Diabetes

2. Diabetes • A disorder of CHO metabolism resulting from inadequate or ineffective insulin, as result of that blood glucose remains high after a meal. • There are tow types of diabetes • Type 1 Diabetes: Insulin-dependent diabetes mellitus (IDDM): this type is less common type of diabetes in which the person produces no insulin at all (mostly develops in childhood, and some cases arises in adulthood) • Type 2 diabetes: Non insulin-dependent diabetes mellitus (NIDDM):: the more common type of diabetes in Kuwait, in which the fat cells resist insulin,

3. Metabolic Consequences of Untreated Diabetes Type 1 Type 2 No Glucose enters The cells Blood glucose Rises (hyperglycemia) Some glucose enter the cells, but slowly Cells break Down protein and fat Humger Hunger Glucose Spills into The urine (glycosuria) Water move To the blood (osmotic effects) Ketones are Produced for energy Weight lost (Polyphagia) Excessive eating Frequent Urination (polyuria • Diabetic acidosis • Manifested by: • *acetone breath • *acetonemi • *acetonuria (Polyphagia) Excessive eating Weight gain Dehyration Excessive thirest Diabetic coma

4. Diabetes • Diabetes in adults may start slowly. In fact, millions of people don't even know they have it. They may just feel very tired at first, then later may have these symptoms: • Urinating more than usual, as the body tries to get rid of the extra sugar in the blood • Feeling unusually thirsty, because the body needs to replace the lost fluid • Nausea • Blurred vision • Feeling hungry while losing weight • Frequent infections • Skin sores that won't heal

7. Ketones • Ketones: when the body can`t use the glucose for energy, it uses fat instead. When fats are broken down for energy, chemicals called ketones appear in the blood and urine. This can occur when not enough food has been eaten to provide glucose for energy, or it can occur in diabtes , when the body can`t use glucose normally.

8. Features of Diabetes Type 1 Diabetes Type 2 Diabetes

12. The Balanced Diet • Meals and snacks should be based on the Food pyramid. Your dietitian may tell you just how many servings you need of each food, and how large a serving should be. • The largest part of each meal should be the foods at the bottom of the pyramid, such as whole grain breads, pasta and rice, and starchy vegetables like potatoes, corn, peas and beans. • Every day, you should have several servings of vegetables and fruit. • Protein should come from lean meats, chicken, turkey, or fish, or meat substitutes like beans, eggs or low-fat cheese. • Dairy foods should be either non-fat or low-fat. • Eat fats and sugars only in small amounts.

14. Hyperglycemia-High Blood Sugar • Hyperglycemia occurs when the blood sugar is too high. • Symptoms of Hyperglycemia • Increased thirst • Nausea & vomiting • Increased urination • Loss of appetite • Weakness, abdominal and/or generalized pains • Large amounts of sugar or ketones in urine

15. Symptoms of Hypoglycemia • A person with hypoglycemia may feel weak, drowsy, confused, hungry, and dizzy. Paleness, headache, irritability, trembling, sweating, rapid heart beat, and a cold, clammy feeling are also signs of low blood sugar. In severe cases, a person can lose consciousness and even lapse into a coma.

17. Atherosclerosis • Is the most frequent cause of myocardial infractions and cerebrovascular accidents. • It begins gradually with the deposit of plaques in the arterial wall. • Eventually progressive thickening and rigidity of the arterial wall • Narrowing of the arterial lumen makes it difficult to deliver O2 and nutrient.

19. Atherosclerosis

20. Atherosclerosis

21. Atherosclerosis

22. Atherosclerosis

23. Atherosclerosis

24. Stroke

25. Atherosclerosis

26. Atherosclerosis

27. Risk factors • Cigaratte • High cholesterol • High triglycride • High blood pressure (Hypertension) • Inactivity • Obesity • Heredity • Gender • Stress • age • DM

28. Prevention • Maintaining a desirable body weight • Cut down the fat consumption to 30% • Limit saturated fat to less than 7% of total Kcal and Chol. • Replace saturated fat with unsaturated • Avoid food products that contain trance-fatty acids. • Choose foods high in soluble fibers. • Regular consume of food products that contain add plant sterols. • Regular consume of foods that contain soy protein to replace those that contain animal fat. • To reduce blood pressure, choose a diet that is high in fruits and vegetables, low-fat milk products, nuts, and whole grain, limit sodium. • Fish can be consumed regularly. • CHO (50-55% of total calories) With emphasis on fiber • Exercising regularly.

29. Hypertension Hypertension is high blood pressure Both Atherosclerosis and Hypertension are life- threatening combination. The high the blood pressure the greater the risk

30. Hypertension • What is Blood Pressure? • Pressure created by the heart as it pumps blood through the arteries and the circulatory system • What do Blood Pressure Numbers Mean? • Top number (Systolic)= Pressure while heart is beating • Bottom number (Diastolic)= Pressure while heart is resting between beats

31. Hypertension

32. Hypertension

33. Hypertension • How can I tell if I have High Blood Pressure? • Usually NO SYMPTOMS! • “The Silent Killer” • May have: • Headache • Blurry vision • Chest Pain • Frequent urination at night

34. Hypertension • How does High Blood Pressure develop? • Certain nerve impulses cause arteries to become larger (dilate) or smaller (contract) • If vessels wide open blood flows easily • If vessel narrows pressure inside increases causing hypertension

35. Blood Pressure (BP): Measurements Figure 15-7: Measurement of arterial blood pressure

36. Hypertension Causes • What Causes High Blood Pressure? • Cause unknown in 90 to 95% of cases = Primary Hypertension • Secondary Hypertension = 5 to 10%

37. CausesHypertension • What Causes High Blood Pressure? • Increased salt intake • High blood lipids. • DM • Gender • Age • Heredity • Race. • Obesity. • Alcohol. • Stress. • Lack of exercise. • Smoking

38. CausesHypertension

39. Hypertension • Women and High Blood Pressure • Birth Control Pill • Pregnancy • Overweight • After Menopause

40. Hypertension • What does High Blood Pressure do to my Body? • Stroke • heart failure • Kidney failure • Heart attack • Heart rhythm problems

41. Diet & Health Recommendations • Reduce total fat intake to <30% of total calories, saturated fats intake to less than 10% of total calories, & cholesterol intake <200 mg per day. • Increase intake of complex carbohydrates. • Maintain protein intake at moderate levels. • Balance food intake and physical activity to maintain appropriate body weight.. • Limit total daily intake of sodium to <2 g. • The DASH Eating Plan • Eat a variety of fruits and vegetables daily fat sodium and potassium, magnesium, and calcium • Avoid taking dietary supplements in excess.

42. Reduce Hypertension Risk • Weight Control • Aim for a healthy weight • Physical Activity • Increase physical activity • Alcohol • Do not drink alcohol • Sodium/Salt Intake (1 tsp salt = 2 g sodium) • Choose and prepare foods with less salt • The DASH Eating Plan • Eat a variety of fruits and vegetables daily fat sodium • Stop smoking • Manage your stress • Drug Therapy