What is Diabetes ?

  • Blood glucose (sugar) levels higher than normal
  • Not enough insulin (without amount or action) to allow glucose to enter cells to be used for energy

Click on the image for details

Normal and diabetes status


Stages in the Natural History of Type 2 diabetes

Types of Diabetes


Type 1 Diabetes


Type 2 Diabetes


Pregnancy diabetes (GDM)

Problem –
(1) Pregnancy hormones (estrogen/progesterone)
(2) Insulin Resistance

Cause – Genetics, overweight (↑ activity & & ↓calories), and pregnancy hormones
Treatment –diet, physical activity, and insulin injections
Other

  • Affects 1 out of 20 women (5% of pregnancy’s)
  • Is a temporary condition occurring in pregnancy
  • 60 % of those affected will develop Type 2 diabetes

Difference

Type 1 Type 2 GDM
Age of onset Usually <30 Usually >30 Pregnant women
Body weight Lean Usually obese Variable
Prone to ketoacidosis Yes No No
Treatment Meal plan
Exercise
Weight control
Meal plan
Exercise
Weight control
Meal plan
Activity
Medication Insulin essential Tablets and /or insulin With or without insulin
Onset of symptoms Acute Gradual (may be asymptomatic) Usually asymptomatic

Get Checked

Get your blood glucose checked for diabetes if you are

  • Age 35 or older
  • Age less than 35 + overweight +/ presence of other DM risk factors

Age 45 or older in Europids

How are diabetes and pre-diabetes diagnosed?

Gold Standard – Oral Glucose Tolerance Test often done

  • Fasting (after 8-12 hrs of overnight fasting)
  • 2hrs after 75 gm glucose drink

Blood Test Normal IFG IGT DM
FPG <6.1 mmol/l 6.1- <7 mmol/l <7 mmol/l ≥ 7.0 mmol/l
2hr PG <7.8 mmol/l X 7.8- <11.1 mmol/l ≥ 11.1 mmol/l

Complication

Diabetes Prevention



Healthy Nutrition Recommendations:

  • Decrease total fat intake
    • smaller amounts of high fat foods
    • broiling/stir fry vs. frying
    • remove skin from chicken
    • substitute with low calorie/low-fat foods
  • Increase healthy foods
    • Whole grains vs. processed
    • Include dry beans and lentils
    • Drink water & calorie free drinks
    • Cut back on high calorie snacks
    • Watch portion sizes
  • Cut down on sugary foods
    • Not a sugar free diet
    • Cut out sweets
    • Cut out sugary drinks
    • Use diet or low calorie, sugar free drinks
    • Can use non-Caloric Sweeteners
  • Reduce salt intake-
    • Cut down on added salt
    • Use alternative seasonings
    • Look out for reduced/low sodium foods, eg bread
    • Avoid salt substitutes
  • Rate your plate
    • ¼ grains or starchy foods
    • ¼ protein
    • ½ non starchy vegetables
    • Add 1 glass milk or small piece of fruit
  • Physical Activity
    • Recommendations:
      • 30 minutes/day for 5 to 7 days a week
      • 10 minutes of activity 3 times/day
  • Weight loss
    • 5% to 10% weight loss
    • Weight loss rate of 1 to 2 lb/week
    • Decrease of 300 to 500 kcal/day = 1/2 to 1 lb weight loss/week
    • Increased physical activity and/or decreased food intake