 1 cause of renal failure,
new cases of blindness, and nontraumatic
amputations
Diabetes Statistics. October 1995 (updated 1997).
NIDDK publication NIH 96-3926. Harris MI. In
Diabetes in America. 2nd ed. 19951-13.
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What is diabetes?

• Diabetes is a disease wherein
• The body is unable to properly use
  and store glucose (a form of sugar).
• Glucose backs up into the bloodstream
  causing your blood glucose or "sugar"
  to rise too high

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NORMAL

• KUMPLETO ANG MANGGAGAWA AT LAHAT AY NAGTATRABAHO
• LAHAT AY GUMAGAWA NG INSULIN

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There are two major types of
diabetes

• Type 1 (also called juvenile-onset or
  insulin-dependent) diabetes
• The body completely stops producing
  any insulin
• The patient must take daily insulin
  injections to survive
• It usually develops in children or young
  adults

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Causes of Diabetes
Peripheral Tissues (Muscle)
Receptor postreceptor defects
Insulin resistance
Glucose
Liver
Increased glucose production
Pancreas
Impaired insulin secretion
Saltiel AR, Olefsky JM. Diabetes.
1996451661-1669.
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DIABETES TYPE 1

• KULANG ANG MANGGAGAWA (ng insulin)
• KULANG SA PRODUKSYON NG INSULIN

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There are two major types of diabetes

• Type 2 (also called adult-onset or non
  insulin-dependent) diabetes
• The body produces insulin but not enough
  to properly convert food into energy
• usually occurs in people who
• Are over 40 years old
• Are overweight
• Have a family history of diabetes.

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Causes of Diabetes
Saltiel AR, Olefsky JM. Diabetes.
1996451661-1669.
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DIABETES TYPE 2

• KUMPLETO ANG MANGGAGAWA PERO HINDI LAHAT MAY
  GINAGAWA (na insulin)
• AYAW GUMAWA NG INSULIN
• AYAW I-PROCESO ANG INSULIN

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Who May Get Diabetes?
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• Diabetes can happen to anyone but the
  following are more likely to develop
  diabetes
• Those who have close relatives with diabetes
• Those who are over 40 years old
• Overweight people
• Those with an Asian heritage
• Women who develop diabetes while pregnant
  (gestational diabetes)

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How will we know if we have diabetes?
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• People with diabetes may experience the
  following symptoms
• Being very thirsty
• Having to go to the bathroom very
  frequently to urinate
• Unexplained weight loss
• Increased hunger

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• People with diabetes may experience the
  following symptoms
• Blurry vision
• Irritability
• Tingling or numbness in the hands or feet
• Frequent skin, bladder or gum infections
• Wounds that don't heal
• Extreme unexplained fatigue / tiredness

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• In some cases, there are no symptoms!

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How is Diabetes Diagnosed?

• All individuals aged 45 years and above
  should be tested for diabetes
• If normal, they should be re-tested
  every three years.

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Testing should be conducted earlier and more
frequently in the following

• Overweight people
• Those with a first degree relative who has
  diabetes
• Members of a high-risk ethnic population (African
  American, Hispanic, Native American, Asian)
• Women who delivered a baby weighing more than 9
  pounds

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Testing should be conducted earlier and more
frequently in the following

• Women who had gestational diabetes
• Those who have HDL cholesterol levels equal to or
  less than 35 mg/dl or triglyceride levels equal
  to or greater than 250 mg/dl
• Those who have high blood pressure
• Those who had impaired glucose tolerance or
  impaired fasting glucose

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How is Diabetes Diagnosed?

• Fasting plasma glucose is above 126 mg/dl
• Diabetes symptoms exist and casual plasma glucose
  is equal to or above 200 mg/dl or
• Plasma glucose is equal to or above 200 mg/dl
  during an oral glucose tolerance test.
• Testing should be repeated on a different day to
  confirm the diagnosis.
• If a casual plasma glucose equal to 200 mg/dl or
  above is detected, the confirming test used
  should be a fasting plasma glucose or an oral
  glucose tolerance test.

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Criteria for the Diagnosis of Diabetes 1997 ADA
Guidelines
Plasma Glucose Level (mg/dL)
Stage of Glycemic Control
OGTT (2-hr Postload Glucose)
Fasting Plasma Glucose
lt110
lt140
Normal
IFGorIGT
110 125
140 199
³126
³200
Diabetes
Third criterion ³200 mg/dL casual plasma
glucose (regardless of time since last meal) plus
symptoms of diabetes (polyuria, polydipsia,
unexplained weight loss)
ADA. Diabetes Care.1997201183-1197.
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What is Borderline Diabetes?

• Impaired fasting glucose.
• Fasting plasma blood glucose in the 110-125 mg/dl
  range
• If your blood glucose two hours after the oral
  glucose tolerance test is between 140-199 mg/dl

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What Should I Eat?

• It's not so much "what" you should eat but how
  much
• If overweight, lose weight.
• Eating more foods that are broiled and fewer
  foods that are fried.
• Cutting back on butter or oil in cooking.
• Eating fish and chicken more often and only lean
  cuts of beef and pork
• Eating more meatless meals
• Begin an exercise program,
• exercise will help you use the insulin you
  produce to convert the food you eat into energy
• this will help keep your blood sugars lower

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Can diabetes be prevented?

• Research suggests that type 2 diabetes risk can
  be lowered by as much as 58 through a program of
  moderate sustained weight loss and moderate daily
  exercise.
• Metformin, a medication used to treat type 2
  diabetes, has been shown to lower diabetes risk
  by 31.

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What other problems can
diabetes cause?

• Poorly managed diabetes can lead to long-term
  complications
• Heart attacks
• Strokes (brain attack)
• Blindness
• Kidney failure
• Blood vessel disease that may require
  amputation of a limb
• Nerve damage
• Impotence in men

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If people keep their blood sugars as
close to normal as possible, they can
reduce their risk of developing some of
these complications by 50 percent
or more.
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Davies MJ. Circulation. 1996942013-2020.
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ADA Targets for Glycemic Control and Recommended
Action Levels

• Biochemical Index

Goal
Action Suggested
FPG (preprandial), mg/dL Bedtime glucose,
mg/dL HbA1c,
gt140 gt160 gt8
80 - 120 100 - 140 lt7
Values are for nonpregnant individuals
ADA. Diabetes Care. 199720(suppl 1)S5-S13.
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• The Philippine College of Physicians wishes to
  acknowledge the following for their invaluable
  contribution in the preparation of this module
• Institute for the Study of Diabetes Foundation
  (ISDF)
• American Diabetes Association (ADA)
• James Wee, MD, FPCP