Diabetes:

What You Should Know and

What You Can Do

What is Diabetes?

• Diabetes Mellitus is a disease in which the body has problems using ingested carbohydrates for energy because the glucose generated from carbohydrates cannot get into the cells of the body

• A hormone called insulin is needed for glucose to enter cells; the pancreas produces this hormone

• Diabetes can result from decreased or no production of insulin by the pancreas, or from a decreased response to insulin by the cells of the body

Types of Diabetes: Type I

• Also called Juvenile Diabetes

• It results from a total lack of insulin production by the pancreas

• It is usually diagnosed in childhood, and treated with insulin injections

Types of Diabetes: Type II

• Also called Adult-Onset Diabetes• It usually occurs later in life, and results from a

decreased production of insulin by the pancreas, or a decreased cellular response to insulin (termed insulin resistance)

• Obesity is a risk factor• Many people are able to control this type of

diabetes through diet and exercise!• This is the type of diabetes that we will focus on

today

Consequences of Uncontrolled Diabetes

• Uncontrolled diabetes leads to too much glucose in the blood because the glucose you eat cannot get into your cells

• This excess glucose can bind to proteins that are a part of cells within many organs of the body, causing structural changes that can result in damage to blood vessels and nerves, and thus importantly to the kidneys, the heart, and the eyes

• It also increases the chances of getting many different kinds of infections

Infections

• Too much blood glucose provides lots of nutrients for microorganisms like bacteria and fungi to grow and reproduce, leading to increased incidence of infections

• This slide shows an infection of the urinary tract by Candida, a fungi

Cataracts

• When there is too much glucose in the blood, excess glucose can accumulate in the lens of the eye and be converted to sorbitol

• This sorbitol then causes the lens to swell, resulting in cataracts

Kidney Damage

• Glucose attachment to proteins within the cells of the kidney can cause these cells to swell, thicken, and deposit fibrous tissue

• This leads to problems with blood filtration

• Over time, filtering units can “blow out,” and scar tissue will be deposited instead

• Kidney failure commonly results

Clogged Blood Vessels

• High levels of glucose in the blood can cause an increased deposition of plaque on the inside of blood vessels

• This can lead to high blood pressure

• It can also lead to tissue death due to decreased blood flow (ulcer formation on the skin is one example)

Heart Attacks

• Increased clogging of blood vessels can lead to a much greater risk of having a heart attack

• In fact, the most common cause of diabetes-related death is heart attacks!

Gangrene and Ulceration

Control of Diabetes: Drugs

• If there is no response to dietary and lifestyle changes, insulin injections or blood glucose lowering drugs may be prescribed

• Most of the time, Type II Diabetes can be controlled with diet and exercise, so drugs are viewed as a last resort!

Control of Diabetes: Exercise

• The ability of cells of the body to take in glucose is increased after exercise

• For this reason, daily activity is very helpful for controlling blood glucose levels

• Exercise also aids weight loss, which has been shown to help control Type II Diabetes by lowering insulin resistance

Control of Diabetes: Nutrition

• One of the most important ways to control Type II Diabetes is through nutrition

• The main objective of dietary modifications is to maintain stable blood glucose levels

Diet: Maintaining Stable Blood Glucose Levels

• One way to help maintain stable blood glucose levels is to eat a greater number of smaller meals throughout the day, to avoid overloading your body with glucose all at once

• Overeating in general should be avoided, especially the overeating of carbohydrates

• Another way to help maintain stable blood glucose levels is by slowing down the absorption of glucose from the intestine by increasing the time needed for carbohydrate digestion

Diet: Maintaining Stable Blood Glucose Levels

Increasing Glucose Absorption Time

• Eating mixed meals, which combine carbohydrates, protein, and some “healthy” fats, increases absorption time

• So does eating fiber-rich, “complex” carbohydrates (like whole grains, fruits, and veggies) instead of “simple” carbohydrates (like sugar and white bread)

Diabetes and Alcohol

• Alcohol aggravates many symptoms of diabetes:– Since alcohol is toxic to

nerves, it can makes diabetic neuropathy, and thus loss of sensation, even worse

– It can also make diabetes-related hypertension worse, since alcohol consumption is linked to high blood pressure