Simplyfying Diabetes by Dr. SK Wangnoo on 30 - Slide 1
Transcript of Simplyfying Diabetes by Dr. SK Wangnoo on 30 - Slide 1
SIMPLYFYING DIABETES
Dr. S. K. WangnooApollo Centre for Obesity, Diabetes and
Endocrinology (ACODE)Apollo Hospital, New Delhi
WHAT IS DIABETES
• Commonly known as having Sugar Diabetes or Madhumeh in Hindi.
• It is a disease in which the body either does not produce enough insulin or is unable to use the insulin the way it should be.
• Insulin is a hormone produced in the pancreas, that helps the body to convert the glucose into energy.
Types of Diabetes
• TYPE 1 OR INSULIN DEPENDENT DIABETES.
• TYPE 2 OR NON INSULIN DEPENDENT • GESTATIONAL DIABETES
Symptoms of Diabetes
• Many Patients are asymptomatic• Symptoms when present are:
– Polyuria (excessive urination)– Polydipsia (excessive thirst)– Polyphagia (excessive appetite)– Unexplained weight loss– Recurrent intermittent blurred vision.– Generalized pruritis or vulvo vaginitis– Peripheral neuropathy– Sexual dysfunction such as ED.– Recurrent skin infections
Diagnosis:
• Fasting plasma glucose 126 or above on at least 2 separate occasions.
• Random plasma glucose of 200 mg/dl or more on 2 separate occasions.
• Abnormal GTT (Plasma Glucose of 200 mg or more at 2 hours)
Risk factors :
• Age 45 and over• Family Hx ( first degree relatives with type 2)• Ethnicity ( African American, Hispanic, South
Asian, Pacific Islander, and Native American)• Hx of gestational diabetes.• Delivery of infants weighing 9 or more lbs.• Polycystic Ovary Syndrome ( PCOS )• Overweight esp. with abdominal obesity• Presence of cardio vascular disease, hypertension,
impaired glucose• Physical inactivity
What is Pre-Diabetes?
• Fasting Blood sugar 110 to 125 mg% on 2• separate occasions• 2 hour OGTT 140 to 199 mg%• Usually asymptomatic
What is Significance of detecting Pre-diabetes?• Converts to diabetes in 4 to 7 years• Can be delayed with life style changes and weight loss of 5 to 10% of body weight• Medication use may be indicated• Early treatment can delay complications from diabetes
How Bad is Type 2 Diabetes, Really?
• Increases your risk of….– Heart disease, high
blood pressure and stroke by about two times.
– Other complications include blindness, numbness, amputation, impotence, and kidney failure!
SYMPTOMS OF HYPOGLYCEMIA
• Confusion• Blurred vision or double vision• Anxiety and tremulousness• Sweating and cold and clammy hands• Light headedness or fainting• Rapid pulse / heart rate• Seizures or convulsion
Symptoms of Hyperglycemia
• Polyuria and polydypsia• Marked fatigue• Nausea / vomiting• Mental stupor progressing to coma if• Untreated• Fruity smell in breath• Serious complication is Diabetic Ketoacidosis
TREATMENT OPTIONS
• LIFE STYLE CHANGES• WEIGHT REDUCTION• DIET• DIET + EXERCISE• DIET + EXERCISE + MEDICINES
REGULAR MONITORING
• Weight• BP• Foot examinations• Pulse rate• Sores, calluses• Test for sensations
• Annual eye exams by ophthalmologist
• Hemoglobin A1C every 3 to 6 months
• Annual fasting lipid panels• Urine test for presence of
proteins
Public Awareness
Survey on 2,000 People with Diabetes (Fall 2001)
• Findings:– 68% do not consider cardiovascular disease to be
complication of diabetes– 50%+ don’t feel risk for heart condition or stroke– 60% don’t feel at risk for high blood pressure or cholesterol– Awareness lowest among elderly, minorities
The Good News…
• By managing the ABCs of diabetes, people with diabetes can reduce their risk for heart disease and stroke.
A stands for A1CB stands for Blood pressureC stands for CholesterolD stands for diet and lifestyle changesE stands for exercise
Ask About Your A1C
• A1C measures average blood glucose over the last three months.
• Get your A1C checked at least twice a year.
A1C Goal = less than 7%
Key Steps for Lowering A1C
• Eat the right foods.
• Get daily physical activity.
• Test blood glucose regularly.
• Take medications as prescribed.
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 BP = less than 130/80
Key Steps for Lowering Blood Pressure
• Eat more fruits and vegetables!• Reduce the amount of salt in diet.• Lose weight.• Lower alcohol intake.• Quit smoking.• Take blood pressure pills.
– many people require more than one pill
Check Your Cholesterol
• Several kinds of blood fats:– LDL (“bad”) cholesterol - can narrow or
block blood vessels– HDL (“good”) cholesterol - helps remove
cholesterol deposits– Triglycerides - can raise your risk for heart
attacks/stroke
ADA Goals for Cholesterol
Target LDL = less than 100
Target HDL = above 40 (men)
above 50 (women)
Target triglycerides = less than 150
Key Steps for Controlling Your Cholesterol
• Eat less saturated fatFoods high in saturated fat: fatty meats, high-fat dairy
products, tropical oils• Eat foods high in fiber
Examples: oatmeal, beans, peas, citrus fruits
• Take cholesterol-lowering medication• Exercise regularly
Exercise
A little bit goes a long way:• Try being more active throughout the day.
Examples: work in the garden, play with the kids, take the stairs
• Walk - work up to at least 30 minutes of walking on most days; you can even split this into a 10-minute walk after each meal.
Other Strategies
• Get help to quit smoking.
• Talk to your health care provider about taking aspirin and other medications to reduce your risk for heart disease and stroke.
Managing Medications
On managing your medications:
• Ask when to take each medicine; make sure instructions and labels are clear.
• Link as many medicines as possible to recurring daily events – getting up, eating, brushing teeth, bedtime.
• Put a reminder note where you’ll see it.
• Set your watch, computer, or a kitchen timer as a reminder.
• Use a daily or weekly pill box.
• Make a chart showing when each medicine should be taken.
• Talk to your health care provider about what you should do if you miss a dose.
General Tips
Take steps to lower your risk of complications:– A1C < 7.– Blood pressure < 130/80.– Cholesterol (LDL) < 100. – Cholesterol (HDL) > 40 (men) and > 50 (women).– Triglycerides < 150.– Get help to quit smoking.– Be active.– Make healthy food choices.– Talk to your doctor about medication.
Thanks!