Diabetes

1. Diabetes Are you at risk?

2. What is diabetes? • Insulin is a chemical, naturally produced in the pancreas, that helps the body process and use sugar for energy • Energy to sustain normal body processes – breathing, blood circulation, digestion • Energy for us to move, exercise and otherwise function through the day

3. What is diabetes? • Diabetes means that the pancreas doesn’t… • …produce any insulin (Type I Diabetes ) • …produce enough insulin (Type II Diabetes) • There are other types of diabetes that we diagnose and treat, but the most common are Type I and II.

4. Type I Diabetes • Usually starts before age 40 • Usually very abrupt onset of disease • Because the pancreas produces virtually no insulin, the only treatment is insulin replacement • Much less common that Type II

5. Type II Diabetes • Usually starts when people are older • Although the average age of onset is getting younger • Does not usually start abruptly – this develops over years • Many therapies to treat • Diet and exercise • Medications (oral) • Medications (injectable), including insulin replacement • New research – cell transplants, “the artificial pancreas,” new medications, etc.

6. Quick Statsfrom the American Diabetes Association • In 2012, 29.1 million Americans with Diabetes (9.3%) • 8.1 million of those are NOT diagnosed yet • Approximately 25% of people over 65 have diabetes • 86 million (age 20+) have pre-diabetes • 7th leading cause of death in the United States

7. Quick Statsfrom the American Diabetes Association • Diabetes causes many other problems in adulthood • About 70% of diabetics have problems with blood pressure and cholesterol • About 29% of diabetics (age 40+) have diabetic retinopathy (can lead to blindness) • 1.8 times more likely to be hospitalized due to a heart attack • 1.5 times more likely to be hospitalized due to a stroke • 44% of new kidney failure cases are due to diabetes • 60% of limb amputations (non-trauma) occur in diabetics

8. Quick Statsfrom the American Diabetes Association • Cost is incredible - $245 billion in 2012 – includes direct medical costs and the cost of lost productivity • Medical expenditures for diabetics are 2.3 times higher than for non-diabetics

9. Increasing numbers of diabetic patients is putting a significant burden on the healthcare system • We need to recognize patients earlier • We need to be better at treating patients and encouraging them to be compliant • We need to work at prevention and education

10. Know the Risk Factors • Age (over 45) • History of gestational diabetes when pregnant, or have a high birth-weight baby • Heredity • High blood pressure • Sedentary lifestyle, lack of exercise • Overweight/obese • Polycystic ovarian syndrome • Certain ethnicities – Latino, Native American, African American and others

11. Doing our part today… • At the 2014 Women’s Expo we are offering a Blood Glucose Screening test • Suggested to be fasting for 8 hours, but we can test if you have already eaten today

12. Screening test results • 70 -100 (fasting) Normal test. Likelihood of diabetes is low • > 100 (fasting) Elevated test result. See your provider for further advice • >200 (non-fasting) See your provider for further advice

13. Diagnosing Diabetes • For those that have results 100-125 • May be considered a “pre-diabetic” • Your provider will be watching your numbers more frequently • May start some medications to delay onset of disease • Will discuss strategies for prevention or how to delay onset

14. Prevention for PreDiabetics • Does not mean that you will automatically develop diabetes • Early recognition and treatment can restore blood sugar levels to normal • Lower your risk 58% • Losing 7% of body weight (15 pounds for 200 pound person) • Exercising moderately (30 minutes/day x 5 days per week)

15. Diagnosing Diabetes • Usually diagnosed when someone has 2 or more fasting blood sugars over 126 • Or if you have one high blood sugar and signs and symptoms of diabetes • Frequently thirsty or urinating often • Unexplained fatigue • Blurry vision • Slow healing wounds • Numbness or tingling in the feet or hands

16. Diagnosing Diabetes • Your provider may do some additional lab tests • Hemoglobin A1C – looks at blood sugar control over the past few months • Glucose Tolerance Test – checks how your body processes a large amount of sugar • Treatment and diagnosis is determined by looking at each patient individually • Not everyone will have the same tests or get the same treatment plan

17. Diabetes Prevention • Cannot control several things – heredity, age, ethnicity • Control the things you can • Weight • Diet • Blood pressure • Activity

18. Living with Diabetes • Early detection • Early and effective treatment • Consultation with support staff – dietician, diabetes educator, etc. • Education • Follow-up with your provider for close monitoring • Support

19. Living with Diabetes • Well-controlled and monitored diabetes can prevent or significantly delay the onset of complications • Despite your best efforts, sometimes the disease advances and the treatment plan needs to change • Need to stay in communication with your clinic to have the best results!

20. Myth: eating too much sugar causes diabetes • Being overweight can contribute to diabetes • Weight gain is typically not just from eating too much sugar • However…sugared beverages are contributing to diabetes • Regular soda, energy drinks, fruit juices, sweet tea, etc. • Make lower sugar choices – water, flavored waters, diet sodas, low sugar juices

21. Myth: Diabetics need special foods • A diabetic diet can include anything that non-diabetics eat • Healthy choices are suggested for everyone • Low fat, moderate sugars, lean protein, whole grains, healthy fats, etc. • Portion control is the key –whether you are diabetic or not

22. Myth: Diabetic can’t have sweets • You can have sweets! It’s all a part of balancing your diet for control of nutrients and carbohydrates • Portion control • Making choices

23. Resources • American Diabetic Association • www.diabetes.org • Medline/National Institutes of Health • www.nlm.nih.gov/medlineplus/diabetes.html • Ask us!