1. Diabetes ABCs Provided Courtesy of RD411.com
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Diabetes ABCs
Contributed by Shawna Gornick-Ilagan, MS, RD, CWPC
Review Date 8/09 D-0549

2. Disclaimer
This presentation should not substitute or replace any medical advice prescribed by your doctor
The presentation is meant to provide you with general health information to empower you and your family to prevent or manage diabetes

3. Objectives What is diabetes? What are my risks of getting it?
How can I prevent diabetes?
How do I manage diabetes if I get it?
What do the ABCs stand for?

4. What Is Diabetes
Diabetes is a condition in which the body is unable to properly utilize blood sugar
Every time you eat, your body converts your food into blood sugar. The larger the meal (carbohydrates break down into blood sugar the quickest), the more blood glucose you will have circulating in your bloodstream. Insulin is a hormone secreted by your pancreas that gets the blood sugar into the cell. Every cell in your body needs blood sugar to survive. As you can see in the first chart, this person ate a small breakfast and lunch and a very large dinner. This would not bother most people, because the pancreas will release insulin to stabilize your blood sugar to a normal value, but when you have diabetes, this will not happen.

5. What’s Your Diabetes IQ?
If you want, you can hand out paper and pencils, so that attendees can write down their answers.

6. Diabetes IQ Test Every 24 hours:
More than 1000 adults are diagnosed with diabetes
More than 2000 adults are diagnosed with diabetes
More than 3000 adults are diagnosed with diabetes
More than 4000 adults are diagnosed with diabetes

7. Diabetes IQ Test Every 24 hours:
About 10 children and adolescents are diagnosed with type 1 diabetes
About 20 children and adolescents are diagnosed with type 1 diabetes
About 30 children and adolescents are diagnosed with type 1 diabetes
About 40 children and adolescents are diagnosed with type 1 diabetes

8. Diabetes IQ Test Every 24 hours:
2 children and adolescents are diagnosed with type 2 diabetes
5 children and adolescents are diagnosed with type 2 diabetes
8 children and adolescents are diagnosed with type 2 diabetes
10 children and adolescents are diagnosed with type 2 diabetes

9. Diabetes IQ Test Every 24 hours:
Approximately 50 people die from diabetes
Approximately 100 people die from diabetes
Approximately 150 people die from diabetes
Approximately 200 people die from diabetes

10. Diabetes IQ Test Every 24 hours:
50 people with diabetes have a nontraumatic lower-limb amputation
100 people with diabetes have a nontraumatic lower-limb amputation
150 people with diabetes have a nontraumatic lower-limb amputation
200 people with diabetes have a nontraumatic lower-limb amputation

11. Diabetes IQ Test Every 24 hours:
About 30 people with diabetes develop kidney failure
About 60 people with diabetes develop kidney failure
About 90 people with diabetes develop kidney failure
About 130 people with diabetes develop kidney failure

12. Diabetes IQ Test Every 24 hours:
Nearly 5 adults with diabetes go blind
Nearly 15 adults with diabetes go blind
Nearly 25 adults with diabetes go blind
Nearly 50 adults with diabetes go blind
Quiz derived from information found at

13. Answer Key The correct answer for all questions— d.
Over the years, high blood glucose (hyperglycemia) damages nerves and blood vessels, leading to complications such as:
Heart disease
Stroke
Kidney disease
Blindness
Nerve problems
Gum infections
Amputation

14. What Are the Symptoms? Some people do not have symptoms
Other people have experienced these symptoms:
Increased thirst
Increased urination
Weight loss without trying
Blurred vision
Increased hunger
Increased fatigue

15. Types of Diabetes The three types of diabetes:
Type 1 (juvenile diabetes, insulin dependent: %-10%
Type 2 (adult onset, noninsulin dependent): %-95%
Gestational diabetes (diabetes during pregnancy): 2%-5%
Prediabetes
Centers for Disease Control estimates that 57 million Americans age 20+ have prediabetes

16. Normal Process Insulin
Islet cells are located in the pancreas and make hormones, including insulin,…

17. Diabetes: Type 1
glucagon, somatomammotropin, and pancreatic polypeptide. In some people, the immune system produces islet cell antibodies, which attack and destroy the islet cells as though they were foreign substances; this can lead to serious health conditions, such as type 1 diabetes.

18. Diabetes: Type 2
= Fat
Insulin

19. Diabetes: Type 2 (Over Time)

20. Type 1 Diabetes: Risk Factors
Family history of type 1 diabetes: 10%-15%
Race: White people have a greater risk
Presence of islet cell antibodies in the blood
Prevention
Currently no way to prevent type 1 diabetes
Can prevent or delay the development of complications, such as:
Vision, kidney, or heart failure
Blood vessel and nerve diseases
Prevention: Keep blood sugar near normal levels

21. Type 2 Diabetes: Risk Factors
Risk factors that you can not control:
Family history
Age
Race
History of gestational diabetes
Risk factors that you can control:
Lose weight if overweight
Eat healthy and exercise
Quit smoking
Get treatment if you have prediabetes, high blood pressure, or high cholesterol

22. Gestational Diabetes
Stay at a healthy weight and do not gain too much weight during pregnancy
Exercise regularly to help keep your blood sugar level within a safe range and to prevent gestational diabetes

23. Weight Gain Recommendations
Weight Gain During Pregnancy
Category
Weight Gain Recommendations
If you began pregnancy at a normal weight
25–35 pounds
If you began pregnancy underweight
28–40 pounds
If you began pregnancy overweight
15–25 pounds
If you are expecting twins
35–45 pounds

24. Plasma Glucose Results (mg/dL)
How Is It Diagnosed?
Fasting plasma glucose: Must fast for 8 hours or more
Plasma Glucose Results (mg/dL)
Diagnosis
99 or below
Normal
Prediabetes
126 or above
Diabetes
dL=deciliter, mg=milligram

25. Glucose Testing Recommendations
Blood glucose:
During a regular physical
Symptoms suggesting hyperglycemia or hypoglycemia
During pregnancy
Diabetic
Starting at age 45 and every 3 years if normal results

26. Prediabetes

27. Prediabetes
Is prediabetes the same as impaired glucose tolerance or impaired fasting?
Yes: Doctors sometimes refer to this state of elevated blood glucose levels as impaired glucose tolerance or impaired fasting glucose (IGT/IFG), depending on which test was used to detect it
Source: American Diabetes Association. Frequently asked questions about pre-diabetes. Available at: Accessed September 10, 2009.

28. Good News
Type 2 diabetes is preventable if you catch it early and make some changes in your lifestyle

29. 85%-90% of Diabetes Is Preventable

30. Diabetes: Type 2 Insulin
The reason why so many diabetes cases are preventable is because 90%-95% of all diabetes cases are type 2. What happens in type 2 diabetes is that extra fat is preventing the insulin from doing its job (to get sugar into the cell).

31. Bad News Type 2 diabetes is a condition that consumes your: Time Money
Energy

32. How to Prevent Type 2 Diabetes
Maintaining a healthy weight
Increasing fruit and vegetable consumption
Increasing fiber intake
Decreasing fat intake
Exercising
Breastfeeding infants
20% less likely to have diabetes and high cholesterol

33. Tips to Maintain a Healthy Weight
Do not drink calories
Eat slowly
Stay hydrated
Try the low-fat or nonfat version of foods
Change habits
Eat three meals each day
Focus on fruits and vegetables
Get enough fiber

34. Tips to Maintain a Healthy Weight
Fruits and vegetables
Canned or frozen
Frozen grapes
Prepackaged
Microwaveable
Low-fat dip
5 servings/day
Dietary fiber
Beans
Oatmeal
Whole grain
Pastas
Cereals
Breads
Adults need grams (g)/day; children older than age 3 need their age plus 5 g (minimum recommendation)
Source: Dwyer JT. Dietary fiber for children: how much? Pediatrics (serial online). 1995;96: Available at: Accessed September 10, 2009

35. Exercise Regularly
Exercise regularly to help raise your high-density lipoprotein (HDL), the good cholesterol, and lower your low-density lipoprotein (LDL), the bad cholesterol
Aim for 30 minutes of activity or more on most days of the week

36. Decrease Saturated and Trans Fats
Type of Harmful Fat
Food Source
Saturated fat
Animal products, such as meat, poultry, seafood, eggs, dairy products, lard, and butter
Coconut, palm, and other tropical oils
Trans fat
Partially hydrogenated vegetable oils
Commercial baked goods, such as crackers, cookies, and cakes
Fried foods, such as doughnuts and French fries
Shortening and margarine

37. Opt for Healthy Fats Type of Healthy Fat Food Source
Monounsaturated fat
Olive oil, peanut oil, and canola oil
Avocados
Nuts and seeds
Polyunsaturated fat
Vegetable oils, such as safflower, corn, sunflower, soy, and cottonseed oils
Omega-3 fatty acids
Fatty cold-water fish, such as salmon, mackerel, and herring
Flaxseeds and flax oil
Walnuts

38. Know Where to Look Lose weight—calories
Lower cholesterol—saturated and trans fats
Manage glucose—total carbohydrate

39. The Good News… A stands for A1c
By managing the ABCs of diabetes, people with diabetes can reduce their risk of heart disease and stroke
A stands for A1c
B stands for body mass index (BMI) and blood pressure
C stands for cholesterol

40. Average Blood Sugar Level
A: Ask About Your A1c
A1c Reading
Average Blood Sugar Level 6%
135 mg/dL 7%
170 mg/dL 8%
205 mg/dL 9%
240 mg/dL
10%
275 mg/dL
11%
310 mg/dL
12%
345 mg/dL
A1c measures average blood glucose over the last 3 months
Get your A1c checked at least twice/year

41. Healthy Plate Format One fourth plate starch One fourth plate meat
One half plate nonstarchy vegetables
8 fluid ounces of reduced-fat milk
One serving of fruit

42. Cereal or Grain 15 g of carbohydrate=one serving
One cereal or grain serving is:
One slide of bread
One half of a hamburger bun
¾ cup (C) of unsweetened cereal
⅓ C cooked pasta
3 C popcorn
½ C cooked oatmeal

43. Fruit 15 g of carbohydrate=one serving One fruit serving is:
⅓ C of fruit juice
½ C of canned fruit
One small piece of fruit, such as an apple

44. Milk or Dairy 15 g of carbohydrate=one serving
One milk or dairy serving is:
1 C of milk
6 ounces of yogurt

45. Starch or Vegetables 15 g of carbohydrate=one serving
One starch or vegetable serving is:
⅓ C of beans
½ C of corn or peas
½ C of mashed potatoes

46. Quick Reference Chart for Eating With Diabetes
Number of Exchanges/Day for Various Calorie Levels
Calories
1200
1500
1800
2000
2200
Starch/Bread 5 8 10 11 13
Meat 4 7
Vegetable 2 3
Fruit
Milk
Fat
Source: University of Maryland Medical Center. Diabetes diet—diabetic exchange lists. Available at: Accessed September 10, 2009.

47. B: BMI BMI is a number calculated from a person’s weight and height
Higher BMI values are associated with risk for health problems
BMI goal=less than 25
More information at

48. Normal Weight Increased Risk High Risk 19 20 21 22 23 24 25 26 27 28
BMI
(kg/m2) 19 20 21 22 23 24 25 26 27 28 29 30 35 40
Height
Normal Weight
Increased Risk
High Risk 58 91 96
100
105
110
115
119
124
129
134
138
143
167
191 59 94 99
104
109
114
128
133
148
173
198 60 97
102
107
112
118
123
153
179
204 61
106
111
116
122
127
132
137
158
185
211 62
120
126
131
136
142
147
164
218 63
113
130
135
141
146
152
163
169
197
225 64
140
145
151
157
174
232 65
144
150
156
162
168
180
210
240 66
155
161
186
216
247 67
121
159
166
172
178
223
255 68
125
171
177
184
190
230
262 69
149
176
182
189
196
203
236
270 70
139
160
181
188
195
202
207
243
278 71
165
193
200
208
215
250
286 72
154
199
206
213
221
258
294 73
212
219
227
265
302 74
194
233
272
311 75
192
224
279
319 76
205
238
246
287
328

49. B: Beware of Your Blood Pressure
High blood pressure raises your risk for heart attack, stroke, eye problems, and kidney disease
Get your blood pressure checked at every visit
Target blood pressure=less than 130/80

50. Key Steps for Lowering Blood Pressure
Lose weight
Eat more fruits and vegetables
Reduce the amount of salt in diet
Lower alcohol intake
Quit smoking
Take blood pressure pills, if prescribed
Many people require more than one pill

51. C: Check Your Cholesterol
Several kinds of blood fats:
Total and LDL (“lousy”) cholesterol—can narrow or block vessels
HDL (“healthy”) cholesterol—helps remove cholesterol deposits
Triglycerides—can raise your risk for heart attack/stroke

52. Know Your Numbers Value Goals A1c Less than 7 Blood pressure
Total cholesterol
Less than 200
LDL cholesterol
Less than 100
HDL cholesterol
Greater than 40 (men)
Greater than 50 (women)
Triglycerides
Less than 150