aetna presentation diabetes

Diabetes Mellitus

Presented by:Evelyn Schumacher, MS, RD, CDE

What is Diabetes? Diabetes Mellitus - “sweet urine”

The body’s inability to make or use insulin properly.

Types of Diabetes Type 1 Diabetes - body makes NO insulin

Type 2 Diabetes - body doesn’t make enough insulin or doesn’t use it properly

Gestational Diabetes - diabetes diagnosed during pregnancy

04/11/23

The Disease:Diabetes

Over 18 million Americans have diabetes.

Diabetes is the sixth leading cause of death by disease among adults and

second leading cause of death among children.

It is a national and world epidemic

Signs and Symptoms Frequent urination

Crave extra liquids

Always hungry

Signs and Symptoms Always tired

Blurry vision

Wounds that won’t heal

Signs and Symptoms Frequent infections

Numbness & tingling feet

Sexual dysfunction

Unexplained weight loss

Risk Factors Family member with diabetes

Overweight

Age

Ethnicity

Diabetes Causes Serious Health Problems and Death

At least 210,000 deaths each year 22 every hour

Causes 24,000 cases of diabetic blindness -- about 2 every hour

Diabetes Causes Serious Health Problems and Death

Causes about 100,000 diabetic kidney failure -- 1,900 every week

Causes about 67,000 diabetic amputations -- about 7 every hour

PRE-TEST

With diabetes, fruit juice raises your sugar less than regular soda? (T or F)

I have diabetes - I can eat sweet cereals? (T or F) On the “Nutrition Facts” label which is more

important? (Sugar or Total Carb) High protein diets like Dr. Atkins and Sugar Busters

are good for diabetes? (T or F) Grapefruit juice burns calories and fat (T or F)

PRE-TEST About 50% of the food we eat in a day should come

from? (Carb, Pro, Fat) Eating protein provides quick energy? (T or F) Cereal, milk and juice is a well balanced breakfast

(T or F)

I understand reading food labels? (T or F) People with diabetes need to eat special foods to

control blood sugar? (T or F)

BASIC DIGESTION

S S S S S S S S S S S S S CELL

BASIC DIGESTION

S S S S S S S S S S S S S

I I IInsulin

Insulin

Insulin

BASIC DIGESTION

S S S S S S S S S S S S S

I I II

I

I

ENERGY

DIABETES NOT A PROBLEM

Diabetes is a problem with the way the body uses food.

WHAT TO DO...

Breakfast Lunch Supper

B Lunch Dinner

WHAT TO DO... No breakfast - what happens by

lunch?

Lunch

MORE DIFFICULT FOR YOUR BODY TO HANDLE THE FOOD EATEN

S S S S S S S S S S S S S SSSSSSENERGY

I I II

I

I

NO DIABETES:

Breakfast6am

Lunch12 noon

Blood sugar levels, appetite, and energy levels can remain stable.

3 MAIN FOOD PARTS Carbohydrate =

(sugar)

Protein =

Fat =

ENERGY

Building Block

Protects

FOOD GUIDE PYRAMID

Bread, Cereal, Rice and Pasta Group

Vegetable Fruit

MilkYogurt

Meat Fish Poultry

OilMayo

Protein

Fat

Picture StoryOf How We Should Eat


(sugar)ENERGY

Sweet Beverages Juice Regular Soda Sweet Tea Kool-aid Punch

BASIC DIGESTION

S S S S S S S S S S S S S CELL


(sugar)

ENERGY 15 min

Breakfast6am

Lunch12 noon

Sweet Beverages(absorption is quick)

Fruit vs. Juice Skin Peel Membranes Strings Seeds

Fruit vs. Juice

Breakfast6am

Lunch12 noon

Fruit by Itself(absorption is quick)


(sugar)

Protein =

Fat =

ENERGY

Building Block

Protects

15 min- 1 hr

2 - 3 hrs

6 - 12 hrs

Breakfast6am

Lunch12 noon

Balanced Meal(absorption is slower)

Appetite, energy level, and blood sugar are all more stable.

High Fat Meals(slows gastric emptying)

The high fat story

How Much Fat? 1 tsp oil = 1 fat serving

How Much Fat? To fry torillas - 1 tsp oil ? NO

__?__ Fat servings

How Much Fat? To fry meat - 1 tsp oil ?

NO __?__ Fat servings

How Much Fat?


(sugar)

Protein =

Fat =

ENERGY

Building Block

Protects

15 min- 1 hr

2 - 3 hrs

6-

12 hrs

Breakfast6am

Lunch12 noon

12 noon Midnight

High Fat Meals(slows gastric emptying)

Blood Sugars are Elevated Not because of the

Blood Sugars are Elevated But because of the

Goals for Meal Planning 1st Goal: How many meals per

day?


day?

3


day? 3

2nd Goal: How to balance the meals?

Goals for Meal Planning 1st Goal: How many meals per day?

3

2nd Goal: How to balance the meals?~50% carbohydrateSMALL protein

SMALL fat

FOOD GUIDE PYRAMID

Bread, Cereal, Rice and Pasta Group

Vegetable Fruit

MilkYogurt

Meat Fish Poultry

OilMayo

15 gr

15 gr

15 gr

5 gr

Time Number ofExchanges

Number of Choices Sample Menu Your Menu Ideas

Carbohydrate group2 Starch 1 bread, ½ cup grits1 Fruit ½ cup orange juice

4

1 Milk 1 cup skim milk1 Meat group (ounce) 1 egg or 1Tbsp. peanut butter2 Fat group 1 tsp. margarine, 1 slice bacon

Carbohydrate group2 Starch 2 bread2 Fruit 1 large apple2 Vegetables 1 cup green beans

4

0 Milk2 Meat group (ounce) 2 ounces lunchmeat1 Fat group 1 tsp. mayonnaise

Carbohydrate group3 Starch 1 cup mashed potatoes, 1 roll1 Fruit 17 grapes2 Vegetables 1 cup broccoli

4

0 Milk3 Meat group (ounce) 3 ounces chicken2 Fat group 2 tsp. margarine

Carbohydrate group1 Starch 3 graham cracker squares

2

1 Milk 1 cup skim milk

1800 Calorie Meal Plan

4 Carbohydrate Groups




60 gr

60 gr

60 gr

30 gr

Food LabelsNutrition FactsServing Size 1 cup (248 g)Servings Per Container 4

Amount Per Serving

Calories 150 Calories from Fat 35

% Daily ValueTotal Fat 4 g

6%Saturated Fat 2.5 g 12%

Cholesterol 20 mg 7%

Sodium 170 mg 7%

Total Carbohydrate 17 g 6%

Dietary Fiber 0 g 0% Sugars 17 g Protein 13 g

Food LabelsNutrition FactsServing Size 1 cup (248 g)Servings Per Container 4

Amount Per Serving

Calories 150 Calories from Fat 35

% Daily ValueTotal Fat 4 g

6%Saturated Fat 2.5 g 12%

Cholesterol 20 mg 7%

Sodium 170 mg 7%

Total Carbohydrate 17 g (15g) 6%

Dietary Fiber 0 g 0% Sugars 17 g Protein 13 g

What About Alcohol Alcohol is processed like fat Replaces 2 fat servings in the meal Suppresses gluconeogenesis Always consume a carb food with

alcohol

What About Alcohol Alcohol is processed like fat Replaces 2 fat servings in the meal Suppresses gluconeogenesis Always consume a carb food with

alcohol

count carbs for alcohol

PRE-TEST

With diabetes, fruit juice raises your sugar less than regular soda? (T or F)

I have diabetes - I can eat sweet cereals? (T or F) On the “Nutrition Facts” label which is more

important? (Sugar or Total Carb) High protein diets like Dr. Atkins and Sugar Busters

are good for diabetes? (T or F) Grapefruit juice burns calories and fat (T or F)

PRE-TEST About 50% of the food we eat in a day should come

from? (Carb, Pro, Fat) Eating protein provides quick energy? (T or F) Cereal, milk and juice is a well balanced breakfast

(T or F)

I understand reading food labels? (T or F) People with diabetes need to eat special foods to

control blood sugar? (T or F)

We’re Here for You. . .Cure. Care. Commitment.

Visit us on the web atwww.diabetes.orgDuring the work week Call 1-800-DIABETES (1-800-342-2383)(Monday-Friday, 8AM-8PM, EST)

WHAT IS DIABETES?

A disease in which the body no longer produces or uses insulin properly

Type 1 diabetes – body makes no insulin

Type 2 diabetes – body doesn’t make enough insulin or doesn’t use it properly

STATISTICS Prevalence of Type 2 diabetes is

1.5 times higher in Latinos than non-Latino whites

Two million or 8.2% of all Latino Americans aged 20 years or older have diabetes

STATISTICS

In the United states among those between ages 45 – 74:

~24% of Mexican Americans have diabetes

~26% of Puerto Ricans have diabetes ~ 16% of Cuban Americans have

diabetes

DIABETES ~ 18.2 million Americans have diabetes

~ 1/3 of these are not diagnosed

~ 41 million Americans have pre-diabetes

6th leading cause of death (69,301 listed on death certificates) in 2000

Contributed to 213,062 deaths

COMPLICATIONSHeart diseaseLeading cause of diabetes related deaths

Adults with diabetes have 2 – 4 times higher heart disease death rate

- 2 studies have shown lower rates of heart attacks

among Mexican Americans

Stroke Adults with diabetes have 2 – 4 times higher

risk for stroke

COMPLICATIONS

High Blood Pressure

~ 73% of adults with diabetes have blood pressure > 130/80 or use medication for hypertension

COMPLICATIONSBlindness

Diabetes is leading cause of new blindness among adults 20-74 years old

Diabetic retinopathy causes 12,000 – 24,000 new cases of blindness every year

- Diabetic retinopathy among Hispanics is twice the

rate of non-Hispanic whites

COMPLICATIONS

Kidney Disease

Diabetes is the leading cause of end stage kidney disease (dialysis)

No clear evidence of increased risk among Hispanics (survive longer on dialysis than non-Hispanic whites per one report)

COMPLICATIONS Nervous System Disease

60% - 70% of people with diabetes have nervous system disease.- impaired sensation or pain in hands/feet- slowed digestion of food in stomach

- carpal tunnel syndrome - other nerve problems

COMPLICATIONS Amputations

More than 60% of nontraumatic lower limb amputations are among those with diabetes

COMPLICATIONS Dental Disease

Gum disease more common among those with diabetes.

~1/3 of people with diabetes have severe gum disease

COMPLICATIONS Pregnancy

Poorly controlled diabetes before conception and during first trimester can cause major birth defects in 5% - 10% of pregnancies and spontaneous abortions in 15% - 20% of pregnancies

Poorly controlled diabetes during 2nd and 3rd trimesters can result in excessively large babies

COMPLICATIONS Other Complications

People with diabetes are more susceptible to many other illnesses. Those who get the flu or pneumonia are more likely to die than those without diabetes

DIABETESSIGNS & SYMPTOMS

Excessive thirst Frequent urination Extreme hunger Increased fatigue Irritability Blurry vision

RISK FACTORS African Americans Latinos Native Americans Asian Americans Pacific Islanders

RISK FACTORS Family history Obesity Inactivity Women who have had a baby

weighing more than 9 pounds 45 – 64 years old

RISK FACTORS(GENETIC IN HISPANICS)

American Indian or African genes thought to increase risk

HISPANICSHOW MANY HAVE DIABETES?

Of minority groups - the 2nd largest The fastest growing minority group 30 million had diabetes in 1998 By 2050 estimated 97 million

Hispanics in the US (1/4 of the US population)

DIABETES PREVENTION PROGRAM (DPP)

Diet and exercise can effectively delay diabetes

in a diverse population of overweight people

with impaired glucose tolerance (pre-diabetes)

FREE PUBLICATION “Take Charge of Your Diabetes” Published by the CDC In Spanish In English Call toll-free 1-877-232-3422

DIABETES & NUTRITION Some studies suggest that More advanced diabetes in Hispanics increases risk of inadequate nutrition Diet and lifestyle change can prevent

or lessen this impact People with diabetes have the same

nutritional needs as anyone else

DIABETES MEAL PLAN A guide to help you determine how much

and the types of food you can choose

It should fit in with your schedule and eating habits

The right meal plan will help improve your blood sugar, blood pressure, cholesterol and help with weight goals

DIABETES REMEDIES Many Hispanics may use numerous

diabetes remedies based on beliefs , in the hope of curing diabetes

Some may be harmless, some dangerous

There is no cure for diabetes – you can control it.

TRADITIONAL ADVANTAGES Many advantages in the traditional

Hispanic diet: Use of complex carbohydrates Consumption of fruits and vegetables

rich in vitamins A and C Limited use of processed foods Simple preparation and nutritionally

balanced

TRADITIONAL DRAWBACKS Traditional Hispanic diets have a

few drawbacks:

Liberal use of added fat

Many foods are fried (beans, meat, tortillas, rice and potatoes)

NUTRITION MODIFICATIONS Use corn tortillas (instead of flour) Use part-skim cheeses Use more fresh vegetables (cooked

without added fat) Use sugar substitutes instead of sugar Use diet or sugar free beverages and

water instead of high sugar beverages

NUTRITION MODIFICATIONS Use no added sugar (or sugar

substitutes) in licuados and aguas frescas

Reduce oil in preparing sopas to < 1 tsp Prepare frijoles cocidos (boiled beans)

instead of frijoles refritos (refried beans) Prepare meats asadas (grilled) instead

of fried Skim fat off broths and stocks when

preparing caldos (soups)

NUTRITION MODIFICATIONS Use low-fat milk instead of whole

milk or cream Bake corn tortilla chips to replace

fried chips Instead of frying tortillas, heat

them in the oven in foil; or in a heavy pan for a short time of each side; or in the microwave

NUTRITION MODIFICATIONS Taste food before salting it Use lemon instead of salt on fruits or

in beer Add flavor using onions, garlic, cumin,

oregano, cilantro, or other spices If you fit alcoholic beverage into your

meal plan do it according to guidelines and choose “light” beer

aetna presentation diabetes

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