Preventing Diabetes: Preventing Diabetes Cecilia Sauter MS, RD, CDE Diabetes Self-Management Education Program University of Michigan


Slide2: Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1990 Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1).


Slide3: Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1991-92 Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1).


Slide4: Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1993-94 Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1).


Slide5: Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1995-96 Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1).


Slide6: Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1995 Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1).


Slide7: Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1997-98 Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1).


Slide8: Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1999 Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1).


Slide9: Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 2000 Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1).


Slide10: Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 2001 Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1).


Diabetes in the US: Diabetes in the US Currently 20.8 million have diabetes 14.6 million have the diagnosis 6.2 million don’t know they have diabetes


Etiology of Diabetes: Etiology of Diabetes Family history Ethnicity African American Native American Hispanic Asian Americans Pacific Islanders Age Gestational Diabetes or babies over 9 pounds


Etiology of Diabetes: Etiology of Diabetes Increased weight BMI: overweight = 25.0 to 29.9 kg/m2 obese andgt; 30.0 kg/m2 Increased central (i.e., visceral) obesity Waist circumference: Men andgt; 40 in Women andgt; 35 in Decreased activity


Metabolism without Diabetes: Metabolism without Diabetes Insulin Sugar SI SI SI SI S S Body Blood


Metabolism without Diabetes: Metabolism without Diabetes Insulin Sugar S S S S S S S Blood Body S


Metabolism with Diabetes: Metabolism with Diabetes Insulin Sugar SI SI SI S S S Body Blood S S S


Metabolism with Diabetes: Metabolism with Diabetes Insulin Sugar SI SI SI S S S Body Blood S S S S


Slide18: FBG: 80-125 10-30 years Insulin Resistance Insulin Production Glucose Intolerance Diagnosis of Diabetes Fasting Blood Glucose Progression of Diabetes


Pre-diabetes: Pre-diabetes 2000 40 % of people aged 40-74 years 41 million 2002 54 million


Prevention of Diabetes: Prevention of Diabetes Diabetes Prevention Program Lifestyle changes Changes in eating habits Increase in physical activity 58% reduction in type 2 diabetes


Prevention of Diabetes: Prevention of Diabetes 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


Prevention of Diabetes: Prevention of Diabetes 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


Prevention of Diabetes: Prevention of Diabetes Healthy Nutrition Recommendations: Increase fruits and vegetables Whole grains vs. processed Include dry beans and lentils Drink water andamp; calorie free drinks Cut back on high calorie snacks Watch portion sizes


Prevention of Diabetes: Prevention of Diabetes Healthy Nutrition Recommendations: Rate your plate ¼ grains or starchy foods ¼ protein ½ non starchy vegetables Add 1 glass milk or small piece of fruit


Prevention of Diabetes: Prevention of Diabetes Physical Activity Benefits: Increases insulin sensitivity Decreases weight Decreases blood pressure and cholesterol Decreases stress DECREASES risk of type 2 diabetes


Prevention of Diabetes: Prevention of Diabetes Physical Activity Recommendations: 30 minutes/day for 5 to 7 days a week 10 minutes of activity 3 times/day


Prevention of Diabetes: Prevention of Diabetes Getting started: What activities can you do Realistic activities Start slow: What, when, where, how often, how long Challenging but not overly difficult Be flexible Reward yourself


Calories Spent in Various Activities : Calories Spent in Various Activities Walking, 3.0 miles/hr Walking 5 miles/hr Cycling, 8 miles/hour Mopping, vacuuming Scrubbing floors Gardening Vigorous dancing 275/hr 420/hr 325/hr 240/hr 300/hr 220/hr 320-500/hr


Fad Diets: Fad Diets Watch for rapid weight loss Loss of muscle mass and water vs. fat Expensive


Nutritional Supplements: Nutritional Supplements They DO not reduce risk of Type 2 Diabetes Safety is uncertain No scientific evidence to aid in weight loss Expensive


Screening for Type 2 Diabetes: Screening for Type 2 Diabetes Positive family history Ethnic group Increased weight and/or central obesity Gestational diabetes or big babies Decreased activity Symptoms of diabetes Increased thirst, increased urination andamp; weight loss


Diagnostic Criteria for Type 2 Diabetes: Diagnostic Criteria for Type 2 Diabetes Fasting blood sugar andgt; 126 mg/dl 2 hour glucose tolerance andgt; 200 mg/dl Acute symptoms plus random glucose andgt; 200 mg/dl


Impaired Glucose Tolerance“Pre-diabetes”: Impaired Glucose Tolerance 'Pre-diabetes' Impaired Fasting: Level between andgt;100 mg/dl and andlt;126 mg/dl Impaired glucose: During 2 hour glucose tolerance test Level between andgt;140 and andlt;200 mg/dl


Thank you: Thank you If you would like a copy of this presentation please send an email to: diabetes@umich.edu Questions?