Diabetes in America: A Public Health Epidemic

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Diabetes in America A Public Health Epidemic
Who? 16 Million Americans (6 of popn) (only
about 2/3 are diagnosed) 7 of Americans have
Impaired Fasting Glucose (IFG gt110-lt125
mg/dl) Disproportionately affects
Minorities African-Americans Latinos,
Hispanics, Asians American Indians Alaska
Natives
1ly Type 2
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New Names, Same Disease
Type 1 Type 2
Type I or Type II IDDM or NIDDM
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Diabetes
Mellitus (passing through (the body)
honey sweet) Definition a metabolic
disorder characterized by altered blood
glucose regulation and utilization, usually
caused by insufficient or relatively
ineffective insulin. Long-term hyperglycemia
Cardiovascular Disease
Microangiopathies (Loss of kidney
fxn retinal degeneration) Neuropath
y (may lead to gangrene loss
of feet or legs)
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New Diagnostic Criteria
FPG gt 126 mg/dl (confirmed by repeat on
different day) Classic Sx casual PG gt 200
mg/dl IFG (Impaired Fasting Glucose) gt110 or
lt126 mg/dl IGT ( Glucose Tolerance) 2
hr postprandial G btw 140-200
mg/dl Screen? Over 45 y/o every 3 yrs Risk
Factors? Yes? Earlier or more often BMIgt27, 1
relative DM, Deliver baby gt 9, High risk ethnic
groups, BP gt140/90, HDL lt 35
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Nutrition Meds client Physical
Activity monitoring
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Goals for Control
(not diagnosis!) Fasting BG and
before meals 80-120 mg/dl One hour after
meals lt180 mg/dl 2 hours after meals lt160
mg/dl Bedtime 100-140 mg/dl Hemoglobin
A1c lt 7 TAKE ACTION LEVELS 140 mg/dl /
8 or gt
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Complications of Diabetes Heart
Disease/ Stroke Relative Risk of Death 2
to 4 High BP (gt140/90) 60-65 with
DM Blindness DM is leading cause of new
cases in 20-74 yo. End-stage Renal Disease DM
causes 40 of new cases.
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