Diabetes Mellitus

1. Diabetes Mellitus What is it? Why do so many people have it? How we can avoid it? *WHO: Diabetes 7th leading cause of death.

2. The Pancreas

3. Insulin and Glucagon Insulin: peptide hormone made by  cells If blood glucose rises (e.g. after a meal) insulin is released. Insulin causes cells in body to take up glucose (e.g. ↓ blood glucose). Also causes liver to synthesize glycogen and other anabolic activities.

4. When blood Glucose is high Insulin is released to make blood Glucose lower (normal) Cells in your body up-take the glucose

5. Glucagon: peptide hormone made by  cells If blood glucose falls (e.g. in between meals) glucagon is released. Causes liver to hydrolyze glycogen into glucose (e.g. ↑ blood glucose) Also causes fats and proteins to be converted into glucose (called gluconeogenisis) and other catabolic activities.

6. When blood Glucose is low Glucagon is released to make blood Glucose higher (normal) Liver is a key site: Hepatocytes liberate Glucose stores (glycogen) and use fats & proteins to make more glucose Glycogenolysis *

7. Diabetes Mellitus • Type I – “Juvenile Onset” (IDDM) ~10% • Type II – “Adult Onset” (NIDDM)~90%

8. Diabetes Mellitus Type I • Autoimmune destruction of pancreatic β cells. • β cells make Insulin. • Insulin transports Glucose into cells. • If no Insulin, then cells cannot use Glucose • Chronically Elevated Blood Glucose = Problems!

9. Diabetes Mellitus Type II • Diet High in Refined Carbohydrates • Roller Coaster of High and Low Blood Glucose • Insulin spikes to control high Glucose levels and cells become less and less sensitive to insulin. • Cells then become de-sensitized to insulin. • Chronically Elevated Blood Glucose = Problems!

11. Insulin Levels

12. Refined Processed Foods White Bread Candy and Soda Low fat Yogurt Girl Scout Cookies Whole Foods Complex Organic Vegetables Brown Rice or Quinoa Nuts and Legumes Fresh Organic Fruits

13. Symptoms of Diabetes Mellitus • Frequent urination (polyuria) • Excessive thirst (polydipsia) • Unexplained weight loss • Extreme hunger • Sudden vision changes (retinopathy) • Tingling or numbness of hands or feet (neuropathy) • Feeling very tired much of the time • Very dry skin • Sores that are slow to heal • More infections than usual

14. Figure 1. Shows the rapid increase in Diabetes Mellitus amongst Americans.

15. Diabetes Mellitus Facts - In the U.S. in 2010 ~ 215,000 aged 20 & under had diabetes - type 1 or 2. ~ 1.9 million aged 20 & over newly diagnosed with diabetes. ~ 10.9 million aged 65 & over had diabetes. About 35% over age of 20 and 50% of adults 65 or over had pre-diabetes. Estimated 79 million Americans over 20 have pre-diabetes. Diabetics (%) in 2010 New cases of diabetes

16. End-Stage Renal Disease (ESRD) attributable to diabetes mellitus increased from over 2,600 in 1980 to 48,374 in 2008. Figure 2. Shows the relationship between Diabetes Mellitus and other chronic debilitating diseases.

17. The Seven (7) year Incidence of Myocardial Infarction %. Figure 3. Patients with diabetes without a previous MI have as great a risk for infarction as individuals without diabetes with a previous myocardial infarction.

18. Diabetes Mellitus causes many other problems… ~ 90% of cases are totally preventable… So why are we getting it?

19. The Glycemic Index (GI) and Load (GL)

21. Glycemic Index (GI) indicates how quickly a certain food turns into sugar in a person’s body. Glycemic Load(GL) indicates the total amount of glucose in the food. Can calculate the total amount in terms of average serving. Glycemic Load = Glycemic Index x Carbohydrates / 100 76 GI x 23 net carbs /100 = 17.5 38 GI x 15 net carbs /100 = 5.7

22. Consequences of Chronic Diabetes Eye Problems most common vision disease retinopathy: Blood vessels to retina leak, bleed and become blocked; may cause partial loss of vision or blindness. Also increased risk for cataracts and glaucoma Heart Disease Chronically elevated blood glucose linked to plaque formation in coronary arteries (atherosclerosis). Diabetics have twice the risk of heart disease. Chronic Kidney Disease & Kidney Failure Diabetes is the leading cause of kidney failure among Americans. Neuropathy Peripheral affects hands and feet; tingling, burning, numbness or complete loss of feeling. Also in organs, can slow digestion, cause constipation, decreased sexual response. Peripheral Arterial Disease Atherosclerosis in extremities, causing leg pain, poor circulation. Gangrene.

23. Skeletal Muscles use Glucose w/out Insulin So walking after a meal lowers blood glucose without using insulin. Neurons can only use glucose! and don’t require insulin (use Glut-2-trans). Low blood glucose, e.g., hypoglycemia, can impair CNS resulting in dizziness, speech problems and loss of consciousness. Unconsciousness => “hypoglycemic coma" often resulting from "insulin shock”.

24. Heart Surgeon Speaks out on what Really Causes Heart Disease Dr. Dwight Lundell: PreventDisease - Thu, 01 Mar 2012 From article: Recent discoveries that chronic inflammation of arterial walls is the real cause of heart disease is slowly leading to a paradigm shift. The long-established severely restricted fat intake has created epidemics of obesity and diabetes. Despite 25% of population on statin drugs, despite having reduced the fat content of our diets, more Americans will die this year of heart disease than ever before. AHA shows that 75 million Americans suffer from heart disease; 20 million have diabetes and 57 million have pre-diabetes. Fat was replaced by Sugar!

26. One of the best foods to eat to control blood glucose is Fats - the right fats!

27. Which one would you choose? Which one should you choose? Why do we make the choices we make?

28. Fight for your Mind! Effects of Watching TV Decreased melatonin Early puberty Cancer Autism Difficulty sleeping Diabetes Obesity Decreased immunity Poor metabolism Poor eyesight Alzheimer's Just Say NO to TV!

29. Girl Scout Cookie Label – Are they liars?!? * Tertiary Butylhydroquinone (TBHQ)

31. So Which one?

32. Salvestrols Synthesized by plants, they belong to a group of phytochemicals called phytoalexins. Plants produce this in response to attack by pathogenic organisms such as fungi, viruses and bacteria. Resveratrol first of the salvestrols discovered. Highest amounts found in Green Vegetables and Red Fruits, also higher in bitter foods!

33. How Salvestrols Work Normal cell Cancer cell So fruits and vegetables really are good for you!

34. In Summary Learn about how your lifestyle affects your physical health Then Act on it! Maybe you will be even happier and healthier than you already are?