1. What is Diabetes?

2. Definition of Diabetes
Diabetes is a disease in which the body does not produce or properly use the hormone insulin. 2
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3. Insulin and Blood Glucose 3
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4. Focus on Blood Glucose
Insulin is required for uptake of glucose (“sugar”) from the blood into cells.
In diabetes, blood glucose levels rise because it can’t get from the blood into the cells.
Consistently high blood glucose causes many health problems. 4
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5. Types of Diabetes Type 1 diabetes Onset usually before age 30.
Absolute insulin deficiency.
Destruction of beta cells in pancreas.
Genetic predisposition
Environmental factors
Auto-immune response
Dependence on exogenous insulin. 5
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6. Type 1 Diabetes: a message from the American Diabetes Association 6
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7. Types of Diabetes Type 2 diabetes Most common in adults over age 40.
Increasing problem in children and adolescents.
Genetic factor: family history.
Metabolic factor: insulin resistance.
Environmental factors: obesity, physical inactivity, and poor dietary habits. 7
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8. Type 2 Diabetes: a message from the American Diabetes Association 8
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9. Type 2 Diabetes: The Situation
About 24 million Americans have type 2 diabetes.
About 6 million of these are undiagnosed.
On average, diabetes is present for 6½ years before diagnosis.
Usually diagnosed during routine medical exam.
About 57 million Americans are at high risk for diabetes. 9
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10. Type 2 Diabetes: Risk Factors
Obesity
Inactivity
Family history
NOTE: About 20% of U.S. adults are obese and sedentary, putting them at high risk for type 2 diabetes. 10
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11. Type 2 Diabetes: Disease Process
Progressive deterioration of glucose tolerance:
Normal glucose tolerance 
Impaired glucose tolerance (pre-diabetes) 
Diabetes mellitus 11
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12. Type 2 Diabetes: Health Complications
Chronic high blood glucose (hyperglycemia) can lead to:
Retinopathy (eye disease)
Nerve damage and amputations
Nephropathy (kidney disease)
Stroke  major cause of death
Heart attack  major cause of death 12
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13. Type 2 Diabetes: Causes of Hyperglycemia
Insulin resistance
Insulin secretory dysfunction
Diagram of insulin crystals 13
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14. Type 2 Diabetes: Insulin Resistance
Decreased ability to use insulin.
Part of a group of conditions called the metabolic syndrome.
Increases risk for atherosclerosis.
Pancreas produces more insulin to attempt to decrease blood glucose. 14
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15. Type 2 Diabetes: Insulin Secretory Dysfunction
Also called defective insulin secretion.
Inability to produce enough insulin to overcome insulin resistance. 15
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16. Insulin Resistance and Defective Insulin Secretion 16
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17. Type 2 Diabetes: The Metabolic Syndrome
Condition exists when person has at least three the following:
Hyperglycemia
Low level of blood high density lipoprotein cholesterol (HDL)
Central obesity
High blood triglycerides
High blood pressure 17
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18. Type 2 Diabetes: Treatment Approach
Best defenses against health complications: WEIGHT LOSS and PHYSICAL ACTIVITY!
Best approach is concurrent management of:
Blood glucose
Blood pressure
Blood lipids
Body weight
Physical activity 18
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19. Type 2 Diabetes: Diabetes Management Plan
To reduce risk of complications by achieving optimal:
blood glucose
blood lipids
blood pressure 19
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20. Tighter Control Improves Health Outcomes
Two major and several smaller research studies over 20 years.
Type 1 and type 2 diabetes studied.
Subjects with tightly controlled blood glucose decreased risk of complications.
Even small improvement in A1C decreased risk! 20
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21. TCYD Participants Decrease A1C
Pilot of TCYD in three Florida counties.
Participants increased knowledge, improved lifestyle behaviors, and monitored blood glucose regularly.
Average A1C decreased from 7.2% to 6.2%.
Average systolic blood pressure decreased from mmHg to 133 mmHg.
You can do it too! 21
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22. Type 2 Diabetes: Treatment Goals
Blood glucose
Fasting blood glucose: 70 to 130 mg/dl
Postprandial (2 hrs after first bite of meal or snack): less than 180 mg/dl
Hemoglobin A1C: less than 7%
NOTE: Your physician may suggest more or less stringent goals. 22
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23. Type 2 Diabetes: Treatment Goals
Blood Lipids
LDL cholesterol: less than 100 mg/dl
HDL cholesterol: over 40 mg/dl (men)
over 50 mg/dl (women)
Triglycerides: less than 150 mg/dl 23
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24. Type 2 Diabetes: Treatment Goals
Blood Pressure
Under 130/80 mmHg
NOTE: Your physician may suggest a more stringent goal. 24
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25. Type 2 Diabetes: Treatment Plan
Proper nutrition
Weight management
Regular physical activity
Medication, if needed 25
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26. Living Well With Type 2 Diabetes
The path to living well includes:
Acceptance
 Education
 Motivation
 Commitment 26
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27. Prepared by: Nancy Gal, Extension Agent IV Marion County - University of Florida IFAS Extension Linda Bobroff, Professor and Extension Nutrition Specialist University of Florida Updated 2010
What is Diabetes?