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Obesity and Diabetes Mellitus

Obesity and Diabetes Mellitus. Body Mass Index. BMI is a definition of the degree of adiposity. It is weight (kg)/height (m) 2. Classification or Overweight and Obesity. Underweight ‹ 18.5 Normal 18.5-24.9 Overweight 25.0-29.9 Obesity, Class I 30.0-34.9

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Obesity and Diabetes Mellitus

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  1. Obesity and Diabetes Mellitus

  2. Body Mass Index • BMI is a definition of the degree of adiposity. • It is weight (kg)/height (m)2

  3. Classification or Overweight and Obesity • Underweight ‹ 18.5 • Normal 18.5-24.9 • Overweight 25.0-29.9 • Obesity, Class I 30.0-34.9 • Obesity, Class II 35.0-39.9 • Extreme Obesity, Class III ≥ 40

  4. Factors Leading to Obesity • Physiologic • Metabolic • Genetic • Glucose intolerane • Insulin resistance • Hypertension • hyperlipidemia

  5. Obesity Factors Cont’ • Excess Energy Intake • Inadequate Physical Activity

  6. Metabolic Syndrome MetS Criteria: Must have three or more symptoms waist circumference exceeding 40”/35” serum triglycerides 150mg/dl HDL less than 40mg/dl…50mg/dl Blood pressure 135/85 or higher serum glucose 110mg/dl or higher

  7. In 1990, among states participating in the Behavioral Risk Factor Surveillance System, 10 states had a prevalence of obesity less than 10% and no state had prevalence equal to or greater than 15%. • By 2000, no state had a prevalence of obesity less than 10%, 23 states had a prevalence between 20–24%, and no state had prevalence equal to or greater than 25%. • In 2010, no state had a prevalence of obesity less than 20%. Thirty-six states had a prevalence equal to or greater than 25%; 12 of these states (Alabama, Arkansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Oklahoma, South Carolina, Tennessee, Texas, and West Virginia) had a prevalence equal to or greater than 30%.

  8. Obesity Trends* Among U.S. AdultsBRFSS,1990, 2000, 2010 (*BMI 30, or about 30 lbs. overweight for 5’4” person) 2000 1990 2010 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

  9. Obesity tends Statewide • F as in Fat: How Obesity Threatens America's Future 2011 - Trust for America's Health

  10. Bariatric Surgeries • Gastric Bypass

  11. LAP Band

  12. Sleeve Gastrectomy

  13. Health Implications • Coronary Heart Disease (CHD) • Diabetes Mellitus Type II • Cancers (breast, colon, endometrial) • Hypertension • Dyslipidemia • Liver/gallbladder disease • Sleep apnea • Osteoarthritis • Gynecological problems (abnormal menses/infertility) • Source:CDC

  14. Diabetes Mellitus • Disease marked by a lack of blood glucose homeostasis • Two Types Discussed: • Insulin Dependent Diabetes Mellitus (IDDM) • Non-Insulin Dependent Diabetes Mellitus (NIDDM)

  15. Symptoms IDDM • Frequent urination (polyuria) • Unusual thirst (polydypsia) • Extreme hunger • Unusual weight loss • Extreme fatigue and irritability • Source: ADA

  16. Symptoms NIDDM • Any of the type I symptoms • Frequent infections • Blurred vision • Slow healing wounds • Tingling/numbness in hands and feet • Recurring skin, gum, bladder infections

  17. Etiology IDDM • Autoimmune disorder • Immune system attacks insulin producing cells of the pancreas

  18. Etiology NIDDM • Tissue insensitivity: • May be due to genetic factors exacerbated by visceral fat • May be worsened by hyperglycemia • NIDDM comprise 90% of all diabetics

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