Diabetes ABCs

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Provided Courtesy of RD411.com Where health care
professionals go for information
Diabetes ABCs
Review Date 8/09 D-0549
Contributed by Shawna Gornick-Ilagan, MS, RD, CWPC
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Disclaimer

• This presentation should not substitute or
  replace any medical advice prescribed by your
  doctor
• The presentation is meant to provide you with
  general health information to empower you and
  your family to prevent or manage diabetes

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Objectives

• What is diabetes?
• What are my risks of getting it?
• How can I prevent diabetes?
• How do I manage diabetes if I get it?
• What do the ABCs stand for?

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What Is Diabetes

• Diabetes is a condition in which the body is
  unable to properly utilize blood sugar

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Whats Your Diabetes IQ?
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Diabetes IQ Test

• Every 24 hours
• More than 1000 adults are diagnosed with diabetes
• More than 2000 adults are diagnosed with diabetes
• More than 3000 adults are diagnosed with diabetes
• More than 4000 adults are diagnosed with diabetes

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Diabetes IQ Test

• Every 24 hours
• About 10 children and adolescents are diagnosed
  with type 1 diabetes
• About 20 children and adolescents are diagnosed
  with type 1 diabetes
• About 30 children and adolescents are diagnosed
  with type 1 diabetes
• About 40 children and adolescents are diagnosed
  with type 1 diabetes

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Diabetes IQ Test

• Every 24 hours
• 2 children and adolescents are diagnosed with
  type 2 diabetes
• 5 children and adolescents are diagnosed with
  type 2 diabetes
• 8 children and adolescents are diagnosed with
  type 2 diabetes
• 10 children and adolescents are diagnosed with
  type 2 diabetes

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Diabetes IQ Test

• Every 24 hours
• Approximately 50 people die from diabetes
• Approximately 100 people die from diabetes
• Approximately 150 people die from diabetes
• Approximately 200 people die from diabetes

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Diabetes IQ Test

• Every 24 hours
• 50 people with diabetes have a nontraumatic
  lower-limb amputation
• 100 people with diabetes have a nontraumatic
  lower-limb amputation
• 150 people with diabetes have a nontraumatic
  lower-limb amputation
• 200 people with diabetes have a nontraumatic
  lower-limb amputation

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Diabetes IQ Test

• Every 24 hours
• About 30 people with diabetes develop kidney
  failure
• About 60 people with diabetes develop kidney
  failure
• About 90 people with diabetes develop kidney
  failure
• About 130 people with diabetes develop kidney
  failure

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Diabetes IQ Test

• Every 24 hours
• Nearly 5 adults with diabetes go blind
• Nearly 15 adults with diabetes go blind
• Nearly 25 adults with diabetes go blind
• Nearly 50 adults with diabetes go blind

Quiz derived from information found at
http//www.cec.gov/features/livingwithdiabetes/
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Answer Key

• The correct answer for all questions d.
• Over the years, high blood glucose
  (hyperglycemia) damages nerves and blood vessels,
  leading to complications such as
• Heart disease
• Stroke
• Kidney disease
• Blindness
• Nerve problems
• Gum infections
• Amputation

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What Are the Symptoms?

• Some people do not have symptoms
• Other people have experienced these symptoms
• Increased thirst
• Increased urination
• Weight loss without trying
• Blurred vision
• Increased hunger
• Increased fatigue

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Types of Diabetes

• The three types of diabetes
• Type 1 (juvenile diabetes, insulin dependent
  5-10
• Type 2 (adult onset, noninsulin dependent)
  90-95
• Gestational diabetes (diabetes during pregnancy)
  2-5
• Prediabetes
• Centers for Disease Control estimates that 57
  million Americans age 20 have prediabetes

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Normal Process
Insulin
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Diabetes Type 1
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Diabetes Type 2
Insulin
Fat
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Diabetes Type 2 (Over Time)
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Type 1 Diabetes Risk Factors

• Family history of type 1 diabetes 10-15
• Race White people have a greater risk
• Presence of islet cell antibodies in the blood
• Prevention
• Currently no way to prevent type 1 diabetes
• Can prevent or delay the development of
  complications, such as
• Vision, kidney, or heart failure
• Blood vessel and nerve diseases
• Prevention Keep blood sugar near normal levels

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Type 2 Diabetes Risk Factors

• Risk factors that you can not control
• Family history
• Age
• Race
• History of gestational diabetes
• Risk factors that you can control
• Lose weight if overweight
• Eat healthy and exercise
• Quit smoking
• Get treatment if you have prediabetes, high blood
  pressure, or high cholesterol

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Gestational Diabetes

• Stay at a healthy weight and do not gain too much
  weight during pregnancy
• Exercise regularly to help keep your blood sugar
  level within a safe range and to prevent
  gestational diabetes

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Weight Gain During Pregnancy
Category Weight Gain Recommendations
If you began pregnancy at a normal weight 2535 pounds
If you began pregnancy underweight 2840 pounds
If you began pregnancy overweight 1525 pounds
If you are expecting twins 3545 pounds
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How Is It Diagnosed?

• Fasting plasma glucose Must fast for 8 hours or
  more

Plasma Glucose Results (mg/dL) Diagnosis
99 or below Normal
100-125 Prediabetes
126 or above Diabetes
dLdeciliter, mgmilligram
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Glucose Testing Recommendations

• Blood glucose
• During a regular physical
• Symptoms suggesting hyperglycemia or hypoglycemia
• During pregnancy
• Diabetic
• Starting at age 45 and every 3 years if normal
  results

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Prediabetes
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Prediabetes
Is prediabetes the same as impaired glucose
tolerance or impaired fasting? Yes Doctors
sometimes refer to this state of elevated blood
glucose levels as impaired glucose tolerance or
impaired fasting glucose (IGT/IFG), depending on
which test was used to detect it
Source American Diabetes Association. Frequently
asked questions about pre-diabetes. Available at
http//www.diabetes.org/pre-diabetes/faq.jsp.
Accessed September 10, 2009.
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Good News

• Type 2 diabetes is preventable if you catch it
  early and make some changes in your lifestyle

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85-90 of Diabetes Is Preventable
Preventable
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Diabetes Type 2
Insulin
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Bad News

• Type 2 diabetes is a condition that consumes
  your
• Time
• Money
• Energy

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How to Prevent Type 2 Diabetes

• Maintaining a healthy weight
• Increasing fruit and vegetable consumption
• Increasing fiber intake
• Decreasing fat intake
• Exercising
• Breastfeeding infants
• 20 less likely to have diabetes and high
  cholesterol

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Tips to Maintain a Healthy Weight

• Do not drink calories
• Eat slowly
• Stay hydrated
• Try the low-fat or nonfat version of foods
• Change habits
• Eat three meals each day
• Focus on fruits and vegetables
• Get enough fiber

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Tips to Maintain a Healthy Weight

• Fruits and vegetables
• Canned or frozen
• Frozen grapes
• Prepackaged
• Microwaveable
• Low-fat dip
• 5 servings/day

• Dietary fiber
• Beans
• Oatmeal
• Whole grain
• Pastas
• Cereals
• Breads
• Adults need 25-35 grams (g)/day children older
  than age 3 need their age plus 5 g (minimum
  recommendation)

Source Dwyer JT. Dietary fiber for children how
much? Pediatrics (serial online).
1995961019-1022. Available at
http//www.diabetes.org/pre-diabetes/faq.jsp.
Accessed September 10, 2009
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Exercise Regularly

• Exercise regularly to help raise your
  high-density lipoprotein (HDL), the good
  cholesterol, and lower your low-density
  lipoprotein (LDL), the bad cholesterol
• Aim for 30 minutes of activity or more on most
  days of the week

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Decrease Saturated and Trans Fats
Type of Harmful Fat Food Source
Saturated fat Animal products, such as meat, poultry, seafood, eggs, dairy products, lard, and butter Coconut, palm, and other tropical oils
Trans fat Partially hydrogenated vegetable oils Commercial baked goods, such as crackers, cookies, and cakes Fried foods, such as doughnuts and French fries Shortening and margarine
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Opt for Healthy Fats
Type of Healthy Fat Food Source
Monounsaturated fat Olive oil, peanut oil, and canola oil Avocados Nuts and seeds
Polyunsaturated fat Vegetable oils, such as safflower, corn, sunflower, soy, and cottonseed oils Nuts and seeds
Omega-3 fatty acids Fatty cold-water fish, such as salmon, mackerel, and herring Flaxseeds and flax oil Walnuts
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Know Where to Look

• Lose weightcalories
• Lower cholesterolsaturated and trans fats
• Manage glucosetotal carbohydrate

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The Good News

• By managing the ABCs of diabetes, people with
  diabetes can reduce their risk of heart disease
  and stroke
• A stands for A1c
• B stands for body mass index (BMI) and blood
  pressure
• C stands for cholesterol

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A Ask About Your A1c
A1c Reading Average Blood Sugar Level
6 135 mg/dL
7 170 mg/dL
8 205 mg/dL
9 240 mg/dL
10 275 mg/dL
11 310 mg/dL
12 345 mg/dL

• A1c measures average blood glucose over the last
  3 months
• Get your A1c checked at least twice/year

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Healthy Plate Format

• One fourth plate starch
• One fourth plate meat
• One half plate nonstarchy vegetables
• 8 fluid ounces of reduced-fat milk
• One serving of fruit

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Cereal or Grain

• 15 g of carbohydrateone serving
• One cereal or grain serving is
• One slide of bread
• One half of a hamburger bun
• ¾ cup (C) of unsweetened cereal
• ? C cooked pasta
• 3 C popcorn
• ½ C cooked oatmeal

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Fruit

• 15 g of carbohydrateone serving
• One fruit serving is
• ? C of fruit juice
• ½ C of canned fruit
• One small piece of fruit, such as an apple

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Milk or Dairy

• 15 g of carbohydrateone serving
• One milk or dairy serving is
• 1 C of milk
• 6 ounces of yogurt

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Starch or Vegetables

• 15 g of carbohydrateone serving
• One starch or vegetable serving is
• ? C of beans
• ½ C of corn or peas
• ½ C of mashed potatoes

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Quick Reference Chart for Eating With Diabetes
Number of Exchanges/Day for Various Calorie Levels Number of Exchanges/Day for Various Calorie Levels Number of Exchanges/Day for Various Calorie Levels Number of Exchanges/Day for Various Calorie Levels Number of Exchanges/Day for Various Calorie Levels Number of Exchanges/Day for Various Calorie Levels
Calories 1200 1500 1800 2000 2200
Starch/Bread 5 8 10 11 13
Meat 4 5 7 8 8
Vegetable 2 3 3 4 4
Fruit 3 3 3 3 3
Milk 2 2 2 2 2
Fat 3 3 3 4 5
Source University of Maryland Medical Center.
Diabetes dietdiabetic exchange lists. Available
at http//www.umm.edu/patiented/articles/what_gen
eral_guidelines_heart-healthy_diets_000042_5.htm.
Accessed September 10, 2009.
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B BMI

• BMI is a number calculated from a persons weight
  and height
• Higher BMI values are associated with risk for
  health problems
• BMI goalless than 25
• More information at http//www.cdc.gov/healthyweig
  ht/assessing/bmi/

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BMI (kg/m2) 19 20 21 22 23 24 25 26 27 28 29 30 35 40
Height Normal Weight Normal Weight Normal Weight Normal Weight Normal Weight Normal Weight Increased Risk Increased Risk Increased Risk Increased Risk Increased Risk High Risk High Risk High Risk
58 91 96 100 105 110 115 119 124 129 134 138 143 167 191
59 94 99 104 109 114 119 124 128 133 138 143 148 173 198
60 97 102 107 112 118 123 128 133 138 143 148 153 179 204
61 100 106 111 116 122 127 132 137 143 148 153 158 185 211
62 104 109 115 120 126 131 136 142 147 153 158 164 191 218
63 107 113 118 124 130 135 141 146 152 158 163 169 197 225
64 110 116 122 128 134 140 145 151 157 163 169 174 204 232
65 114 120 126 132 138 144 150 156 162 168 174 180 210 240
66 118 124 130 136 142 148 155 161 167 173 179 186 216 247
67 121 127 134 140 146 153 159 166 172 178 185 191 223 255
68 125 131 138 144 151 158 164 171 177 184 190 197 230 262
69 128 135 142 149 155 162 169 176 182 189 196 203 236 270
70 132 139 146 153 160 167 174 181 188 195 202 207 243 278
71 136 143 150 157 165 172 179 186 193 200 208 215 250 286
72 140 147 154 162 169 177 184 191 199 206 213 221 258 294
73 144 151 159 166 174 182 189 197 204 212 219 227 265 302
74 148 155 163 171 179 186 194 202 210 218 225 233 272 311
75 152 160 168 176 184 192 200 208 216 224 232 240 279 319
76 156 164 172 180 189 197 205 213 221 230 238 246 287 328
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B Beware of Your Blood Pressure

• High blood pressure raises your risk for heart
  attack, stroke, eye problems, and kidney disease
• Get your blood pressure checked at every visit
• Target blood pressureless than 130/80

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Key Steps for Lowering Blood Pressure

• Lose weight
• Eat more fruits and vegetables
• Reduce the amount of salt in diet
• Lower alcohol intake
• Quit smoking
• Take blood pressure pills, if prescribed
• Many people require more than one pill

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C Check Your Cholesterol

• Several kinds of blood fats
• Total and LDL (lousy) cholesterolcan narrow or
  block vessels
• HDL (healthy) cholesterolhelps remove
  cholesterol deposits
• Triglyceridescan raise your risk for heart
  attack/stroke

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Know Your Numbers
Value Goals
A1c Less than 7
Blood pressure Less than 130/80
Total cholesterol Less than 200
LDL cholesterol Less than 100
HDL cholesterol Greater than 40 (men) Greater than 50 (women)
Triglycerides Less than 150