1. Who?16 Million Americans (6% of pop’n) (only about 2/3 are diagnosed) 7% of Americans have Impaired Fasting Glucose (IFG; >110-<125 mg/dl) Disproportionately affects Minorities: African-Americans Latinos, Hispanics, Asians American Indians Alaska Natives 1˚ly Type 2

2. Type 1 & Type 2 Type I or Type II IDDM or NIDDM

3. Diabetes Mellitus (“passing through (the body)”; “honey sweet”) Definition:a metabolic disorder characterized by altered blood glucose regulation and utilization, usually caused by insufficient or relatively ineffective insulin. Long-term hyperglycemia Cardiovascular Disease Microangiopathies (Loss of kidney fxn; retinal degeneration) Neuropathy (may lead to gangrene; loss of feet or legs)

4. FPG > 126 mg/dl (confirmed by repeat on different day) Classic Sx + casual PG > 200 mg/dl IFG (Impaired Fasting Glucose) >110 or <126 mg/dl IGT (“ “ Glucose Tolerance)= 2 hr postprandial G btw 140-200 mg/dl Screen? Over 45 y/o every 3 yrs; Risk Factors? Yes? Earlier or more often BMI>27, 1˚ relative DM, Deliver baby > 9#, High risk ethnic groups, BP >140/90, HDL < 35

5. Nutrition Meds client Physical Activity monitoring

6. Goals for Control (not diagnosis!) Fasting BG and before meals 80-120 mg/dl One hour after meals<180 mg/dl 2 hours after meals<160 mg/dl Bedtime100-140 mg/dl Hemoglobin A1c< 7 % TAKE ACTION LEVELS 140 mg/dl / 8 or >%

7. Complications of Diabetes Heart Disease/ Stroke:Relative Risk of Death: 2 to 4 High BP (>140/90): 60-65% with DM Blindness:DM is leading cause of new cases in 20-74 yo. End-stage Renal Disease: DM causes 40% of new cases.