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:
[email protected]
Questions?