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World Kidney Day March 11, 2010

World Kidney Day March 11, 2010. Dr. Joyce M. Richey, Presenter Keck School of Medicine of USC. Diabetes -Greek derivation, to siphon, passing through . What Is Diabetes ??. Glucose (Sugar) Goes where it’s needed for energy!. INSULIN. Insulin – the “Miracle” Drug. Type I “juvenile” IDDM

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World Kidney Day March 11, 2010

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  1. World Kidney DayMarch 11, 2010 Dr. Joyce M. Richey, Presenter Keck School of Medicine of USC

  2. Diabetes -Greek derivation, to siphon, passing through

  3. What Is Diabetes ?? Glucose (Sugar) Goes where it’s needed for energy! INSULIN

  4. Insulin – the “Miracle” Drug

  5. Type I “juvenile” IDDM Usually in children, can be adults 0.5% of populations Family History Fatal if not treated Usually normal weight Type II “adult” NIDDM Usually in adults, increasing in children 5-10% of population (epidemic) Family History Increased prevalence in minorities 80% of patients are obese Types of Diabetes • Gestational Diabetes

  6. Diabetes Treatment Type I • Insulin Type II • Insulin • Oral Medications

  7. Who Does Diabetes Affect? Prevalence • >20 million; one third don’t know they have it • >41 million with pre-diabetes Greater in minority populations • African Americans; ~2 times than Caucasians • Hispanic Americans, ~2 times than Caucasians • Native Americans, 50% of the Pima Indians

  8. Pre-Diabetes What is Pre-Diabetes? • Comes before type 2 diabetes • Blood glucose higher than normal but not yet diabetes • Normal fasting glucose: Below 100 • Pre-diabetes: 100 – 125 • Diabetes: 126 and above

  9. Pre-Diabetes What Does It Mean? • You have a greater chance of getting type 2 diabetes • You are more likely to get heart disease or have a stroke or kidney disease

  10. Diabetes and Obesity Epidemic

  11. Obesity and Diabetes too much weight

  12. Causes of Obesity • Lack of physical activity/sedentary • Genetics • Unhealthy eating patterns

  13. “Digging Our Graves”

  14. Apple or Pear? Gynoid Android

  15. Variability of VAT among obese subjects RF-149, Male, Age 40, BMI 54.4 WC: 142 cm VAT volume: 3162 cm3 SAT volume: 9158 cm3 RF-107, Female, Age 41, BMI 49.5 WC: 118 cm VAT volume: 559 cm3 SAT volume: 11,658 cm3

  16. Obesity is not Restricted to Humans

  17. Symptoms of Diabetes • Frequent urination (bedwetting in children) • Excessive thirst • Extreme hunger • Unusual weight loss • Increased fatigue • Irritability • Blurry vision

  18. Diabetes Testing • Urine Analysis • Blood Test (Fasting Glucose) (less than or equal to 100 mg/dl;101 – 126 mg/dl, pre-diabetes; greater than 126 mg/dl, diabetic) • Oral Glucose Tolerance Test (OGTT)

  19. Diabetes Testing “ A1C?” • Measures your sugar level for the past 2-3 months • Should be checked at least twice a year • The higher the number, the higher risk for diabetes complications

  20. What should your A-1-C be? • Ideally it should be less than 7! • However, please check with your healthcare provider for a reasonable goal.

  21. Major Complications

  22. Complications of Diabetes • Heart disease and stroke; 2-4 greater risk • accounts for > 65% of all deaths in people with diabetes • Leading cause of blindness (retinopathy) • Leading cause of kidney failure (nephropathy) • Nerve disease and amputations (neuropathy) • >300,000 diabetes-related deaths/year

  23. Kidney Failure

  24. Kidney Disease Also known as Nephropathy (neh-FROP-uh-thee) • Over time kidney disease is caused by • Diabetes • High blood pressure

  25. Your Kidneys • Your kidneys are two bean-shaped organs about the size of your fist. • They are located just below the rib cage, near your back

  26. Kidney Disease • Signs and Symptoms • Swelling in extremities, ankles, legs, hands • Shortness of breath • Feeling tired • Nausea and vomiting

  27. Kidney Disease • Later Signs and Symptoms • Loss of appetite • Feeling cold • Poor concentration • Itchy skin • Bruising • Weight loss • Muscle cramps

  28. Tests to find kidney problems • A blood test helps to measure your GFR • GFR stands for Glomerular (glo-MEH-yoo-lur) Filtration Rate. The GFR shows how well your kidneys are filtering wastes from the blood. • Microalbumin (My-crow-alb-YOU-min) • A urine test that measure the amount of protein in the urine

  29. What You Can Do to Prevent, Delay, or Treat Kidney Damage • Keep your blood glucose levels in your target range • ADA suggests: • 70 to 130 when you wake up and before meals • Under 180 two hours after eating a meal • Ask your doctor about the best blood glucose targets for you

  30. What You Can Do to Prevent, Delay, or Treat Kidney Damage • Have an A-1-C check (A-one-see) at least twice a year • Shows your blood glucose level for the past 2 to 3 months • The higher the A-1-C, the greater the risk for kidney disease • If 7 or higher, you may need a change in your plan

  31. What You Can Do to Prevent, Delay, or Treat Kidney Damage • Aim for your target blood pressure level • ADA suggests under 130 over 80 • Ask your doctor about your target blood pressure • Ask your doctor about medicines that slow down kidney disease • ACE Inhibitors (AYCE in-HIB-ih-tor) • ARBs (ay-ar-bee)

  32. Slowing Down Kidney Disease • Eat a well-balanced meal plan • Cut back on salt and high sodium foods • Limit your protein if your doctor tells you to • Limit potassium and phosphorus • Limit supplements and drugs that are hard on your kidneys • Watch out for injected dyes used in X-rays

  33. Steps to Delay or Prevent Type 2 Diabetes • Weight loss • Regular physical activity, such as walking or gardening about 30 minutes a day • Healthy eating

  34. Diabetes Prevention and TreatmentIncrease Physical Activity!

  35. Healthy Eating • Choose low-fat dairy products, lean meats, poultry without skin, and fish • Limit saturated fats • Minimize trans fats • Limit high cholesterol foods • Eat more fruits and vegetables

  36. (4) 7 inch fillets 1 egg Cornmeal Salt/pepper 1 stick of butter of half cup of oil (4) 7 inch fillets 2 teaspoons of lemon Salt/pepper Bread crumbs Spices (oregano,oil,parsley sprigs, lemon wedges, tomato wedges) Fried Vs. Baked

  37. Calories 410 Fat = 26 grams 57% fat calories Cholesterol = 183 mg Sodium = 859 mg Protein = 36 mg Carbohydrate = 7 mg Fiber = 1 g Calories 290 Fat = 8 grams 25% fat calories Cholesterol = 66 mg Sodium = 263 mg Protein = 35 mg Carbohydrate = 19 mg Fiber = 2 g Fried vs. BakedNutritional Value

  38. Remember the 3 P’s of Prevention • Planning • Preparation • Portions

  39. Remember • Learn all you can about diabetes and kidney disease • Keep your blood pressure and blood glucose levels in your target range • Take your medicines • Have regular checkups • Get lab tests each year to know how well your kidneys are working

  40. “Know that your body is a temple” 1Cor. 6:19-20 Keep It Healthy!

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