TYPE 1, TYPE 2, AND GESTATIONAL

DIABETESAMONG LATINOS IN

NEW YORK

Kevin Cabrera & Margie Perez

Type 1 Diabetes

What is Type 1 diabetes?

• Disorder of the immune system that makes it hard to produce insulin.

• The body then can not convert sugar from food into nutrients. It leads to excess sugar being built up in the blood stream.

• It can be genetic.

• People with type 1 diabetes must inject themselves with insulin to stay alive.

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Complications of Type 1 diabetes•Heart disease•Nerve damage•Amputations•Blindness•Kidney failure

Type 2 Diabetes

What is Type 2 diabetes?

• Most common form of diabetes.• The body either does not produce enough insulin or the

cells ignore the insulin. That is necessary for the body to use glucose for energy.

• Obesity can be tied to type 2 diabetes

Complications of Type 2 diabetes•Foot complications•Stroke•High Blood Pressure•Kidney Disease•Extreme fatigue

image url: http://guardiansoflife.weebly.com/uploads/2/6/9/8/26984883/7938736_orig.jpg

Diabetes among race

• Among Hispanics:• Cubans : 7.6%• Mexican Americans : 13.3%• Puerto Ricans : 13.8%

(According to the American Diabetes Association)

• Race and ethnicity ages 20 years and older with diabetes:

• Non-Hispanic Whites : 7.1%• Asian Americans : 8.4%• Hispanics : 11.8%• Non-Hispanic blacks : 12.6%

(According to the American Diabetes Association)

Obesity and diabetes

• More than 80% of people with type 2 diabetes are overweight.• In 2011, Hispanic adults were 30% less likely to engage in active

physical activity as non-Hispanic whites.• From 2007-2010, Mexican American Women were 40% more likely to

be overweight, as compared to non-Hispanic whites.

Diabetes in NYC

• About 6,000 New Yorkers die every year because of obesity related illnesses.

• African Americans and Latinos are affected by diabetes. In particular Mexican Americans and Puerto Ricans.

• They get diabetes at almost twice the rate of whites. Especially in the Bronx and Brooklyn.

• In places like the upper east side, it is less likely for new yorkers to have diabetes.

• New York’s diabetes rate is ⅓ higher than the rest of the country.

Gestational Diabetes

What is gestational?

• A degree of glucose intolerance with an onset or first recognized during preganancy.

• Increases the risk of developing type 2 diabetes later in life.• Related to both maternal and fetal health• Between 2 and 10 percent of expectant mothers develop this• Develops in nearly 5% of live birth in NYC

www.babycenter.com; (Brissette, Mills), www.nyc.gov

Adult Diabetes Prevalence in New York State

Why ?

• Latinas have a greater tendency to develop diabetes, all types. • 1 in 4 have some form of this disease • 52.5% risk of developing diabetes in their life time • Many do not know they have diabetes when they get pregnant• Overall it has risen nearly 50% in about ten years • “Some arrive into their pregnancies obese and leave them more

obese”( Hackley, certified nursed-midwife)• In 2001 there 4,200 cases in New York • Ranges in age • Its a vicious cycle

Babycenter.com, Klienfiled,2006 (nytimes.com)

How does it effect the baby?

• Too much glucose (hyperglycemia)• The baby’s pancreas has to develop insulin to process it• Excess sugar and insulin cause baby to put on extra weight while in utero

• Mainly in the upper body• Leads to macrosomia

• A newborn with an excess bodyweight• May be too large to enter the birth canal• Baby’s head may enter the birth canal but the baby’s shoulders might get stuck

• Special maneuver to deliver the baby• May result in bone fracture or nerve damage

• Both heal with no permanent damage (99%)• Rare case-baby suffers brain damage

• The maneuver used to deliver can lead to injuries • Vaginal Area• A large episiotomy (incision) required Babycenter.com

Other Effects to pregnancy

• Increases the risk of still birth• Last two months

• More likely to develop preeclampsia• If obesity or blood sugar not monitored• High blood pressure and high level of protein in urine • More conditions

• Swelling of feet, legs and hands• Lead to more complications

Babycenter.com

Baby After Birth

• Continues to be overweight in childhood and adulthood• After birth, baby may have hypoglycemia

• Low blood sugar

• Breathing problems• Risk of jaundice

• Yellow discoloration of skin, mucus membrane, and whites of eyes

• Risk of baby with polycythemia • Increases in number of red cells blood

• Risk of hypocalcaemia• Low calcium in blood

• Baby’s heart function Babycenter.com

Risk Factors• History of gestational diabetes• Being overweight or obese• Older than 25• Family history of diabetes• Previously delivered baby weighing more than 9 pounds• Glucose in urine • Being African-American, Hispanic, Native American, or Asian

Terrie,2013

Preventative Methods

Preventative methods

• Informative Packets• Programs

• Nurse-Family Partnership• Newborn Home Visiting Program

• Lifestyle modification• Monitor Blood Sugar • Support• Eat-low fat, well balanced meals• Maintain a healthy weight • Lose weight • Limit alcohol

Preventative Methods (cont.)

• Breast feed your child• Have a regular doctor• Treatment if required

• Daily blood glucose monitoring• Insulin therapy• Medications

• Stick with the plan• Physical Activities

• 30 minutes of brisk walking or longer• 2 hour and 30 minutes of moderate intensity aerobic activity• 1 hour and 15 minutes of vigorous intensity aerobic activity• Combination of exercises• Muscles-strengthening

Sources

• Barowitz, J., Loeser, S., & Mullin, S. (2006, February 21). Mayor Bloomberg and Commissioner Frieden Launches Educational Campaign for Moms Who Develop Diabetes During Pregnancy : Press Releases : NYC DOHMH. Mayor Bloomberg and Commissioner Frieden Launches Educational Campaign for Moms Who Develop Diabetes During Pregnancy : Press

Releases : NYC DOHMH. Retrieved April 8, 2014, from http://www.nyc.gov/html/doh/html/pr2006/mr053-06.shtml• Adult Diabetes Prevalence in New York State. (n.d.). New York State Department of Health. Retrieved April 8, 2014, from

https://www.health.ny.gov/diseases/conditions/diabetes/docs/adult_diabetes_prevalence.pdf• Diabetes. (2010, May 18). womenshealth.gov. Retrieved April 8, 2014, from http://

womenshealth.gov/minorityhealth/latinas/diabetes.html• Diabetes. (2013, June 11). Diabetes. Retrieved April 8, 2014, from

http://www.nyc.gov/html/doh/html/living/diabetes-faq.shtml• Berlin, E. E. (2009, July 29). Gestational Diabetes and Ethnicity. EverydayHealth.com. Retrieved April 8, 2014, from

http://www.everydayhealth.com/gestational-diabetes/gestational-diabetes-ethnicity.aspx• Hispanic women and pregnancy: Gestational diabetes. (n.d.). BabyCenter. Retrieved April 8, 2014, from

http://www.babycenter.com/0_hispanic-women-and-pregnancy-gestational-diabetes_10346415.bc?page=1• Kleinfield, N. (2006, February 18). Diabetes Is Seen as a Rising Risk in Mothers-to-Be . The New York Times, p. 1. Retrieved

April 8, 2014, from http://www.nytimes.com/2006/02/18/nyregion/nyregionspecial5/18diabetes.html?pagewanted=1• Terrie, Y. C. (2013, May 6). Diabetes during pregnancy: Know your risk of gestational diabetes. NY Daily News. Retrieved April

8, 2014, from http://www.nydailynews.com/life-style/health/women-diabetes-pregnancy-article-1.1336314

Sources

• 1.Boseley, Sarah, and Jamie Wilson. "New Yorkers in Grip of Diabetes Epidemic." The Guardian. Guardian News and Media, 10 Jan. 2006. Web. 27 Feb. 2014.http://www.theguardian.com/world/2006/jan/10/usa.health

• 2."Complications - American Diabetes Association®." American Diabetes Association. N.p., n.d. Web. 23 Apr. 2014. <http://www.diabetes.org/living-with- diabetes/complications/>.

• 3."Facts About Type 2 - American Diabetes Association®." American Diabetes Association. N.p., 1 July 2013. Web. 24 Apr. 2014. <http://www.diabetes.org/diabetes-basics/type- 2/facts-about-type-2.html>.

• 4."The Big Issue." The Observer. Guardian News and Media, 09 Mar. 2003. Web. 27 Feb. 2014. http://www.theguardian.com/lifeandstyle/2003/mar/09/foodanddrink.features6

• 5."Type 1 diabetes." Complications. Mayo Foundation for Medical Education and Research, 23 Jan. 2013. Web. 23 Apr. 2014. <http://www.mayoclinic.org/diseases-conditions/type-1-diabetes/basics/complications/con-20019573>.

• 6."We're In!" Obesity and Hispanic Americans. N.p., n.d. Web. 24 Feb. 2014.http://minorityhealth.hhs.gov/templates/content.aspx?ID=6459

• 7."What is Type 1 Diabetes (T1D)?." What is Type 1 Diabetes?. N.p., n.d. Web. 23 Apr. 2014. <http://info.jdrfdsw.org/jdrf/what-is-type1diabetes.php>.