Take Steps Against Diabetes: What You Can Do NOW

1. Take Steps Against Diabetes: What You Can Do NOW M. Elson, MD, MME

2. DISCLOSURE STATEMENT I have no financial conflicts of interest I AM interested in promoting YOUR health I have been to Spain! And the food was great!

3. When It Comes to Diabetes, You Have Power • Diabetes is a serious disease. • You have the power to fight it! • You can start taking steps NOW to delay or prevent diabetes and its complications.

4. Start by Educating Yourself Important things to learn: • What is diabetes? • What is pre-diabetes? • Who is at risk? • Should you be tested for diabetes? • If you have diabetes, how can you manage it? • What can you do to delay or prevent diabetes and its complications?

5. What Is Blood Sugar? • During digestion, food is converted into glucose, a sugar your body uses for energy. • The hormone insulin ushers glucose (blood sugar) into your cells for fuel. • Diabetes affects how your body uses blood sugar to fuel your body.

6. What Is Diabetes? • In people with diabetes, insulin doesn’t work properly, or their bodies don’t make enough insulin. • When insulin doesn’t do its job effectively, cells don’t get the glucose they need for fuel. • When glucose can’t get into the cells, it builds up in the blood and can harm the body. This is called having high blood glucose, or high blood sugar.

7. How Many People Have Diabetes? • 25.8 million people in the U.S. have diabetes (8.3 percent of the population). • This includes 1.6 million children and teens. • 7 million people have undiagnosed diabetes—they have diabetes, but they don’t know it.

8. Diabetes by Type • Type 1 diabetes • also called insulin-dependent diabetes or juvenile-onset diabetes • Type 2 diabetes • also called adult-onset diabetes, although children and teens can also get it • Gestational diabetes • develops during pregnancy • usually goes away after delivery

9. Type 2 Is the Most Common Kind of Diabetes

10. You Have Power! • You can start taking steps today to prevent or delay diabetes and its complications. • You can make small changes that deliver big health rewards. • You have the power to alter your health!

11. Risk Factors for Diabetes • Being overweight or obese • Age (45 or older) • A family history of diabetes • Excess belly fat • A diagnosis of pre-diabetes • Inactivity (exercising fewer than three times a week) • Certain ethnic backgrounds (African American, American Indian, Asian American, Pacific Islander, or Hispanic American/Latino) • High blood pressure (140/90 or higher) • Low HDL (“good”) cholesterol (35 or lower) • High triglycerides (250 or higher) • Pregnancy • A history of gestational diabetes or giving birth to a large baby (9 pounds or more) • Insulin resistance • Cardiovascular disease or polycystic ovary syndrome

12. Do You Have Pre-Diabetes? • People with pre-diabetes have blood sugar levels that are higher than they should be, but not high enough to be considered diabetes.

13. How Many People Have Pre-Diabetes? • 79 million American adults have pre-diabetes. • 35 percent of adults age 20 or older • 50 percent of adults age 65 or older

14. Pre-Diabetes Is a Warning • Without making changes to improve their health, 15 percent to 30 percent of people with pre-diabetes will develop diabetes within five years.

15. Excess Weight Is a Major Risk Factor for Diabetes • Being overweight or obese is the No. 1 risk factor for developing diabetes. • Being overweight makes you seven times more likely to develop diabetes. • Being obese makes you 20 to 40 times more likely to develop diabetes.

16. How Do You Weigh In? Does your weight raise your diabetes risk? Check your weight on this chart. If it is at or above the amount listed next to your height, your weight may put you at risk.

17. Measure Your Waist • Having excess belly fat is another diabetes risk factor. • Anyone of any age who has excess belly fat (a waist measurement of 40 inches or more for men, or 35 inches or more for women) is at risk even if he or she is not overweight.

18. How’s Your Blood Sugar? • Ask your provider if you should be tested!

19. Ways to Test for Diabetes • We use three main kinds of blood testing to check for diabetes: • A1C test • Fasting Plasma Glucose (FPG) test • Oral Glucose Tolerance Test (OGTT)

20. Be on the Lookout for Diabetes Symptoms • Frequent urination • Excessive thirst • Extreme hunger • Unexplained weight loss • Sudden vision changes • Tingling or numbness in hands or feet • Fatigue • Very dry, itchy skin • Sores that are slow to heal • More infections than usual, especially in the skin, gums, bladder, or vagina • Confusion or dizziness • Breath that smells like nail polish remover • Darkening of skin around the neck or in the armpits • An absence of menstrual periods • Unexplained nausea, vomiting, or stomach pain

21. Now That You Know Your Risk • You can start taking steps toward lowering it!

22. Good News About Prevention • The Diabetes Prevention Program (DPP), a major research study, found that people with pre-diabetes could delay or prevent diabetes without taking medication. • Participants in the DPP who lost weight through diet and exercise cut their diabetes risk by 58 percent.

23. A Little Weight Loss Brings Big Rewards • Participants in the DPP study lost just 5 percent to 7 percent of their body weight through exercise and diet. • For someone who weighs 200 pounds, that’s only 10 to 14 pounds.

24. How Can You Lower Your Weight? • Healthy Diet + Exercise = Weight Loss

25. Start With a Healthy Diet

26. Choose Whole-Grain Foods

27. Great Grains • Try these delicious, nutritious whole grains: • Buckwheat • Bulgur • Millet • Quinoa • Sorghum • Whole rye • Barley

28. Eat a Rainbow of Fruits and Vegetables • Diets that contain lots of fiber-rich fruits and vegetables may reduce the risk of heart disease, obesity, and diabetes.

29. Pick Powerful Proteins • Choose low-fat or lean protein sources, such as: • Lean meat, poultry, fish, and shellfish • Low-fat or nonfat dairy (milk, cheese) • Soy foods • Eggs • Nuts and seeds • Dried beans, legumes, peas, and lentils

30. Choose Healthy Fats • “Good” fats: • Polyunsaturated • Monounsaturated • Omega-3 • “Bad” fats: • Saturated • Trans fat

31. Avoid Sugary Drinks 12 ounces of Coca-Cola = 39 grams of sugar (about 10 teaspoons) 12-ounce serving of Nestea iced tea = 33 grams of sugar (about 8 teaspoons) 1.55-ounce Hershey’s bar = 24 grams of sugar (about 6 teaspoons) 20-ounce bottle of Coca-Cola = 65 grams of sugar (about 16 teaspoons)

32. Get Moving • Becoming more active is another great way to reduce your weight, lower your diabetes risk, and boost your overall health.

33. How to Get Started • Brisk walking is one of the best exercises you can do—even if you’re overweight or obese. • Begin with a few minutes of walking each day, and build up from there. • It’s OK to start slow!

34. Make It a Goal • Your eventual goal: 30 to 60 minutes of moderate exercise five or more days per week. • If you use a pedometer, aim for 10,000 steps a day. • Set weekly goals, and reward yourself when you reach them!

35. Take Breaks from Sitting • Get up, stretch, and walk around for a couple of minutes every hour.

36. What Else Can You Do? • Talk with your provider if you’re having trouble sleeping. • Quit smoking. • Reduce stress.

37. If You Have Diabetes • Control your blood sugar, and have it checked as recommended • Control your blood pressure (to help your kidneys) • Control your blood lipids • Follow your provider’s instructions about using diabetes medication • Educate yourself about how best to take care of your health

38. Take Steps to Avoid the Complications of Diabetes • Heart disease • Stroke • High blood pressure • Blindness • Kidney failure • Nervous system damage • Limb amputations • Gum disease • Problems with everyday mobility • Depression

39. What Have You Learned? • Remember, you have the power to reduce the risk of diabetes and its complications. • By taking the steps outlined in this presentation, you can live a healthier, happier life.

40. Other Resources • Your health care provider • American Diabetes Association (www.diabetes.org) • A registered dietitian or certified diabetes educator (www.ncbde.org) • National Diabetes Education Program (www.ndep.nih.gov)