1. Categories of disease Genetic (born with – even if disease doesn’t develop till later in life) Infectious – Virus and bacterial Environmental / Self-inflicted Develop because of life habits or surroundings Combination – combination of any/all of above (especially genetic and environmental)

2. Diabetes

3. What is Diabetes? A group of diseases characterized by high levels of blood glucose (blood sugar) and associated with inability to make or regulate insulin. Can lead to serious health problems and premature death NIDDK, National Diabetes Statistics fact sheet. HHS, NIH, 2005.

4. 20.8 million Americans have diabetes with 1-2 million new cases being diagnosed each year. 54 million US adults (over age 20) have pre-diabetes

5. EVERY 24 HOURS New Cases – 4,100 Deaths – 810 Amputations – 230 Kidney Failure – 120 Blindness - 55 National Diabetes Statistics fact sheet. HHS, NIH, 2005.

6. Diabetes Complications 2 in 3 people with diabetes die of heart disease or stroke Diabetes is the #1 cause of adult blindness Diabetes is the #1 cause of kidney failure Diabetes causes more than 60% of non- traumatic lower-limb amputations each year NIDDK, National Diabetes Statistics fact sheet. HHS, NIH, 2005.

7. Insulin A Protein made in the pancreas that regulates glucose levels.

8. Type One Genetic predisposition Usually onset in childhood or early teenage years 5-10% of diagnosed cases Immune system attacks pancreas which is where insulin is made.

9. Type Two Diabetes 90-95 % of all cases Linked to obesity, a sedentary (non-active) lifestyle, and a diet high in sugar Can begin at any age

10. Risk Factors for Diabetes Age 45 and older Overweight (BMI ≥ 25) Hypertension Abnormal lipid levels Family history of diabetes Race/ethnicity History of gestational diabetes American Diabetes Association. Diabetes Care 2008; 31;(Suppl.1):S12-54. History of vascular disease Signs of insulin resistance (such as PCOS or acanthosis nigricans) IGT or IFG on previous test Inactive lifestyle

11. Diagnostic Criteria for Pre-diabetes and Diabetes Fasting Plasma Glucose Test (FPG) 2-Hour Glucose Challenge Test Acceptable Below 100 mg/dlBelow 140 mg/dl Pre- diabetes 100-125 mg/dl (IFG)140-199 mg/dl (IGT) Diabetes 126 mg/dl or above200 mg/dl or above American Diabetes Association. Diabetes Care 2008; 31;(Suppl.1):S12-54..

12. The Great Limiting Factor Weight gain, diet and exercise

13. Hypoglycemia Prevention Strategies Monitoring

15. Obesity Trends 1990 2001 Diabetes Trends 1990 2001 BRFSS, 1990- 2001

18. The U.S. Department of Health and Human Services’ National Diabetes Education Program is jointly sponsored by the National Institutes of Health and the Centers for Disease Control and Prevention with the support of more than 200 partner organizations. For more information about NDEP and to order free diabetes materials: Call 1-888-693-NDEP (6337) or Click www.YourDiabetesInfo.orgwww.YourDiabetesInfo.org