1. Diabetes

2. What is Diabetes: Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat.blood sugar Insulin is a hormone that helps the glucose get into your cells to give them energy Insulin is made In the Pancreas Diabetes is an autoimmune disease

3. Types of Diabetes Type I: With type 1 diabetes, your body does not make insulin. Once called Juvenile diabetes because usually diagnosed in children or youth. 5- 10 % of people have this typetype 1 diabetes Can develop in adults Symptoms usually develop over short period of time  increased thirst  increased urination  constant hunger  weight loss  blurred vision  extreme fatigue.  If not diagnosed and treated with insulin, a person with type 1 diabetes can lapse into a life-threatening diabetic coma, also known as diabetic ketoacidosis.  Must take Insulin rest of one lifetime

4. Types of Diabetes Type II: With type 2 diabetes, the more common type, your body( pancreas)usually makes insulin but the body cannot use it effectively. 90-95% of people have this typetype 2 diabetes May progress to loss of insulin production Without enough insulin, the glucose stays in your blood Will need oral medication and sometimes Insulin Often called adult onset diabetes now Type 2 diabetes is increasingly being diagnosed in children and adolescents, especially among African American, Mexican American, and Pacific Islander youth.

5. Types of Diabetes Gestational : Develops during late pregnancy Gestational diabetes is diagnosed based on blood glucose levels measured during the OGTT Usually goes away after birth Is a risk factor for developing type II diabetes

6. Types of Diabetes Pre Diabetes Blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. Also called Impaired Fasting Glucose (IFG) -blood glucose level is high—100 to 125 mg/dL—after an overnight fast. Also called Impaired Glucose Tolerance(IGT) -blood glucose level is high—140 to 199 mg/dL—after a 2-hour OGTT ( oral glucose tolerance test ). Those with pre diabetes are likely to develop type 2 diabetes within 10 years, unless they take steps to prevent or delay diabetes. This condition raises the risk of developing type 2 diabetes, heart disease, and stroke.

7. Diagnosis of Diabetes Lab tests A1C Test The A1C test is a blood test that provides information about a person’s average levels of blood glucose, also called blood sugar, over the past 3 months. The A1C test is sometimes called the hemoglobin A1c, HbA1c, Diagnosis* A1C Level Normal below 5.7 percent Diabetes 6.5 percent or above Prediabetes 5.7 to 6.4 percent Fasting Plasma Glucose Test- FPGT Oral Glucose Tolerance Test- OGTT Random Glucose Test- RGT

8. The following table provides the blood test levels for diagnosis of diabetes for non pregnant adults and diagnosis of pre diabetes.

9. Diagnosis of Diabetes Signs and Symptoms A random plasma glucose (RPG) of 200 or above, and the individual also shows symptoms of diabetes increased urination increased thirst unexplained weight loss blurred vision increased hunger sores that do not heal

10. Who should be tested for diabetes and Pre diabetes? Adults, pregnant women, children, and teens should be tested for diabetes and pre diabetes according to their risk factors Adult Risk Factors: Age- Overweight or Obese physical inactivity parent, brother, or sister with diabetes family background that is African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander American

11. Risk Factors Adult history of giving birth to at least one baby weighing more than 9 pounds history of gestational diabetes high blood pressure—140/90 mmHg or higher—or being diagnosed with high blood pressure high-density lipoprotein, or HDL, cholesterol—“good” cholesterol—level below 35 mg/dL or a triglyceride level above 250 mg/dL polycystic ovary syndrome, also called PCOS

12. Risk Factors Adult Pre diabetes—an A1C level of 5.7 to 6.4 percent; an FPG test result of 100–125 mg/dL, indicating IFG; or a 2-hour OGTT result of 140–199 mg/dL, indicating IGT acanthosis nigricans, a condition associated with insulin resistance and characterized by a dark, velvety rash around the neck or armpits history of cardiovascular disease—disease affecting the heart and blood vessels

13. Risk Factors YOUTH Type 2 diabetes has become increasingly common in children and teens. Children are at high risk for developing type 2 diabetes and should be tested if they are: overweight or obese inactive have other risk factors, such as a family history of diabetes older than age 10 or have already gone through puberty

14. Delaying or preventing type 2 Diabetes Weight Loss Low fat- low calorie diet Regular physical activity of at least 150 min/wk Diabetes Prevention Program for Pre diabetes

15. Diabetes Treatment #1. Educate yourself Ask your health care team what type of diabetes you have. Learn why diabetes is serious. Learn how caring for your diabetes helps #2. Know your diabetes ABCs A is for the A1C test B is for Blood Pressure C is for Cholesterol

16. Diabetes Treatment # 3. Learn how to live with Diabetes. Ask for a healthy meal plan. Ask about ways to be more active. Ask how and when to test your blood sugar and how to use the results to manage your diabetes. Use these tips to help with your self-care. Discuss how your diabetes plan is working

17. Diabetes Treatment # 4. Get routine care to stay healthy See your health care team at least twice a year to find and treat any problems early. At each visit, be sure you have a: blood pressure check foot check weight check review of your self-care Two times each year, have an: A1C test. It may be checked more often if it is over 7. A1C test

18. Diabetes Treatment Once each year, be sure you have a: cholesterol test triglyceride (try-GLISS-er-ide) test - a type of blood fat complete foot exam dental exam to check teeth and gums dilated eye exam to check for eye problems flu shot urine and a blood test to check for kidney problems

19. Diabetes Treatment At least once in your lifetime, get a: pneumonia shot hepatitis B shot # 5. Know and take your medications Take medication as prescribed Review meds with each doctor you visit Report any side effects Talk to md before taking over the counter medications and or supplements Do not stop taking meds with talking with md

20. Complications of Diabetes Cardiovascular disease including coronary artery disease with chest pain (angina), heart attack, stroke and HBP Nerve damage (neuropathy). This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. Left untreated, you could lose all sense of feeling in the affected limbs. Damage to the nerves related to digestion can cause problems with nausea, vomiting, diarrhea or constipation. For men, it may lead to erectile dysfunction.

21. Complications Kidney damage (nephropathy) kidney failure or irreversible end-stage kidney disease, which may require dialysis or a kidney Eye damage (retinopathy damage to the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. increased risk of other serious vision conditions, such as cataracts and glaucoma.

22. Complications Foot damage Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can become serious infections. Severe damage might require toe, foot or even leg amputation. Skin and mouth conditions Alzheimer's disease Osteoporosis.

23. High Blood Pressure and Diabetes High blood pressure (hypertension) can lead to and make worse many complications of diabetes, including diabetic eye disease and kidney disease. Most people with diabetes develop high blood pressure during their life. Having diabetes makes high blood pressure and other heart and circulation problems more likely because diabetes damages arteries and makes them targets for hardening (atherosclerosis). Atherosclerosis can cause high blood pressure, which if not treated, can lead to blood vessel damage, stroke, heart failure, heart attack, or kidney failure.

24. High Blood Pressure and Diabetes Compared to people with normal blood pressure readings, men and women with hypertension more often have: Coronary artery disease (heart disease) Strokes Peripheral vascular disease (hardening of the arteries in the legs and feet) Heart failure