1. UNIT ONE LESSON 1 Diabetes Basics

2. Objectives At the end of the lesson, participants should be able to: 1. Define diabetes 2. Identify the risks of diabetes 3. Identify signs and symptoms of diabetes 4. Differentiate between the types of diabetes 5. Describe feelings and experiences of living with diabetes 6. Set a goal related to managing their diabetes 7. Identify ways to modify everyday recipes to fit into the diabetes meal plan

3. L-esson

4. Facts about Diabetes Diabetes is a growing problem around the world

5. Facts about Diabetes People with diabetes may have reduced quality of life Diabetes increases the risk of heart, kidney, and eye disease, amputations and stroke The effects of diabetes can be controlled by diet and exercise

6. Diabetes Terms Glucose: most of the food we eat is turned into glucose which our body uses for energy Insulin: a hormone that moves glucose into cells Pancreas: the organ that makes insulin

7. What Is Diabetes? Diabetes is a disease in which the body either does not make enough insulin or cannot effectively use the insulin it makes When there is not enough insulin, the blood glucose levels become elevated

8. Balance Is Needed The body normally keeps a balance of insulin and glucose in the blood The normal fasting level of plasma blood glucose of a person without diabetes is: 65-99 mg/dL

9. Risks of Diabetes Damaged nerves can lead to: Pain Weak muscles Loss of feeling in the legs and feet Having high blood glucose over a period of time could damage nerves in the body

10. Ways to Avoid these Risks Make healthy food choices Pay attention to portion sizes Be physically active Control blood glucose

11. Ways to Avoid these Risks Take medication as prescribed Reduce risky behaviors, such as smoking Learn to solve diabetes-related problems Learn to cope with situations in healthy ways

12. Role Playing: Scene 1 What happens to the food we eat? Most of the food we eat is changed into glucose The glucose enters the blood stream and makes the level of glucose in the blood rise The pancreas releases insulin that helps lower the glucose in the blood Insulin helps glucose move from the blood into the cells of the body This helps to maintain normal blood sugars

13. Role Playing: Scene 2 A person who has diabetes: Food is changed into glucose The glucose enters the blood stream and makes the level of glucose in the blood rise The pancreas releases insulin (but not enough to take up the glucose in the blood) Insulin takes some of the glucose to cells A high level of glucose remains in the blood. The high level of glucose in the blood spills over in the urine

14. Role Playing: Scene 3 There is enough insulin but the cells of the body may be resistant to insulin: Food is changed to glucose The glucose enters the blood stream and makes the level of glucose in the blood rise The pancreas releases insulin Insulin and glucose are carried to cell The cells cannot use the glucose. This is called insulin resistance This leads to high blood glucose

15. Symptoms of Diabetes Excessive Urination Excessive Thirst Excessive Hunger Fatigue

16. Symptoms of Diabetes Blurred Vision Tingling in Hands and Feet Sores and Cuts that Heal Slowly Itchy, Dry Skin

17. Symptoms of Diabetes Impotence in Males Yeast Infections in Females Blood Glucose Levels Higher than 126 mg/dL

18. Pre-diabetes A condition where the blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes Individuals with this condition tend to develop type 2 diabetes within 10 years Risk of diabetes and stroke is increased Modest weight loss and physical activity can prevent or delay the onset of this condition

19. Types of Diabetes Type 1 diabetes Type 2 diabetes Gestational diabetes

20. Type 1 Diabetes Usually found in children, teenagers and young adults The cells that protect the body have destroyed the cells in the pancreas that make insulin These individuals depend on insulin to live

21. Type 2 Diabetes Once called “adult onset diabetes” Most common type of diabetes in 90-95% of all cases Usually occurs in people who are overweight or obese

22. Type 2 Diabetes The body does not produce enough insulin or the cells ignore the insulin As a result, the cells do not get enough glucose for energy The pancreas tries to make more insulin to help the cells Eventually the pancreas loses the ability to make enough insulin or the body cannot use the insulin adequately.

23. Type 2 Diabetes Risk factors include: Type 2 diabetes in a family member Being overweight or obese Physical inactivity Age greater than 45 years

24. Gestational Diabetes Develops during the later stages of pregnancy Generally goes away after the birth of the baby Women who develop this type of diabetes are more likely to develop type 2 diabetes later in life

25. Game – Who Am I? Types of Diabetes 1. I am the type of diabetes in which people need insulin injections to live 2. I am the type of diabetes that develops during the late stages of pregnancy and generally goes away after the birth of the baby

26. Game – Who Am I? Types of Diabetes 3. I am normally seen in children, teenagers and young adults 4. I may be called “adult onset diabetes” 5. I am the most common form of diabetes

27. Game – Who Am I? Types of Diabetes 6. I am the type of diabetes where blood glucose levels are higher than normal but not high enough for the individual to be diagnosed with the disease.

28. E-mpowerment Diabetes Education Series: Diabetes Basics

29. Diabetes Education Series Describe your experiences and feelings living with diabetes. What was most difficult for you? What are ways that you could overcome some of these difficulties?

30. A-ction Set a goal to help you avoid the dangers of diabetes

31. R-eal-Life Problem Solving John’s Story

33. Questions about John’s Story What are John’s issues or problems? What is the first step that John needs to take in this situation? What are some other things that John needs to do in this situation? (List as many suggestions as possible.) What are two things that John could do right away to deal with this problem? Why?

34. Review Question A person is said to have diabetes when he or she: a) Eats too much sugar b) Has too much glucose in the blood c) Has too much insulin in the blood Answer: Diabetes is defined as having too much glucose in the blood.

35. Review Question Which of the following is a symptom of diabetes? a) Excessive urination b) Excessive thirst c) Blurred vision d) Sores and cuts that do not heal Answer: All of the above are correct.

36. Review Question The risks of diabetes include which of the following? a) Kidney disease b) Stroke c) Loss of feeling in the legs and feet d) Weak muscles Answer: All of the above are correct.

37. Questions about John’s Story Please find the Real-Life Problem Solving handout for this lesson in your folder These questions will help with your understanding of John’s story

38. N-utrition Menu: Banana Yogurt Smoothie

39. See you next week! Remember: “Life is not over because you have diabetes. Make the most of what you have, be grateful.” - Dale Evans, actress Topic: Managing Diabetes

40. Date: References: Margaret E. Cook-Newell, Ph.D., R.D., L.D., CDE Irene Hong-McAtee, MD, MCR Hazel Forsythe, Ph.D., R.D., L.D., CFCS Laura Hieronymus, MSEd, APRN, BC-ADM, CDE Cheryl Case, M.S., Harrison County Ann Hollon, M.A., Wolfe County Adrienne Glodt, B.S., Graduate Student Stephen D. Perry, M.S., R.D., L.D. Lynn Blankenship, M.S., Metcalfe County Theresa Scott, M.A., Floyd County Tamara Thomas, M.S., Franklin County Jennifer Allen, B.S., Graphic Artist Rusty Manseau, B.A., Graphic Artist Author: Ingrid Adams, Ph.D., Assistant Professor, Nutrition and Food Science, University of Kentucky Other Contributors