diabetes. diabetes prevalence in u.s., 1994-2004 (cdc)

Diagnosis Changes

Diabetes knowledge has increased in last four decades

Criteria for diabetes have changed (Source: American

Diabetes Association)

Criteria change may explain some of the increase seen in the 1990s

World Prevalence

Which country has the most diabetes? Top 10 - International Diabetes Federation

(Table 2.1) World Health Organization International Diabetes Federation

Diabetes

An excess of glucose (sugar) in the blood Inadequate insulin

production Inefficient insulin use

Diabetes Symptoms

Frequent urination Thirst Hunger Weight loss (despite thirst,

hunger) Fatigue Irritability Type 2 diabetes may often

have no symptoms until later

Insulin

Hormone produced by pancreas beta cells (WebMD)

After a meal, blood glucose levels rise Insulin moves glucose into body’s cells

For use For storage Animation (WebMD; click “Anatomy/Function”)

Insulin

Insulin released from pancreas Insulin binds to specific receptors on cells (WebMD;

click “Anatomy/Function;” 2nd animation)

Insulin-receptor triggers a transporter to move glucose into the cellExample:GLUT-4, found inside fat and muscle cells Insulin binding triggers transporter GLUT-4 to move

from inside cell to cell membraneGLUT-4 opens up, allowing glucose to move inside

Types of Diabetes

Type I Juvenile-onset Diabetes Insulin-Dependent Diabetes

Type II Adult-onset Diabetes Non-Insulin-Dependent Diabetes

Type I Diabetes

5-10% of the population Person with Type I has little or no insulin to

move glucose into cells Two classifications:

Type Ia Type Ib

Type Ia Diabetes

The most common form of Type I diabetes Insulin production is halted Autoimmune response

Antibodies destroy pancreas’ beta cells (WebMD; click “Causes,” select 1st animation)

YouTube animation (4 min) Genetics, infant diet may be related to susceptibility

Insulin injections required

Type Ib Diabetes

Insulin production is halted Of unknown origin

Not due to autoimmune response Chromosomal abnormality possibility Viral infection possibility Genetic predisposition triggered by environmental factor Those of Asian, African American and Hispanic descent

more frequently diagnosed Insulin therapy

Oral medication may be used to control condition

Type II Diabetes

Most common Approximately 90% of diabetes cases

Up to one half unaware they have Type II Stereotype: over age of 50 years Type II increasing among youth Treatments: diet, activity, medication

Type II Diabetes

Inadequate insulin production Uncontrolled insulin release rate Reduced insulin sensitivity Insulin receptor problems

Reduction in receptor number Antibodies attaching to receptors, blocking insulin Animation (WebMD)

Type II Diabetes

Video: insulin resistance YouTube

Type II Diabetes Risk Factors

Poor diet (high fat, low fiber, simple carbohydrates)

Physical inactivity Genetic predisposition & family history History of gestational diabetes Age

Type II Diabetes and Ethnicity

Some minority populations at increased risk Japanese Chinese South African blacks Native American

Pimas, Navajos, Aleuts Native Hawaiian Latino

Maskarinec G, et al. Diabetes prevalence and body mass index differ by ethnicity: the multiethnic cohort. Ethnicity & Disease 19(1), 2009.

Kitagawa,T. Owada,M. Urakami,T. Yamauchi,K. Increased incidence of non-insulin dependent diabetes mellitus among Japanese schoolchildren correlates with an increased intake of animal protein and fat. Clin Pediatr (Phila).1998; 37(2): 111-115

Type II Diabetes and Ethnicity

Reasons for increased risk are many Lifestyle factors

Diet Inactivity Obesity

Genetic factors Thrifty gene controversy

Latent Autoimmune Diabetes of Adulthood

Per title, impacts adults Also known as Type 1.5, Latent Type 1, Slow onset

Type 1, Autoimmune diabetes in adults May be misdiagnosed

Person often normal weight, may lack family history Onset is slow, with similar blood sugar challenges seen

in Type 2 Like Type 1, an autoimmune response results in

destruction of pancreatic beta cells

Diabetes Complications

Blood vessel damage Increased CV disease risk

Atherosclerosis More lipids in bloodstream

Damage in kidneys affects filtration of waste Damage in vessels leading to retina

Nerve damage Numbness, paralysis Sores, amputation

Video (WebMD)

Hyperglycemia & Hypoglycemia

Hyperglycemia When glucose cannot enter cell, levels in bloodstream remain

elevated If dysfunctional, pancreas cannot make enough insulin to

move glucose out of blood and into cells If functional, pancreas releases more insulin

“hyperinsulinemia”

Hypoglycemia Too much insulin production Can occur in those with diabetes (too much insulin, not

enough food)

Diabetes Resources

Support Groups Little Kids with Insulin Dependent Diabetes - for

parents, 10am Saturdays, every other month beginning January, Seattle Children’s Hospital; Zuraya Aziz: 425-985-9199

Parents of Kids Experiencing Diabetes - for family of those all-age children with Type I diabetes; email for newsletter: [email protected].

Diabetes Resources - Support Groups

Northwest Hospital Diabetes Support Group Second Tuesday of each month, 1-2:30pm Third Thursday of each month, 7-8:30pm

Diabetes Education Classroom/TCU Dining Room, NW Hospital Register by phone, 206-368-1564, or online

Swedish Diabetes Education Center Group First Wednesday of each month, 7:30am First Hill, 206-215-2440

Diabetes Resources

American Diabetes Association: http://www.diabetes.org/

National Diabetes Education Program: http://www.ndep.nih.gov/

Annual ADA Diabetes Expo April, Seattle Convention Center

diabetes. diabetes prevalence in u.s., 1994-2004 (cdc)

Documents

sex diabetes prevalence

diabetes casesup

cdcdiabetes prevalence

diabetesdiabetes prevalence

type iistereotype

pancreas beta cells

common form of type

inside cell