What is Diabetes?

Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Definition of Diabetes

Diabetes is a disease in which the body does not produce or properly use the hormone insulin.

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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Insulin and Blood Glucose

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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Focus on Blood Glucose

Insulin is required for uptake of glucose (“sugar”) from the blood into cells.

In diabetes, blood glucose levels rise because it can’t get from the blood into the cells.

Consistently high blood glucose causes many health problems.

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Types of Diabetes

Type 1 diabetes– Onset usually before age 30.– Absolute insulin deficiency.– Destruction of beta cells in pancreas.

Genetic predisposition Environmental factors Auto-immune response

– Dependence on exogenous insulin.

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Type 1 Diabetes: a message from the American Diabetes Association

Types of Diabetes

Type 2 diabetes– Most common in adults over age 40.– Increasing problem in children and

adolescents.– Genetic factor: family history.– Metabolic factor: insulin resistance.– Environmental factors: obesity, physical inactivity,

and poor dietary habits.

Take Charge of Your Diabetes, University of Florida IFAS Extension © 20107

Type 2 Diabetes: a message from the American Diabetes Association

Take Charge of Your Diabetes, University of Florida IFAS Extension © 20108http://professional.diabetes.org/ResourcesForProfessionals.aspx?cid=60378&typ=17

Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Type 2 Diabetes:

The Situation

About 24 million Americans have type 2 diabetes.– About 6 million of these are undiagnosed.

– On average, diabetes is present for 6½ years before diagnosis.

– Usually diagnosed during routine medical exam.

About 57 million Americans are at high risk for diabetes.

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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Type 2 Diabetes:

Risk Factors

Obesity Inactivity Family history

NOTE: About 20% of U.S. adults are obese and sedentary, putting them at high risk for type 2 diabetes.

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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Type 2 Diabetes:

Disease Process

Progressive deterioration of glucose tolerance:Normal glucose tolerance

Impaired glucose tolerance (pre-diabetes)

Diabetes mellitus

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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Type 2 Diabetes:

Health Complications

Chronic high blood glucose (hyperglycemia) can lead to:– Retinopathy (eye disease)

– Nerve damage and amputations

– Nephropathy (kidney disease)

– Stroke major cause of death

– Heart attack major cause of death

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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Type 2 Diabetes:

Causes of Hyperglycemia

Insulin resistance Insulin secretory dysfunction

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Diagram of insulin crystals

Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Type 2 Diabetes: Insulin Resistance

Decreased ability to use insulin. Part of a group of conditions called

the metabolic syndrome. Increases risk for atherosclerosis. Pancreas produces more insulin to attempt to

decrease blood glucose.

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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Type 2 Diabetes: Insulin Secretory Dysfunction

Also called defective insulin secretion. Inability to produce enough insulin to

overcome insulin resistance.

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Insulin Resistance and Defective Insulin Secretion

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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Type 2 Diabetes:

The Metabolic Syndrome

Condition exists when person has at least three the following:– Hyperglycemia

– Low level of blood high density lipoprotein cholesterol (HDL)

– Central obesity

– High blood triglycerides

– High blood pressure

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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Type 2 Diabetes:

Treatment Approach

Best defenses against health complications: WEIGHT LOSS and PHYSICAL ACTIVITY!

Best approach is concurrent management of:– Blood glucose– Blood pressure– Blood lipids– Body weight– Physical activity

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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Type 2 Diabetes: Diabetes Management Plan

To reduce risk of complications by achieving optimal:

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blood glucose

blood pressure

blood lipids

Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Tighter Control Improves Health Outcomes

Two major and several smaller research studies over 20 years.

Type 1 and type 2 diabetes studied. Subjects with tightly controlled

blood glucose decreased risk of complications.

Even small improvement in A1C decreased risk!

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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

TCYD Participants Decrease A1C

Pilot of TCYD in three Florida counties. Participants increased knowledge, improved

lifestyle behaviors, and monitored blood glucose regularly.

Average A1C decreased from 7.2% to 6.2%. Average systolic blood pressure decreased from

142 mmHg to 133 mmHg. You can do it too!

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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Type 2 Diabetes: Treatment Goals

Blood glucose– Fasting blood glucose: 70 to 130 mg/dl

– Postprandial (2 hrs after first bite of meal or snack): less than 180 mg/dl

– Hemoglobin A1C: less than 7%

NOTE: Your physician may suggest more or less stringent goals.

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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Type 2 Diabetes: Treatment Goals

Blood Lipids– LDL cholesterol: less than 100 mg/dl– HDL cholesterol: over 40 mg/dl (men)

over 50 mg/dl (women)– Triglycerides: less than 150 mg/dl

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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Type 2 Diabetes: Treatment Goals

Blood Pressure

– Under 130/80 mmHg

NOTE: Your physician may suggest a more stringent goal.

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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Type 2 Diabetes:

Treatment Plan

Proper nutrition Weight management Regular physical activity Medication, if needed

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Take Charge of Your Diabetes, University of Florida IFAS Extension © 2010

Living Well With Type 2 Diabetes

The path to living well includes:

Acceptance

Education

Motivation

Commitment

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Prepared by:

Nancy Gal, Extension Agent IVMarion County - University of Florida IFAS Extension

Linda Bobroff, Professor and Extension Nutrition SpecialistUniversity of Florida

Updated 2010

What is Diabetes?