1. Diabetes

2.  Prevalence of Diabetes: 25.8 million adults in the US – 8.3%.  Metabolic Syndrome: Risk factors related to obesity.  Type I: Beta cells produce little or no insulin.  Type II: Fat, Liver, and muscle cells do not respond to insulin (insulin resistance)  Gestational Diabetes: High sugars in Preg.

3. Pathophysiology of Diabetes When you eat, your body breaks food down into glucose. Glucose is a type of sugar that is your body’s main source of energy. 6

4. Pathophysiology of Diabetes As blood glucose rises, the body sends a signal to the pancreas, which releases insulin. 7

5. Pathophysiology of Diabetes Acting as a key, insulin binds to a protein on the cell membrane (an insulin receptor), stimolating GLUT4 to merge with the membrane so glucose can move inside. There, most of the glucose is used for energy right away. 7

6. Blood glucose regulation Blood glucose goes up and down throughout the day: 8  As your blood glucose rises (after a meal), the pancreas releases insulin.

7. PBRC 20097 of 38 Type 1: Overview  Usually diagnosed in children and young adults.  Previously known as “juvenile diabetes”.  In this type of diabetes, the body does not produce insulin.  Insulin is required in order for the body to properly use sugar, in the form of glucose.  Sugar is the basic fuel for the cells in the body.  Insulin’s role is to take the sugar from the blood and carry it into cells where it can be used to provide energy for the body to work.

8. PBRC 20098 of 38  Insulin is a hormone made from beta cells inside of the pancreas.  With each meal consumed, beta cells release insulin in order to help the body use or store the blood glucose it gets from foods.  With Type 1 Diabetes; however, the pancreas no longer makes insulin.  These beta cells have been destroyed for some reason and insulin shots are thus required in order for the body to use the glucose coming from meals. About Insulin

9. Type 2 diabetes Your cells don’t use insulin properly. The insulin can’t fully “unlock” the cells to allow glucose to enter (insulin resistance). Your pancreas may not produce enough insulin (insulin deficiency). 13

10. Natural History of Diabetes

11. Diagnosing diabetes less than 100 mg/dL normal 125 mg/dL to 100 mg/dL pre-diabetes 126 mg/dL or greaterdiabetes Fasting plasma glucose test (FPG) results 28

12. Risk factors for type 2 diabetes  Are overweight.  Are 45 or older.  Are physically inactive.  Have a parent or sibling with type 2 diabetes.  Are African American, Native American, Hispanic American, or Pacific Islander.  Have high cholesterol levels.  Have had gestational diabetes, or given birth to a baby greater than 9 lbs.  Have high blood pressure. Type 2 is more common in people who: 14

13. Hyperglycemia Can Cause Serious Long-Term Problems

14. Blood Glucose Targets for Adults  Pre-meal or fasting : 80-120  2 hours post-meal: 80-140  Bedtime: 80-140 or 100-140

15. When & How Often Should I Be Testing?  On insulin: 4 times per day.  Not on insulin: 2 times per day.

16. Hypoglycemic Symptoms