1. Diabetes Healthy Schools, Healthy Families Mithila Jegathesan, M.D. Kate Avitabile, M.D.

2. What is Diabetes? • A disease in which there are high levels of blood glucose in the body • Glucose is the medical term for sugar • It is the fuel the body uses to stay active, just like gas in a car

3. Why does diabetes happen? • Normally, an organ called the pancreas produces a hormone called insulin • Insulin controls the level of sugar in the body • In diabetes the insulin does not control the sugar correctly

4. Type 1 Diabetes • The body destroys the cells in the pancreas that usually make insulin • There is no insulin in the body to control the levels of sugar • Insulin must be injected into the person to control the levels of sugar

5. Type 1 Diabetes • Usually happens in children and young adults • May be “in their genes” • No way to prevent or cure this type of diabetes yet

6. Type 2 Diabetes • At the beginning the pancreas is able to produce insulin to control the sugar • But the other cells in the body, like the muscles, cannot respond to this insulin • The pancreas tries to produce more and more insulin but the organs cannot respond • This is called “insulin resistance”

7. Type 2 Diabetes • The pancreas eventually gets tired out and cannot produce any more insulin • The body’s sugar levels are uncontrolled • Some people need medications to decrease the level of sugar in the body • Other people may eventually need insulin injections

8. Who often gets Type 2 Diabetes? • Older age - adult and young adult cases • Overweight or obese people • Women who had diabetes during pregnancy • People who do not exercise often • Some races and ethnicities • African American • Hispanic/Latinos • Native Americans • Some Asians • May run in families

9. Gestational Diabetes • Diabetes in pregnant women • May go away after the baby is born • But some women with this type of diabetes may be more likely to develop permanent diabetes after pregnancy • Can cause problems for the baby including heart and lung problems and problems with the baby’s sugar

10. Who may get diabetes of pregnancy? • Obese women • Women with family members with diabetes • More common in African Americas, Hispanic/Latina Americans, and Native Americans

11. Body Parts Affected by Diabetes • Eyes • Diabetes causes the blood vessels of the back of the eye called the retina to grow too much • This may cause the retina to separate from the back of the eye • This may lead to permanent blindness • Some people may have surgery to remove these blood vessels

12. Body Parts Affected by Diabetes • Kidneys • Diabetes causes the blood vessels of the kidneys to become weak • This may lead to leaking of important proteins into the urine • These important proteins are lost from the body

13. Body Parts Affected by Diabetes • Kidneys • Loss of proteins may lead to swelling of the feet and ankles • Kidney damage can also cause high blood pressure • Some people need kidney transplants

14. Body Parts Affected by Diabetes • Heart • High sugar causes damage to the blood vessels that bring blood to the muscle of the heart • The vessels can become narrow • Blood cannot get to all parts of the heart • This may lead to chest pain, heart attacks, and possibly death

15. Body Parts Affected by Diabetes • Other blood vessels • The vessels of the legs, ankles, and feet may be damaged by diabetes • This may lead to change in color, pain, and ulcers • Some diabetics need to have amputations

16. Body Parts Affected by Diabetes • Nerves • The nerves of the feet are often damaged • This can cause changes in feeling as well as burning sensations in the feet • The nerves of the stomach and intestine can also be damaged and cause problems with digestion

17. Body Parts Affected by Diabetes • Infections • Diabetics are more prone to getting infections • They may get very serious infections with fungi • The ulcers of the feet can become infected and spread to infection of the bone

18. What is Pre-Diabetes? • A condition that may later develop into diabetes • The levels of sugar in the blood are higher than normal but not as high as in diabetes

19. Who can get Pre-Diabetes? • Adults • Also children! • As more and more children are overweight, more and more children are getting pre-diabetes

20. What are the signs of Pre-Diabetes? • A person with pre-diabetes has high sugar on a blood test taken first thing in the morning, before eating anything • The doctor may then test the blood after the person eats a sugary meal and the blood sugar is even higher

21. What are the signs of Pre-Diabetes? • Acanthosis nigricans • Dark color of the skin on the back of the neck or under the armpits • May be seen in both light and dark skinned people • Sign of high levels of blood sugar • Especially important in finding children at risk of pre-diabetes and diabetes

22. Now for some GOOD NEWS!!

23. How can I prevent diabetes in myself and my children? • Exercise • 30 minutes per day or 3 times per week • Try walking more rather than taking the bus or subway • Take the stairs instead of the elevator • Try buying an exercise video to use at home • Find a friend to exercise with you!

24. How can I prevent diabetes in myself and my children? • Eat healthy • Eat a diet low in fat, low in carbohydrates, and high in fiber • Limit fast food • Limit soda and juice • Parents’ examples help children form good habits!

25. How can I prevent diabetes in myself and my children? • Lose weight • Obesity is a major risk factor for developing diabetes • Exercise and healthy eating can help you maintain a healthy weight and lower your risk of developing diabetes

26. How can I prevent diabetes in myself and my children? • Decrease screen time • Instead of watching TV or playing video games with your kids, go for a walk or go to the park together • Cutting down TV time from 4 hrs a day to 2 hrs a day can decrease children’s risk of being overweight and developing pre-diabetes

27. How can I prevent diabetes in myself and my children? • See your doctor for regular check-ups • Follow advice on how to lower blood pressure and cholesterol • Having diabetes along with obesity, high blood pressure, and high cholesterol increases your risk of heart and kidney disease

28. How can I prevent diabetes in myself and my children? • Limit alcohol intake • Ask your doctor for information about how you can stop smoking • Dial 411 for other programs