Understanding Diabetes: Types, Risks, and Prevention Strategies

School

CUNY Hunter College**We aren't endorsed by this school

Course

PHILO 216

Subject

Nursing

Date

Dec 10, 2024

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Uploaded by Mendes_Styles

Chapter 10 - DiabetesPart I Learning Outcomes (O):O1. Where is insulin produced, and what is its role in the body?O2.Explain the differences among type 1 diabetes, type 2 diabetes and pre-diabetes?O3. What are the risk factors for diabetes?O4. Type 2 diabetes is by far the most common form of the disease, yet it’s largely preventable. Its prevalence in the population is at an all-time high and projected to rise even higher. Why is this happening and what needs to be done to turn the tide?---------------------------------------------------------------------------------------------------------------------------------------1 - Diabetes- a group of disorders characterized by hyperglycemia resulting from deficits in insulin production and its actionDisabling, deadly, and on the riseUnintended consequence of our societyThe 6thleading cause of death in the U.S.Hyperglycemia - high blood glucose levels; the hallmark of uncontrollable diabetesInsulin - a hormone produced in the pancreases, which helps glucose pass into the cells where it can be used as energy Pancreas, metabolism, and diabetes - Pancreases produce’s hormones and enzymes that assist in in digestion of food, then balances the release of glucagon and insulin to regulate glucose needs of the body Diabetes disrupts the normal metabolic system Not enough insulin = deficit = high levels of glucose in the blood = inadequate levels of glucose in the cellsNormal levels of blood glucose range from 70-110 mg/dlType 1 - Insulin dependent diabetes (juvenile diabetes)•Develops during childhood or young adulthood•Pancreatic beta cell (make insulin) destructionType 2 - Previously called adult onset diabetes, Now seeing it in a much younger population •Non-insulin dependent diabetes•Pancreases continues to produce insulin but the body becomes insulin resistant•Primary cause is excessive body fat•80 to 90% of the Type 2 diabetics are obese Gestational diabetes•Glucose intolerance develops during pregnancy•Affect about 4% of pregnant women•Requires treatment to normalize maternal blood glucose levels•Generally resolves after pregnancy•May be a pre-cursor to later diabetesPre-diabetes - A borderline condition in which blood glucose level is between normal and diabetic levels2-Complications: Damage to blood vesselsMicro vascular systems are compromised causing them to thicken and leakBlood flows is restricted to the skin and nervesIncrease in the levels of fat in the bloodAtherosclerosis occurs at a younger ageHeart attack and stroke

Compromised circulation harms organs and Angina, heart failure, stroke can occurEye disease and blindnessLeading cause of blindnessDamage to the retina (retinopathy)Cataracts, GlaucomaKidney diseaseDiabetes is responsible for 40% of all kidney diseaseTiny blood vessels in the kidney are damagedNerve damageOccurs in 60 – 70% of people with diabetesHigh blood sugar due to metabolic factors leads to nerve damage (neuropathy)Amputations - Poor circulation and nerve damageUlcersInfections of the feet and legsWounds that don’t healPart II Learning Outcomes (O):O1.Define metabolic syndrome and the criteria for diagnosis.O2. Just as with high blood pressure and abnormal blood lipids, we should know the numbers that define the condition. What fasting blood glucose levels define pre-diabetes and diabetes? What is the A1c measurement, and when is it used?O3.Explain how eating a healthy diet and exercising regularly lowers a person’s risk for developing type 2 diabetes and the metabolic syndrome?---------------------------------------------------------------------------------------------------------------------------------------3-Diagnosis and Control:Testing and diagnosisEveryone over 45BMI greater than 25Testing every 3 yearsScreening should begin earlier if:Physically inactiveDiabetes in the familyPrevious diagnosis of diabetesHigh-risk ethnic group (Asian, Black, Hispanic, Native American, Pacific Islander)Testing includes:•Fasting plasma glucose (the preferred test)•Casual plasma glucose•Oral glucose tolerance test:Normal glucose levels = 70 / 99Pre-diabetes = 100 / 125Diabetes = 126 / and greaterChallenge of treatment - The goal: do what the body does naturally•Food = rise in blood glucose levels•Insulin = exercise = decrease in levels of blood glucose - Look at pictureControl sequencing, type and amount

•Diet•Exercise•DrugsChallenge of treatment:1- Hyperglycemia - Blood glucose levels are too high (the challenge)2- Hypoglycemia - Low blood glucose levels due to treatment3- Ketoacidosis - Life-threatening condition requiring immediate treatment: typically associated with uncontrollable diabetes and characterized by accumulations of ketones and acidity in the blood Managing diabetes:1- Patient education - A specialized medical team, provides education, medical care2- Everyday steps - Self- testing of blood glucose, guides the persons actions regarding eating, exercise, and medication3- A1c - blood glucose management test4- Medical alert bracelets - Friends and family need to knowManaging type 1 diabetes•Take insulin as prescribed •Eat a healthy, balanced diet, paying special attention to the amount of carbohydrates in each meal and the diabetes meal plan •Monitor blood sugar levels several times a day •Get regular physical activity Managing type 2 diabetes•Take control•Lower your blood sugar level to within the normal range•Diet•Exercise•Medications•Maintain a normal weight4-Prevention of Type 2 Diabetes:If you feel that you are at risk, make lifestyle changes If you are overweight, lose 5 to 7 percent of your total body weight Exercise 30 minutes at least five times a weekEat a healthy diet:•Salads •Vegetables •Fruits •Whole grains •Fish •Beans•Poultry and other lean meats Limit sugars & processed foodsGet 20 grams of fiber per dayOverweight among children and adolescents 1963-2000 - Look at pictureFindings from the diabetes prevention program - Diabetes prevention program (3-year study)

•High-risk participants assigned to lifestyle intervention group - Reduced risk by 58%•Participants selected for treatment with oral medication - Reduced risk by 31% 5-Metabolic Syndrome:What is metabolic syndrome? - A group of risk factors that come together in a single individual. Look at table 10.1Interrelationships among lifestyle, physiological responses & disease outcomes - Look at pictureTreatment goals and strategies•Commit to a healthy diet, Lose weight, Exercise, If you smoke, stop, Eat fiber-rich foods, Regular checkupsPrediabetes: Your Chance to Prevent Type 2 Diabetes

What Is Prediabetes?Prediabetes is a serious health condition where blood sugar levels are higher thannormal, but not high enough yet to be diagnosed as type 2 diabetes. Approximately 88 million American adults—more than 1 in 3—have prediabetes. Of those with prediabetes, more than 80% don’t know they have it. Prediabetes puts you at increased risk of developing type 2 diabetes, heart disease, and stroke.The good news is that if you have prediabetes, the CDC-led National Diabetes Prevention Programcan help you make lifestyle changes to prevent or delay type 2 diabetes and other serious health problems.What Causes Prediabetes?Insulin is a hormone made by your pancreas that acts like a key to let blood sugarinto cells for use as energy. If you have prediabetes, the cells in your body don’t respond normally to insulin. Your pancreas makes more insulin to try to get cells to respond. Eventually your pancreas can’t keep up, and your blood sugar rises, setting the stage for prediabetes—and type 2 diabetes down the road.Signs & SymptomsYou can have prediabetes for years but have no clear symptoms, so it often goes undetected until serious health problems such as type 2 diabetes show up. It’s important to talk to your doctor about getting your blood sugar tested if you have any of the risk factors for prediabetes, which include:Being overweightBeing 45 years or olderHaving a parent, brother, or sister with type 2 diabetesBeing physically active less than 3 times a weekEver having gestational diabetes(diabetes during pregnancy) or giving birth to a baby who weighed more than 9 poundsHaving polycystic ovary syndromeRace and ethnicity are also a factor: African Americans, Hispanic/Latino Americans, American Indians, Pacific Islanders, and some Asian Americans are at higher risk.Simple Blood Sugar TestYou can get a simple blood sugar testto find out if you have prediabetes. Ask your doctor if you should be tested.Preventing Type 2 Diabetes

If you have prediabetes, losing a small amount of weight if you’re overweight and getting regular physical activity can lower your risk for developing type 2 diabetes. A small amount of weight loss means around 5% to 7% of your body weight, just 10 to 14 pounds for a 200-pound person. Regular physical activity means getting at least 150 minutes a week of brisk walking or a similar activity. That’s just 30 minutes a day, five days a week.A lifestyle change program offered through the CDC-led National Diabetes Prevention Programcan help you make those changes—and make them stick. Through the program, you can lower your risk of developing type 2 diabetes by asmuch as 58% (71% if you’re over age 60). Highlights include:Working with a trained coach to make realistic, lasting lifestyle changes.Discovering how to eat healthy and add more physical activity into your day.Finding out how to manage stress, stay motivated, and solve problems that can slow your progress.Getting support from people with similar goals and challenges.Ask your doctor or nurse if there’s a CDC-recognized National Diabetes PreventionProgram offered in your community or find one here. The best time to prevent type 2 diabetes isnow.Dining Out With Diabeteshttps://www.cornerstones4care.com/content/dam/nni/cornerstones4care/pdf/content/healthy-eating/Dining_Out.pdf- If you want to see it with the pictures

Diabetes doesn’t have to stop you from enjoying life’s pleasures. And that includes dining out. You can eat out and still stay on your meal plan. Here are some tips that can help.Stay on schedule- If you take diabetes pills or injectable diabetes medicines, timing of your meals may be important. So it’s a good idea to plan ahead. If you’ll be dining with family or friends, ask if they would be willing to eat when you usually eat so you can stay on scheduleAvoid times that restaurants are usually busy so you won’t have to wait. If you’re not sure when the busy times are, call ahead and askMake reservations, and arrive promptly. When you call, or when you arrive at the restaurant, consider mentioning that you have diabetes so timing of your meal mattersThink about looking at the restaurant’s menu online. That way you can decide on a healthy choice while still at home and you won’t waste time looking at the menuBefore ordering, ask whether the dish you want will take extra time to prepareIf you will be eating lunch or dinner later than usual, think about eating a fruit or starch serving from that meal at your usual mealtimeWhen it’s time to order - Don’t just choose the first meal that looks good to you. Think carefully about how the food willfit into your meal plan.If you don’t know what is in a dish or how it’s prepared, ask the server so you can decide whether it fits into yourmeal planIf you’re counting carbs, ask about “hidden” carbs, like flour or cornstarch in sauces and soupsIf you’re on a low-salt meal plan, ask for your meal without added saltAsk for salad dressing, sauces, and gravy to be served on the side. That way you can control how much you useIf you’ll be ordering meat or fish, ask that it be broiled with no extra butterMix and match menu items your way. If it fits your meal plan better, order a salad and soup or an appetizer instead of an entréeDon’t hesitate to ask for substitutes. For example, if your meal comes with French fries, ask for a vegetable insteadConsider ordering one meal to share with a fellow dinnerWhen your food arrives - You’re hungry and you’re ready to dig in! But take a moment to think about these tips first, so you can be sure to stay on your meal plan.Try to eat the same size portion you normally would. Restaurant portions tend to be large. So estimate your normal portion and put the extra food in a container to go before you begin to eat.That way you won’t be tempted to eat everything on the plateYou can estimate portion sizes even when you can’t measure. For example:A serving of meat, fish, or poultry is 3 ounces— about the size of the palm of your handA serving of cheese is 1 ounce—about the size of your thumbA serving of milk, yogurt, or fresh vegetables is 1 cup—about the size of a tennis ballDon’t pour dressing on your salad. Instead, the American Diabetes Association suggests that you dip the tip of your fork in the salad dressing and then spear a piece of lettuce. You’ll use less dressing that wayTry to limit alcohol and sugary drinks. They add calories but no nutrients to your meal

Don’t rush! Eat slowly and really enjoy your mealWhen it’s time to head home - Just a couple of things before you go.Was it easy for you to order because there were a lot of healthy choices on the menu? Let the manager know. Restaurants want to please you, and they’ll only know what you want if you tell themDon’t forget that to-go container for tomorrow!Review QuestionsCHAPTER 10: DIABETESPage(s): 3321.Diabetes is the ______ leading cause of death in the United States.a.fourth

b.fifthc.sixthd.seventh2.About ______ million people in the United States have diabetes.a.7b.20c.24d.333.Which of the following races/ethnicities has the highest incidence of diabetes?a.Whitesb.Mexican Americansc.African Americansd.Native Americans4.Diabetes is a defect in the transfer of ______ from the bloodstream into the cells.a.cholesterolb.glucosec.mineralsd.waterPage(s): 3345.What organ produces insulin?a.liverb.pancreasc.biled.colon6.All of the following are types of diabetes EXCEPT -- a.type 1.b.gestational.c.type 3.d.type 2.7.Type 1 diabetes is commonly found in all of the following EXCEPT --a.children.b.teenagers.c.young adults.d.older adults.Page(s): 334–3358.Symptoms of type 1 diabetes include increased urination, unexplained weight loss, and…a.unexplained bleeding.b.primary insomnia. c.increased thirst. d.eczema.Page(s): 3359.More than ______ percent of people with diabetes have type 2.a.60b.70c.80d.90

10.In response to insulin resistance, the pancreas……a.produces more insulin.b.produces less insulin.c.fails.d.resists introduced insulin.11.About ______ percent of people with type 2 diabetes are obese.a.40–50b.70–80c.80–90d.90–10012.Type 2 diabetes is most likely to develop in people older than…a.10.b.20.c.30.d.40.Page(s): 33613.A woman who has gestational diabetes during pregnancy is ______ percent more likely to develop type 2 diabetes within 5 to 10 years.a.10–20b.20–40c.40–60d.60–7014.Pre-diabetes may be reversed by losing weight, improving diet, and…a.doing physical therapy.b.hydrating regularly.c.increasing physical activity.d.decreasing physical activity.Page(s): 33715.The following are all complications of diabetes EXCEPT….a.eye disease.b.hair loss.c.kidney disease.d.nerve damage.16.Which disease occurs at younger ages and is at least twice as common in those with diabetes as in those without diabetes?a.atherosclerosisb.cancerc.stroked.congestive heart failure17.Complications from diabetes can damage which part of the eye?a.retinab.corneac.pupild.iris

Page(s): 33818.Peripheral neuropathy causes all of the following EXCEPT…a.pain.b.numbness.c.bleeding.d.tingling.19.All the complications from diabetes, including major diseases, can be managed if the patient carefully maintains…a.insulin levels.b.blood glucose levels.c.proper nutrition.d.an active lifestyle.Page(s): 33920.Macrovascular diseases include all of the following EXCEPT……a.kidney disease.b.heart disease.c.stroke.d.peripheral vascular disease.Page(s): 34021.What is the most common blood glucose test?a.casual plasma glucose testb.fasting plasma glucose testc.oral glucose tolerance testd.normal glucose platelets test22.All of the following are ways of diagnosing diabetes EXCEPT……a.a fasting plasma glucose test.b.a casual plasma glucose test.c.a normal glucose platelets test.d.an oral glucose tolerance test.23.What makes blood glucose levels rise?.a.insulinb.foodc.walkingd.running24.Among adults with diagnosed diabetes, ______ percent take oral medication only….a.12b.17c.20d.5725.About ______ percent of adults with diagnosed diabetes take both oral medications and insulin….a.13b.25c.57d.72

Page(s): 34126.Which of the following terms means low blood glucose levels?..a.diabetesb.glycemiac.hypoglycemiad.hyperglycemiaPages: 341–34227.All of the following are used to treat hypoglycemia EXCEPT…a.fruit juice.b.coffee.c.glucose tablets.d.candy.Page(s): 34228.All of the following professionals serve on a diabetes-care medical team EXCEPT…a.a dietician.b.an exercise specialist.c.a pharmacist.d.a cardiologist.Page(s): 34529.Which type of diabetes is the most difficult to control?...a.type 1b.type 2c.gestationald.pre-diabetes30.In controlling type 1 diabetes, one should consider all of the following diet management techniques EXCEPT…a.eating times.b.eating places.c.type of food.d.amount of food.Page(s): 34831.Type 2 diabetes in children is associated with all of these EXCEPT…a.cavities.b.obesity.c.low levels of physical activity.d.poor dietary patterns.Page(s): 35132.Metabolic syndrome promotes a.pancreatitis. b.atherosclerosis. c.obesity. d.vascular syndrome.