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Preventing Diabetes

Preventing Diabetes. Cecilia Sauter MS, RD, CDE Diabetes Self-Management Education Program University of Michigan. No Data <4% 4%-6% 6%-8% 8%-10% >10%. Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1990.

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Preventing Diabetes

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  1. Preventing Diabetes Cecilia Sauter MS, RD, CDE Diabetes Self-Management Education Program University of Michigan

  2. No Data <4% 4%-6% 6%-8% 8%-10% >10% Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1990 Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1).

  3. No Data <4% 4%-6% 6%-8% 8%-10% >10% Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1991-92 Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1).

  4. No Data <4% 4%-6% 6%-8% 8%-10% >10% Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1993-94 Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1).

  5. No Data <4% 4%-6% 6%-8% 8%-10% >10% Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1995-96 Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1).

  6. No Data <4% 4%-6% 6%-8% 8%-10% >10% Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1995 Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1).

  7. No Data <4% 4%-6% 6%-8% 8%-10% >10% Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1997-98 Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1).

  8. No Data <4% 4%-6% 6%-8% 8%-10% >10% Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1999 Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1).

  9. No Data <4% 4%-6% 6%-8% 8%-10% >10% Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 2000 Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1).

  10. No Data <4% 4%-6% 6%-8% 8%-10% >10% Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 2001 Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1).

  11. Diabetes in the US • Currently 20.8 million have diabetes • 14.6 million have the diagnosis • 6.2 million don’t know they have diabetes

  12. Etiology of Diabetes • Family history • Ethnicity • African American • Native American • Hispanic • Asian Americans • Pacific Islanders • Age • Gestational Diabetes or babies over 9 pounds

  13. Etiology of Diabetes • Increased weight • BMI: • overweight = 25.0 to 29.9 kg/m2 • obese > 30.0 kg/m2 • Increased central (i.e., visceral) obesity • Waist circumference: • Men > 40 in • Women > 35 in • Decreased activity

  14. Metabolism without Diabetes Blood Body SI SI S Insulin SI Sugar SI S

  15. Metabolism without Diabetes Blood Body S S S S Insulin S S S Sugar S

  16. Metabolism with Diabetes Blood Body SI SI S S Insulin SI S Sugar S S S

  17. Metabolism with Diabetes Blood Body SI SI S S S Insulin SI S S Sugar S S

  18. Progression of Diabetes 10-30 years Insulin Resistance Insulin Production Fasting Blood Glucose Glucose Intolerance FBG: 80-125 Diagnosis of Diabetes

  19. Pre-diabetes • 2000 • 40 % of people aged 40-74 years • 41 million • 2002 • 54 million

  20. Prevention of Diabetes • Diabetes Prevention Program • Lifestyle changes • Changes in eating habits • Increase in physical activity • 58% reduction in type 2 diabetes

  21. Prevention of Diabetes • Weight loss • 5% to 10% weight loss • Weight loss rate of 1 to 2 lb/week • Decrease of 300 to 500 kcal/day = 1/2 to 1 lb weight loss/week • Increased physical activity and/or decreased food intake

  22. Prevention of Diabetes • Healthy Nutrition Recommendations: • Decrease total fat intake • smaller amounts of high fat foods • broiling/stir fry vs. frying • remove skin from chicken • substitute with low calorie/low-fat foods

  23. Prevention of Diabetes • Healthy Nutrition Recommendations: • Increase fruits and vegetables • Whole grains vs. processed • Include dry beans and lentils • Drink water & calorie free drinks • Cut back on high calorie snacks • Watch portion sizes

  24. Prevention of Diabetes • Healthy Nutrition Recommendations: • Rate your plate • ¼ grains or starchy foods • ¼ protein • ½ non starchy vegetables • Add 1 glass milk or small piece of fruit

  25. Prevention of Diabetes • Physical Activity • Benefits: • Increases insulin sensitivity • Decreases weight • Decreases blood pressure and cholesterol • Decreases stress • DECREASES risk of type 2 diabetes

  26. Prevention of Diabetes • Physical Activity • Recommendations: • 30 minutes/day for 5 to 7 days a week • 10 minutes of activity 3 times/day

  27. Prevention of Diabetes • Getting started: • What activities can you do • Realistic activities • Start slow: • What, when, where, how often, how long • Challenging but not overly difficult • Be flexible • Reward yourself

  28. Walking, 3.0 miles/hr Walking 5 miles/hr Cycling, 8 miles/hour Mopping, vacuuming Scrubbing floors Gardening Vigorous dancing 275/hr 420/hr 325/hr 240/hr 300/hr 220/hr 320-500/hr Calories Spent in Various Activities

  29. Fad Diets • Watch for rapid weight loss • Loss of muscle mass and water vs. fat • Expensive

  30. Nutritional Supplements • They DO not reduce risk of Type 2 Diabetes • Safety is uncertain • No scientific evidence to aid in weight loss • Expensive

  31. Screening for Type 2 Diabetes • Positive family history • Ethnic group • Increased weight and/or central obesity • Gestational diabetes or big babies • Decreased activity • Symptoms of diabetes • Increased thirst, increased urination & weight loss

  32. Diagnostic Criteria for Type 2 Diabetes • Fasting blood sugar > 126 mg/dl • 2 hour glucose tolerance > 200 mg/dl • Acute symptoms plus random glucose > 200 mg/dl

  33. Impaired Glucose Tolerance“Pre-diabetes” • Impaired Fasting: • Level between >100 mg/dl and <126 mg/dl • Impaired glucose: • During 2 hour glucose tolerance test • Level between >140 and <200 mg/dl

  34. Thank you If you would like a copy of this presentation please send an email to: diabetes@umich.edu Questions?

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