Educational Grand Rounds: Diabetes and Lifestyle Modification
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Transcript of Educational Grand Rounds: Diabetes and Lifestyle Modification
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Blood Sugar Regulation, Diabetes and Life
Style ChangeBy
Zahida Chaudhary MD
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An American Epidemic
26 million with Diabetes79 million with Pre-Diabetes
Diabetes affects almost 26 million Americans (8.3%), one quarter of whom don’t know they have it.
Another 79 million Americans have pre-diabetes, which raises their risk of developing type 2 diabetes, heart disease, and stroke. About 1.9 million new cases of diabetes were diagnosed in people aged 20 or older in 2010. (CDC)
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The law of the body is that body must maintain certain level of sugar in the blood, around 100 can range 100-120
Normal blood fasting glucose level for non-diabetics, should be between 70 and 100 (mg/dL) and should be below 125 mg/dL.
Blood Sugar Regulation
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Liver is on right side of our body It is about 3 pounds We have a tiny organ called pancreas right below the left rib cage Liver and pancreas have mutual relation ship. They coordinate to control the blood sugar levels But liver is the most ignored piece of puzzle in diabetes
How Sugar Control Works?
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-Liver control blood sugar levels when we are not eating
-Pancreas control blood sugar levels when we eat
-They go back and forth.
Pancreas makes a hormone called insulin
Insulin takes sugar out of the blood and put sugar in the liver where it is stored as glycogen. Hence blood sugar level is decreased
Liver takes this Glycogen and converts it into sugar when needed, and puts it back in the blood and keep it normal 100
Body does not like to burn fat under normal situation, unless there is no sugar The purpose of fat is to act as storage and uses it when we are not eating, starving or exercising.
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Three things happen when the sugar is pulled out of blood in the presence of insulin.
-Energy— our cell use sugar as a form of energy e.g. during exercise
-Stored in the liver and muscles as glycogen
-Fat—After certain amount if sugar is not used , it is stored as Fat and can be used as energy source
Action Of Insulin
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Types of Diabetes
• Type 1 Diabetes5-10% of diagnosed cases of diabetes
• Type 2 Diabetes90-95% diagnosed cases of diabetes
• Gestational Diabetes7% of all U.S. pregnancies
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Cause of Hyperglycemia in Type 2 Diabetes
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Insulin Resistance And Health Problems
Insulin resistance is associated with many health problems including:
-Fatigue.-Brain fogginess and inability to focus.-High blood sugar.-Intestinal bloating-Sleepiness, especially after meals.-Weight gain, fat storage, difficulty losing weight-Increased blood triglyceride levels.-Increased blood pressure-Depression.-Increased hunger.
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Diabetes Complications
• 2 in 3 people with diabetes die of heart disease or stroke
• Diabetes is the #1 cause of adult blindness
• Diabetes is the #1 cause of kidney failure
• Diabetes causes more than 60% of non-traumatic lower-limb amputations each year
• Nerve: Neuropathy
Age
Race/ethnicity
Gender/Family history
Overweight Abnormal lipid metabolism Inflammation, hyper coagulation Hypertension Smoking Physical inactivity, Unhealthy diet, insulin resistance
Non-Modifiable
Modifiable
Cardio metabolic Risk
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• The major components of the treatment of diabetes are:
Management of DM
• Diet and ExerciseA
• Oral Hypoglycaemic TherapyB
• Insulin TherapyC
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Many studies show that lifestyle changes, such as losing weight, eating healthy and increasing physical activity can dramatically reduce the progression of type 2 diabetes and are important to controlling type 1 diabetes.
These lifestyle changes can help minimize other risk factors as well, such as high blood pressure and blood cholesterol, which can have a tremendous impact on people with diabetes.
Lifestyle changes must be complemented by a regimen of medications to control blood glucose levels, high blood pressure and cholesterol as well as to prevent heart attack and stroke, which claim the lives of many diabetes patients.
Diet and Exercise Life style modification
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Life style modification
• Blood glucose (sugar) control
• Body weight monitoring• Blood pressure control• Blood lipid (fat) control• Smoking cessation• Preventive care/ Personal
hygiene• practices for eyes, kidneys,
feet, teeth and gums
Research studies have found that lifestyle changes can prevent or delay the onset of type 2 diabetes among high-risk adults.
Lifestyle interventions included diet and moderate-intensity physical activity (such as walking for 2-3 or more, hours each week).
In the Diabetes Prevention Program, a large prevention study of people at high risk for diabetes, the development of diabetes was reduced 58% over 3 years.
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Our bodies are not design to consume 149 pounds of sugar/year-Our bodies are not design for the amount of sugar we are eating, even baby food is loaded with sugar-Juices, sodas etc. are way very high in sugar.
Life Style Modification
Diet is a basic part of management in every case.
Dietary treatment should aim at:◦ensuring weight control◦providing nutritional requirements◦allowing good glycaemic control with blood glucose levels as
close to normal as possible◦correcting any associated blood lipid abnormalities
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Changing the way you live can change the way you feel.
While there is no cure for diabetes, there are ways to manage and prevent
Finding out how body weight affects diabetes and discover lifestyle changes, just a little easier to live with.
In ConclusionLife style modification
Reduce stress