Chapter 12a Lecture

Health: The BasicsTenth Edition

Focus On: MinimizingYour Risk for Diabetes

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Minimizing Your Risk for Diabetes

• The CDC estimates that 25.8 million people, 8.3% of the population, have diabetes.

• It is the fastest growing chronic disease in American history.

• Approximately 225,000 people die each year of diabetes-related complications.

• About 79 million people over age 20 have prediabetes.

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ABC News Video: Will Diabetes Cases Double in 25 Years? Discussion Questions

1. Medical studies predict that the numberof Americans with diabetes will double in the next 25 years. What does Dr. Richard Besser claim to be the cause of this extreme increase?

2. How will this increase in the number of people with diabetes affect the cost of treatment of the disease? How do you think this would affect the overall cost of health care?

3. What lifestyle adjustments can you make now to help reduce your risk of type 2 diabetes later in life?

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Diabetes Mellitus

• Disease characterized by a persistently high level of sugar (glucose) in the blood

• Another characteristic is the production of an unusually high volume of glucose-laden urine

• Pancreas fails to produce enough insulin or the body fails to use insulin effectively

• Hyperglycemia—high blood glucose levels seen in diabetes

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Percentage of U.S. Population with Diagnosed Diabetes

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What Is Diabetes?

• In Healthy People, Glucose Is Taken Up Efficiently by Body Cells– Carbohydrates from the foods are broken down into a

monosaccharide called glucose.– Liver and muscle cells store glucose as glycogen,

then use it as needed to fuel metabolism, movement, and other activities.

– Pancreas—an organ located just beneath the stomach that secretes a hormone called insulin

– Insulin—hormone secreted by the pancreas and required by body cells for the uptake and storage of glucose

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Type 1 Diabetes

• Type 1 Diabetes Is an Immune Disorder– The individual's own immune system attacks

and destroys the insulin-making cells in the pancreas.

– Risk increases with European ancestry, a genetic predisposition, and an environmental 'insult' such as a viral infection.

– Daily insulin injections, or insulin infusion, are required for survival.

– Type 1 patients must monitor their diet and exercise levels.

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Type 2 Diabetes

• Type 2 Diabetes Is a Metabolic Disorder– Accounts for 90% of all diabetes cases.– Either the pancreas does not make sufficient insulin or body

cells are resistant to its effects (insulin resistance).

• Development of the Disease– The overabundance of free fatty acids contributes to insulin

resistance.– As the progression to type 2 diabetes continues, pancreatic

insulin-producing cells become exhausted from overwork and damage occurs.

• The current epidemic of type 2 diabetes suggests lifestyle factors, such as increased caloric intake, and decreased physical activity, are to blame.

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Risk Factors for Diabetes

• Nonmodifiable Risk Factors• Increased age• Certain ethnicities (Native Americans and African Americans)• Genetic factors• Biological factors

• Modifiable Risk Factors• Body weight• Dietary choices• Level of physical activity• Sleep patterns• Level of stress• BMI of 25 or greater• Waistline of 40 inches or more in males and 35 inches or

more in females

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Discussion Questions

1. Discuss the relationship the Blankenship family has with type 2 diabetes. Why do you think they have been so afflicted by this disease?

2. What complications can diabetes cause both physically and mentally? How do you think diabetes affects a person's day-to-day life? Why do you think diabetes might be considered a more difficult disease to manage than some other diseases?

3. In what ways do you think diabetes can be considered a pandemic?

ABC News Video: Diabetes Plagues West Virginia County

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Prediabetes

• Prediabetes can lead to type 2 diabetes– A condition in which blood glucose levels are

higher than normal, but not high enough to be classified as diabetes

– Affects more than 35% of the adult population

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Metabolic Syndrome

• Prediabetes plays a role in metabolic syndrome– Metabolic syndrome (MetS)—Cluster of six

conditions linked to overweight and obesity – Prediabetes and central adiposity appear to

be the dominant factors for development of MetS.

– A person with MetS is five times more likely to develop type 2 diabetes than a person without the syndrome.

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Gestational Diabetes

• Gestational diabetes develops during pregnancy– A state of high blood glucose that is first recognized in a woman

during pregnancy– Occurs in 4% of all pregnancies.– Women with gestational diabetes have a significantly increased

risk of progressing to type 2 diabetes 9 years after giving birth.– There is a 35–60% chance of developing diabetes in the next

10-20 years.– There is increased risk of birth-related complications, such as

difficult labor, high blood pressure, high blood acidity, increased infections, and death.

– The fetus is also endangered: Risks include malformations of the heart, nervous system, and bones; respiratory distress; and excessive growth that can lead to birth trauma.

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Diabetes: What It Is; How It Develops

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What Are the Symptoms of Diabetes?

• Thirst

• Excessive urination

• Weight loss

• Fatigue

• Nerve damage

• Blurred vision

• Poor wound healing and increased infections

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Diabetes Can Have Severe Complications

• Diabetic ketoacidosis

• Cardiovascular disease

• Kidney disease

• Amputations

• Eye disease and blindness

• Flu and pneumonia-related deaths

• Tooth and gum disease

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Complications of Uncontrolled Diabetes

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Blood Tests to Diagnose and Monitor Diabetes

• Fasting Plasma Glucose Test (FPG)– Patient is required to fast overnight, then blood is

drawn and tested for glucose concentration.

• Oral Glucose Tolerance Test (OGTT)– Patient is required to drink a liquid containing

concentrated glucose, then blood is drawn two hours later and tested for glucose concentration.

• Hemoglobin A1C Test– A regular blood glucose test done by a physician

every three to six months

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Lifestyle Changes Can Improve Glucose Levels

• Weight Loss– Recommended goal is to lose 5 to 10% of current

weight.

• Adopting a Healthy Diet– Whole grains– High-fiber foods– Fatty fish

• Increasing Physical Fitness– The Diabetes Prevention Program recommends 30

minutes of physical activity 5 days a week.

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How Is Diabetes Treated?

• Oral medications and weight loss surgery can help– Medications can

• Reduce glucose production by the liver • Slow the absorption of carbohydrates from the small intestine• Increase insulin production by the pancreas• Increase the insulin sensitivity of cells

– People who have undergone gastric bypass surgery appear to have high rates of cure.

– Gastric bypass surgery risks include serious complications and death.

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Insulin Injections

• Insulin injections may be necessary– Essential for those with type 1 diabetes– Essential for people with type 2 diabetes

whose blood glucose levels cannot be adequately controlled with other treatment options

– Insulin cannot be taken in pill form because it is a protein and would be digested in the gastrointestinal tract.

– Most people use an insulin infusion pump.