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November is National Diabetes Awareness Month

Patty Melody, M.A.

Health and Physical Education Instructor

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What’s New?

The American Diabetes Association and the U.S. Department of Health and Human Services are now using the term “pre-diabetes”. This term is used to describe blood sugar levels that are higher than normal but not yet diagnosed with diabetes.

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Pre-diabetesIf you do not take action pre-diabetes will develop into diabetes within 10 years. The state of being pre-diabetic is already increasing your risk for heart disease significantly.

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Agenda

How Big a Problem is This? Define Diabetes Who is at risk? Symptoms of diabetes Should I Get Tested? Prevention Resources

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Some Facts…

Diabetes has become an epidemic in the U.S. for adults and children

Diabetes is the sixth leading cause of death in the U.S. About 17 million Americans have diabetes and 6 million

don’t know they have it About 90% of diabetes cases are related to type 2

diabetes About 90% of type 2 cases are caused by obesity The number of diabetes cases grows by about 1 million

each year

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Diabetes

Diabetes is a metabolic disorder caused by the body’s inability to control chemical processes. The body either doesn’t produce enough insulin or the body does not use the insulin properly. Insulin is the hormone secreted by the islet cells of the pancreas that is necessary for the utilization of glucose. If the insulin is not secreted or used effectively by the cells, glucose levels continue to rise in the blood stream thereby not fulfilling the body’s primary energy needs. The body therefore “thinks” it is starving. This leads to a variety of short-term and long-term medical complications which will be discussed.

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The Insult of Diabetes

The Cardiorespiratory System

Cardio: heart and blood vessels transports oxygen,

nutrients, and wastes among vital organs and tissues

Respiratory: lungs, air passages, and

breathing muscles supplies oxygen and

removes carbon dioxide

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Three types of diabetes

Type 1 (Insulin-dependent) Type 2 (Non-insulin dependent) Gestational diabetes

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Type 1:Insulin-Dependent Diabetes Mellitus (IDDM)

The islet cells of the pancreas does not produce insulin. Usually the onset of this form of diabetes occurs before age 35 (generally during childhood). Destruction of the islet cells by the immune system may be caused by a viral infection within the pancreas. Type 1 diabetes is more serious than type 2 with sudden, irreversible consequences.

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Type 2:Non-Insulin-Dependent Diabetes Mellitus (NIDDM)

Insulin is produced by the islet cells of the pancreas. In type 2 diabetes the insulin receptors on the cells become less sensitive to insulin. This disruption of the body’s system of “checks and balances” in relation to glucose levels causes the blood glucose levels to rise (hyperglycemia). Inactivity and obesity have been correlated to type 2 diabetes. Lifestyle management during pre-diabetes can reverse the onset of diabetes.

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Gestational Diabetes

Some women are diagnosed with gestational diabetes during their pregnancy. These women are at greater risk of developing type 2 diabetes in the future.

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Risk Factors Obesity (>30% body fat) or Overweight (BMI > 25) Sedentary lifestyle Unresolved stress or depression Carrying fat around the waist and stomach Over 45 years old (+65 increases risk even further) Family history of type 2 diabetes Gestational diabetes or having a baby that weighed +9 lbs Being of African-American, Latino, Asian-American, or

Native American descent Low HDL cholesterol level (less than 35) High triglyceride level (250 or above) High blood pressure (140/90 mm/Hg or higher)

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Pre-Diabetes Screening

ACSM GUIDELINES 2000Coronary Artery Disease Risk Factors

Positive Risk Factors Family history Cigarette smoking Hypertension Hypercholesterolemia Impaired fasting glucose Obesity Sedentary lifestyleNegative Risk Factor High serum HDL cholesterol > 60mg/dL

(1.6mmol/L)

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Symptoms of Diabetes1. Polydipsia

2. Polyphagia

3. Polyuria

4. Fatigue

5. Infections

6. Cuts that don’t heal

7. Blurred vision

8. Weight loss Remember this disease is unforgiving when it is left

untreated. Diabetes is the leading cause of blindness, leg and foot amputations and kidney disease. As well as the 6th leading cause of death.

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Signs/Symptoms of Depression

Sadness/hopelessness Loss of pleasure Poor appetite/weight loss Insomnia/disturbed sleep Restless or fatigue Feelings of worthlessness and guilt Trouble concentrating/making decisions Thoughts of death or suicide Or s/s can be opposite of these listed

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Stressors – “The Good, The Bad and The Ugly”

Good Stressors – 1. Getting a promotion2. Graduating3. Getting married4. Winning the lottery5. Dating6. Going on vacation7. Going to a party

Your stress response to these stressors is called Eustress.

Bad stressors –

1. Death of a loved one

2. Divorce

3. Getting fired

4. Car accident

5. Victim of a violent act

6. Being depressed or anxious

Your stress response to these stressors is called Distress.

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Who Should Be Tested?

Anyone 45 or older and overweight Younger overweight people who

have one or more risk factors If you present with any symptoms

of diabetes

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Two Tests to Measure Blood Glucose

Fasting blood glucose test (blood glucose measured before eating breakfast) Normal blood glucose is below 110 mg/dL; Pre-diabetes is 110-125 mg/dL; Diabetes is 126+ mg/dL

Oral glucose tolerance test (measures body’s reaction to a sugary drink) Normal blood glucose is below 140 mg/dL; Pre-diabetes is 140—199 mg/dL; Diabetes is 200+ mg/dL

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Prevention of Diabetes Lose 5-10% of body weight Exercise 30 minutes/day Improve your psychosocial health (stress/depression) Limit sugar to 10 –25% of your calories (6-18

teaspoons/day) (soda has approx. 10 teaspoons of sugar)

Fiber intake – average American takes in 15g/day - increase to 25g/day for women and 38g/day for men

Increase Magnesium Eat 5 servings of fruits/vegetables each day and at

least 3 servings of your 6-11 starch servings should be whole-grain

Get tested for diabetes periodically if you are at risk

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Resources

American Diabetes Association American Dietetic Association (

www.eatright.org) Centers for Disease Control and

Prevention (CDC) American College of Sports Medicine American Heart Association

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Do not automatically conclude that a pill dissolving in your stomach is necessarily more powerful than a healing thought dissolving in your mind

Carr Clifton