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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

142/2/06 14

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

152/2/06 15

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

162/2/06 16

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

172/2/06 17

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

182/2/06 18

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