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Chapter 15A Lecture

Access to Health Thirteenth Edition

Focus On

Minimizing Your

Risk for Diabetes

Did you PREPARE and did you LEARN?

• Why should college students be concerned

about diabetes?

• Can people with diabetes eat sweets?

• Do people with diabetes have to give

themselves injections?

Minimizing Your Risk for Diabetes

• Worldwide more than 366 million people have

diabetes.

• It is estimated that 26 million Americans have

some form of diabetes.

• Diabetes is the fastest-growing chronic disease in

the United States.

• About 225,000 people die each year of diabetes-

related complications.

Percentage of U.S. Population with

Diagnosed Diabetes, 1958–2009

What Is Diabetes?

• Diabetes mellitus is characterized by a persistently

high level of blood glucose and an unusually high

volume of glucose in the urine.

• High blood glucose is known as hyperglycemia.

Type 1 Diabetes Is an Immune Disorder

• For type 1 diabetes to occur, the immune system

must attack the insulin-making cells in the

pancreas, making them incapable of producing

insulin.

• Type 1 is normally diagnosed in younger people

but can occur at any age.

• European ancestry, a genetic predisposition, and

viral assaults are all risk factors.

Type 1 Diabetes Is an Immune Disorder

• People with type 1 diabetes require daily injections

or infusions of insulin.

• Exercise and diet must be monitored so that insulin

is given in appropriate amounts.

• Type 1 is more serious than type 2, and there are

fewer options for treatment.

Type 2 Diabetes Is a Metabolic Disorder

• Type 2 accounts for 90 to 95 percent of all diabetes

cases.

• In this disease, the pancreas either does not make

enough insulin or body cells are resistant to its

effects and so do not use insulin efficiently.

• Type 2 diabetes develops slowly, whereas type 1

diabetes has a rapid onset.

Development of Type 2

• In early stages, in the body begin to resist the effects of insulin.

• Hyperglycemia results, and the pancreas tries to compensate by releasing more insulin.

• Insulin-producing cells become exhausted from the overwork and become nonfunctional.

• Blood glucose levels rise high enough to warrant a type 2 diagnosis.

Diabetes: What It Is and How It Develops

Nonmodifiable Risk Factors for Type 2

• Increasing age—1 in 4 adults over age 65 has

type 2 diabetes.

• Certain ethnicities—Native Americans, Hispanics,

and non-Hispanic blacks—have a higher risk of

the disease.

• Genetic factors—having close relatives with the

disease is a significant risk factor.

Modifiable Risk Factors for Type 2

• Being overweight and obese—that is, having a

BMI of over 25—increases risk.

• Central adiposity—too much weight around the

waistline (a waist measurement of more than 40

in males and 35 inches in females) is highly

correlated with the development of type 2.

• Having a sedentary lifestyle increases risk.

Unhealthy eating habits and a sedentary lifestyle can

lead to type 2 diabetes even among children.

Type 2 Diabetes

Pre-Diabetes Can Lead to Type 2 Diabetes

• An estimated 79 million Americans above age 20

have symptoms known as pre-diabetes. This

condition results in blood glucose levels that are

higher than normal but not high enough for a

diagnosis of diabetes.

• Pre-diabetes plays a role in metabolic syndrome, a

condition that increases the risk for heart disease.

Do college students

really need to be

concerned about

diabetes?

Type 2 Diabetes

Six Steps to Begin Reducing Your Risk for

Diabetes

Gestational Diabetes

• Gestational diabetes is a form of diabetes that develops during pregnancy in about 4 percent of all pregnancies.

• It is associated with an increased risk of birth- related complications, including difficult labor, high blood pressure, high blood acidity, increased infections, and death.

• Risks for the fetus include malformations of heart, nervous system, and bones; respiratory distress; and excess growth.

What Are the Symptoms of Diabetes?

• Thirst

• Excessive urination

• Weight loss

• Fatigue

• Nerve damage

• Blurred vision

• Poor wound healing and increased infections

Complications of Uncontrolled Diabetes:

Amputation and Eye Disease

Complications of Diabetes

• Cardiovascular disease—more than 68 percent of diabetics have hypertension.

• Kidney disease—about 48,000 diabetics develop kidney failure each year.

• Amputations—more than 60 percent of nontraumatic amputations are due to diabetes.

• Nearly 35 percent of those over the age of 40 have early-stage retinopathy, which could lead to blindness without treatment.

Blood Tests Diagnose and Monitor Diabetes

• The fasting plasma glucose (FPG) is a test that

tests a person's glucose concentration. A value

greater than or equal to 126 mg/dL indicates

diabetes.

• The oral glucose tolerance test (OGTT) requires a

patient to consume a concentrated glucose fluid to

determine how his or her body adapts to glucose.

After two hours, a blood glucose reading of greater

than 140 mg/dL indicates pre-diabetes. A reading

equal to or over 200 mg/dL indicates diabetes.

Blood Glucose Levels in Pre-Diabetes and

Untreated Diabetes

Treating Diabetes

• Treatment options depend on whether a person

has pre-diabetes, type 1 diabetes, or type 2

diabetes.

• Prediabetics may prevent progression of the

disease by eating a healthy diet, reducing weight,

and exercising regularly.

• For type 2 diabetes, a healthy diet, reducing weight,

and exercising are also first steps. Some may need

oral medications, while others may need insulin

injections.

Oral Medications and Weight-Loss Surgery

Can Help

• If lifestyle changes do not improve blood glucose

values, oral medications may be prescribed.

Medications may either inhibit liver production of

glucose, increase insulin production, or increase

sensitivity to insulin.

• Recent findings suggest that gastric bypass

surgery may cure type 2 diabetes, though more

research is necessary.

Treating Type 1 Diabetes

• Since people with type 1 do not produce insulin,

it must be injected or infused regularly. Insulin

cannot be taken orally because it would be

digested.

• The amount of insulin injected or infused must

correlate with the number of carbohydrates

eaten, exercise, and—in some individuals—

stress levels.

Do people with

diabetes have to

give themselves

injections?

Insulin Injections

Assessing Yourself–A Personal Inventory

• Go online to the Live It! section of

www.pearsonhighered.com/donatelle to take the

"Are You at Risk for Diabetes?" assessment.

• Are you or is someone you know overweight or

obese? Will your knowledge of type 2 diabetes

cause you to reconsider your own weight

management?

• If you have diabetes or know someone with type 1

diabetes, has your view of this disease changed?