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DiabetesWhat are you going to do??
Dr. George Rapier
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What is Diabetes
Type 1 Diabetes – Lack of Insulin produced
Type 2 Diabetes – Insulin Resistance of the
Fat Cells
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Type 1 Diabetes
Autoimmune reaction (possibly triggered by a
virus) that destroys the insulin producing
cells in the pancreas
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Type 2 Diabetes
Receptors on the surface of Fat Cells and
other Cells become resistant to the action of
insulin
Extra insulin is secreted by the Pancreas
Blood Sugar becomes elevated because the
action of insulin is low
Eventually insulin production by the pancreas
declines
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Type 2 Diabetes
The more fat you carry on your body, the
more likely you are to develop type 2
diabetes
If you have a family history of Diabetes you
are more likely to develop Type 2 Diabetes
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Carbohydrates
Sugars – Fructose(fruit sugar),
Sucrose(table sugar), Glucose
(sugar in the blood)
Starches – All broken down to
Glucose for absorption in the body
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Carbohydrate Metabolism
Sugars and
Starches
Absorbed
as
Glucose
Glucose
enters
CellsFat Cell
stored as
Fat
Muscle Cell
stored as
Glycogen
Insulin
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Glycemic Index
The glycemic index, or GI is a measure of
the effects of carbohydrates on blood sugar
levels.
Foods with a high GI are absorbed quickly
and raise blood sugar quickly
Foods with a low GI are absorbed slowly and
raise blood sugar much less
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Glycemic Index and Insulin
High GI foods cause a large secretion of
Insulin
Low GI foods produce a very small secretion
of Insulin
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Low, Medium, and High GI
Low GI 55 or less most fruits and vegetables, legumes/pulses, whole grains, meat, eggs, milk, nuts, fructose and products low in carbohydrates
Medium GI 56–69 products whole wheat
basmati rice, sweet potato, sucrose
High GI 70 and above baked potatoes, watermelon, white bread, most white rice, corn flakes, extrudedbreakfast cereals, sugar
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Glycemic Load
The glycemic load (GL) is a ranking system
for carbohydrate content in food portions
based on their glycemic index (GI) and the
portion size.
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Glycemic Load 100g of food
FoodGlycemic
Index
Carbohydrate
content
(by weight)
Glycemic Load
(typical
serving)
Bread, white,
plain100 47% 100
Banana 74 15% 85
Carrots 70 6% 21
Corn tortilla 74 48% 87
Potato 121 20% 246
Rice 91 24% 283
Watermelon 103 5% 52
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Fats and Oils
Bad Fats – Trans Fats and Saturated Fats –
Butter, Margarine, Fried Foods, Red Meat
Good Fats – Nuts, Fish Oil, Olive Oil
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Heart and Vascular Disease
Acute Myocardial Infarction Risk
by Diet trans Fat
0
1
2
3
Q1 Q2 Q3 Q4 Q5
Diet trans Fat Quintile
Acute MI
Relative
Risk
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Heart and Vascular Disease
Dietary Sources of Trans Fat
~ 33% from Butter & Stick Margarine
Most From
Commercially Fried Food
Partially Hydrogenated Vegetable Oil
Red Meats
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Nuts
Adventist Health Study
Times/Week Ate Nuts
0
0.5
1
Relative
Risk
< 1 1 1
1 - 4 0.78 0.76
≥ 5 0.49 0.52
Nonfatal MI Fatal CHD
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Heart and Vascular Disease and Nuts
Types of Fat in Nuts
0% 20% 40% 60% 80% 100%
Soybean
Cashew
Pistachio
Peanut
Almond
Hazelnut/Filbert
Brazilnut
English Walnut
Pecan
Macadamia
Tropical Mono-unsaturated ω-6 ω-3
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Heart and Vascular Disease and Fish Oils
Chicago Western Electric 30-Year Cohort F/U Study
1.00
0.88
0.76
0.56
None 1 - 17 18 - 34 ≥ 35
Avg Daily Fish Eaten (g)
Relative
Risk of
Fatal MI
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Staying Healthy in Diabetes
Exercise
Control your Blood Pressure
Control your Cholesterol
Control your Blood Sugar
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Exercise
2 to 3 times a week for at least 30 minutes
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Control your Blood Pressure
At or Below 130/80
Protects your kidneys, heart and brain
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Control your Cholesterol
LDL (Bad) Cholesterol below 100, preferably
below 70
HDL (Good) Cholesterol above 40
Triglycerides below 150
Protects your Heart and Circulation to your legs
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Control you Blood Sugar
Proper Diet
Proper Exercise
Medication is necessary
Long term measure of Blood Sugar –
Hemoglobin A1c below 7
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Dietary Comparisons for Carbohydrate Content, Calories and Weight Loss