The Basics of Diabetes Jane M. Threlfall RN, BA, CDE

What is Diabetes?

Katie Mick, MS, RD, LD

True or FalseDiabetes is a rare disease

False!2How Widespread is the Problem?In the United States nearly 26 million people have diabetes (2011)11.3 % of the U.S. adult populationThe CDC projects that as many as one in three adults in the U.S. could have diabetes by 2050 if current trends continue.

Question: How might you present this slide to Lifestyle Coaches? How do you frame these terms in a way that makes an impact?

Have 1 in 10 stand up, then 1 in 3 to show progression.

Ask how many facebook friends someone has do the math on how many now likely have diabetes, and how many will in 2050.3True or FalseEating too much sugar causes diabetes.

False4Diabetes develops because:The pancreas is not making any insulin.

The pancreas does not make enough insulin.

The body does not use insulin correctly.

Insulin resistance

A Warning Sign Acanthosis nigricansSkin disorder in which there is darker, thick, velvety skin along body folds and creasesBack of the neck, armpits, over joints of fingers and toesMost common in people of African, Caribbean, and Hispanic descent but anyone can have it. More commonly seen with obesity.

** Could be a signal that the person is at risk for type 2 diabetes

6Three Types of Diabetes Gestational DiabetesInsulin resistance during pregnancy, appears during 18% of pregnancies Usually goes away after birth, but some develop diabetes35-60% chance of developing type 2 diabetes in the next 10-20 years

Type 1 Autoimmune disease that is usually diagnosed at young age. Always need insulin!

Type 2Most people with diabetes have type 2 (90%)Usually diagnosed after age 30 or 40, but recently we are seeing type 2 diabetes at younger agesObesity and sedentary lifestyle play a major roleMay take pills, insulin, or both

7What is Prediabetes?Blood glucose levels increased but not high enough for type 2 diabetesImpaired Glucose Tolerance (IGT) Impaired Fasting Glucose (IFG) Fasting blood glucose level: Between 100 mg/dL to 125 mg/dL

Increases your risk for:Type 2 diabetesHeart diseaseStroke

Healthy lifestyle changes may restore blood sugar levels to normal

QUESTION: What is prediabetes?

Prediabetes is a relatively new term that refers to a condition where a persons blood glucose levels are higher than normal, but not high enough to diagnose type 2 diabetes. People with prediabetes have signs of a metabolic defect which impacts how effectively their body uses insulin. This causes glucose to build up in the blood rather than be used effectively by the bodys cells.

Prediabetes is also referred to as Impaired Glucose Tolerance (IGT) or Impaired Fasting Glucose (IFG), depending on which test is used to determine blood glucose levels. The term prediabetes is most commonly used because it more clearly explains that people with this condition are at higher risk for developing diabetes and related health conditions, and may already be experiencing complications.

(lay persons may have heard it called borderline diabetes in the past-this is the same as pre-diabetes)

The exact cause of prediabetes is not fully known but there is a link between excess weight and lack of physical activity. There could also be a genetic component.

Without treatment or lifestyle changes, people with prediabetes are more likely to develop type 2 diabetes, experience adverse health conditions, and are at an increased risk for cardiovascular disease.

The good news is that with healthy lifestyle changes which include weight loss and physical activity, people with prediabetes may be able to restore their blood sugar to normal levels.8Prediabetes: The Bottom of the Iceberg

35% of U.S. adults5%-15% develop diabetes each yearDiabetes: 26 million U.S. Adults

Prediabetes: 79 million U.S. AdultsQUESTION: So, we know that 26 million U.S. adults have diabetes anyone know the number who have prediabetes?

The number of cases of diagnosed diabetes only describes the tip of the iceberg. In addition to the 24 million Americans with diabetes, it is estimated that 60 million more have prediabetes (thats about 30% of the U.S. adult population). Moreover, as the rates of obesity continue to rise, this estimate is likely to grow rapidly.

If left untreated, approximately 5-15% of people with prediabetes will develop diabetes. That would mean an additional 3 to 9 million cases per year!9Risk Factors for Diabetes

Overweight/Obesity, certain ethnic groups (African American, Asian American, Latino, Pacific Islander, American Indian), poor nutrition habits, A history of gestational diabetes, physical inactivity, family history (genetics), and high blood pressure.10TheType 2 diabetes can be prevented or delayed.

Diabetes complications can be prevented or delayed through blood sugar management!

The Keys: Maintaining a normal weight, increased physical activity, and balanced nutrition!

11Since we all have a role to play in preventing diabetes and obesity-what do we need to do?

Get Moving!Aim for 60 minutes of physical activity per day

This can be split up into 10 minute sessions, 6 times a day! Its just as beneficial!

13True or FalseA person with diabetes needs to take dessert and sugary food out of their diet to keep blood sugar at normal levels.

Meals:You do not have to give up the foods you like to eat

Sugar is not evil its all about the PORTIONS

Eating healthy with diabetes is a lot like eating healthy without diabetes

What would you eat?Drink ChoicesSoda100% Fruit JuiceWaterSweet TeaFlavored Whole MilkKool-Aid Skim milk And drink?EntreesSidesChicken TendersFrench friesHamburgerPotato saladCheeseburgerOnion ringsBeef and Cheese NachosFruit CocktailChicken Caesar SaladCole SlawSoft TacoApple SlicesSlice of Pepperoni PizzaWhole Wheat Roll Chicken Salad SandwichGreen beansHot DogBaked BeansRoasted Turkey Sandwich Corn on the cobGrilled Chicken SandwichSide Salad16

Nutrition it matters!

Which food group(s) below contain carbohydrates?

Carbs raise blood sugar18Carbohydrates (Carbs) Raise Blood SugarFoods that contain Carbohydrates:Starches/Grains - Bread, Pasta, Rice, Couscous, Oatmeal, Cereal, Pancakes/Waffles Fruits VegetablesStarchy veggies Corn, Potatoes, YamsNonstarchy veggies - less than 5 grams of carbs per serving Not enough to significantly raise your blood sugar!Legumes - Peas (green, crowder), Beans (navy, pinto, black, kidney, lima), LentilsDairy - Milk, Yogurt, etc.Sweets - Cakes, Pastries, Candy, Honey, Syrup, Sugar, Ice CreamBeverages Sweet tea, regular sodas, sports drinks, fruit juices

Nonstarchies

Amaranth or Chinese spinachArtichokeAsparagusBaby cornBamboo shootsBeans (green wax, Italian)Bean sproutsBeetsBroccoliBrussels sproutsCabbage (green, bok choy, Chinese)CarrotsCauliflowerCeleryChayoteColeslaw (packaged, no dressing)CucumberEggplantJicama

KohlrabiLeeksMushroomsOkraOnionsPea podsPeppersRadishesRutabagaSalad greens (chicory, endive, escarole, lettuce, romaine, spinach, arugula, radicchio, watercress)SauerkrautSugar snap peasSummer squashSwiss chardTomatoWater chestnutsYard-long beansZucchini

Eat Regular Meals and SnacksAvoid skipping meals, especially if you are on insulin!

Include snacks to prevent low blood sugarTry to space your meals out, at least every 4-5 hours

Make your plate COLORFUL

Watch out for extra calories

What is a way for someone with diabetes to enjoy sweetened beverages without compromising their blood sugar?What could you change in your lunch?Drink ChoicesSoda100% Fruit JuiceWaterSweet TeaFlavored Whole MilkKool-Aid Skim milkHow could you change your drink?EntreesSidesChicken TendersFrench friesHamburgerPotato saladCheeseburgerOnion ringsBeef and Cheese NachosFruit CocktailChicken Caesar SaladCole SlawSoft TacoApple SlicesSlice of Pepperoni PizzaWhole Wheat Roll Chicken Salad SandwichGreen beansHot DogBaked BeansRoasted Turkey Sandwich Corn on the cobGrilled Chicken SandwichSide SaladQuestions before we moove on?

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