DM 2022(1)

DIABETES

Prevalence of Obesity and Diabetes

• Obesity (BMI ≥30 kg/m²)

  • Age-adjusted prevalence in years: 1994, 2000, 2014.

  • Categories:

    • No Data

    • <14.0%

    • 14.0% - 17.9%

    • 18.0% - 21.9%

    • 22.0% - 25.9%

    • 26.0%

• Diabetes

  • Age-adjusted prevalence in years: 1994, 2000, 2014.

  • Categories:

    • No Data

    • <4.5%

    • 4.5% - 5.9%

    • 6.0% - 7.4%

    • 7.5% - 8.9%

    • 9.0%

• Source: CDCT Division of Diabetes Translation, CDC

Characteristics of Diabetes Mellitus (DM)

• Definition: Characterized by elevated blood glucose and inadequate or ineffective insulin production.

• Impact: Impairs the body’s ability to regulate blood glucose.

• Complications:

  • Amputations

  • Blindness

  • Heart disease

  • Kidney disease

Diabetes Statistics

• Death Rank: Diabetes ranks 7th among leading causes of death in the US.

• Risks:

  • Individuals with DM have doubled risk of heart disease and stroke.

• Economic Burden: Diabetes costs approximately $132 billion in US healthcare services.

Prediabetes and Testing

• Diagnosis:

  • Fasting blood glucose levels:

    • Normal: 70-99 mg/dl

    • Prediabetes: 100-125 mg/dl

    • Diabetes: >126 mg/dl

Cellular Level of Blood Sugar Regulation

• After meals, blood sugar levels rise.

• Cells and body tissues require glucose for energy.

• Insulin is needed for glucose uptake or produced by the pancreas.

Dangers of Elevated Blood Sugar

• Alters metabolism in every cell.

• Impairs blood vessel function leading to:

  • Nerve damage

  • Loss of circulation

  • Kidney damage (dialysis may be required)

Signs/Symptoms of Type 1 Diabetes

• Frequent urination (Polyuria)

• Increased hunger (Polyphagia)

• Extreme fatigue

• Increased thirst (Polydipsia)

• Unexplained weight loss

• Blurred vision

• Slow healing of cuts and bruises

• Frequent infections

• Easily tiring

Treatment for Type 1 Diabetes

• Components:

  • Diet

  • Exercise

  • Insulin injections

• Pancreatic Cells:

  • Alpha cells produce glucagon.

  • Beta cells produce insulin (Islets of Langerhans).

Symptoms for Type 2 Diabetes

• Symptoms similar to Type 1.

• Additional symptoms:

  • Blurred vision

  • Numbness in limbs

  • Frequent infections

  • Slow wound healing

  • Foot ulcers

• Nature: Type 2 diabetes is never cured; requires ongoing monitoring of diet and weight.

Treatment for Type 2 Diabetes

• Components:

  • Exercise

  • Weight loss

  • Diet

  • Oral hypoglycemic agents

  • Insulin (if necessary)

Risk Factors for Type 2 Diabetes

• Demographics:

  • Age > 30 years

  • Overweight/obese individuals

  • Family history of diabetes

  • Women who have given birth to babies weighing > 9 pounds

  • Risk higher in racial groups:

    • African Americans: 1.6x greater risk than Caucasians.

    • Hispanics: 2x greater risk than Caucasians.

    • Native Americans: 2.7x greater risk than Caucasians.

Hypoglycemia

• Definition: A symptom of low blood sugar, not a disease.

• Symptoms:

  • Anxiety attacks

  • Weakness

  • Rapid heartbeat

  • Sweating

  • Hunger

  • Trembling

• Causes: May be due to overexertion, poor diet, or over-exercising.

Diet Recommendations

• Meal Structure: 6 small meals throughout the day.

• Carbohydrate Management: Simple sugars must be counted in daily intake.

• Nutrient Inclusion: Ensure a balanced intake to avoid deficiencies.

  • Adequate fiber (fruits, vegetables, whole grains) for stable blood sugar.

  • Low in saturated fats.

  • Adequate but moderated protein to avoid kidney damage (especially in those with diabetes).

Management of Diabetes

• Medical Nutrition Therapy: Focuses on controlling carbohydrate intake.

• Carbohydrate Recommendations: Varies based on individual glucose tolerance and timing of carbohydrate consumption.