Saima M. Ahmad, MD M. Ahmad, MD Saima Physicians Clinic of Spokane Physicians Clinic of Spokane Clinical Faculty, University of Washington. Clinical Faculty, University of Washington.
Diabetes Statistics Diabetes Statistics � 8.3% of the population, or 25.8 million 8.3% of the population, or 25.8 million � children and adults in the US children and adults in the US � Diagnosed: 18.8 million people Diagnosed: 18.8 million people � � Undiagnosed: 7.0 million people Undiagnosed: 7.0 million people � � Prediabetes Prediabetes: 79 million people : 79 million people � � 1.9 million new cases of diabetes 1.9 million new cases of diabetes were were � diagnosed in people over 20 years old in diagnosed in people over 20 years old in 2010. 2010.
Diabetes Statistics Diabetes Statistics � Diabetes is the leading cause of blindness Diabetes is the leading cause of blindness � among adults aged 20– –74 years. 74 years. among adults aged 20 � Diabetes is the leading cause of kidney Diabetes is the leading cause of kidney � failure, accounting for 44% of new cases failure, accounting for 44% of new cases yearly. yearly. � A total of A total of 202,290 people with end 202,290 people with end- -stage stage � kidney disease due to diabetes are living kidney disease due to diabetes are living on chronic dialysis. on chronic dialysis. � 60% 60% - - 70% of people with diabetes have 70% of people with diabetes have � some nervous system damage . some nervous system damage .
People with Diabetes 2010 and People with Diabetes 2010 and 2030 2030
Cost of Diabetes Cost of Diabetes � $174 billion: Total cost of diagnosed $174 billion: Total cost of diagnosed � diabetes in the United States in 2007 diabetes in the United States in 2007 � $116 billion for direct medical costs $116 billion for direct medical costs � � $58 billion for indirect costs $58 billion for indirect costs (disability, (disability, � work loss, premature mortality work loss, premature mortality
Prevention of Diabetes Prevention of Diabetes � Diet Diet – – Whole grain and high fiber foods Whole grain and high fiber foods � � Exercise Exercise � � Try to lose 5 Try to lose 5- -7% body weight 7% body weight � � Goal BMI under 25. Goal BMI under 25. � � Screening every 3 years Screening every 3 years �
Basic Diabetes Information Basic Diabetes Information � Diabetes is a disease in which body does Diabetes is a disease in which body does � NOT produce or properly use Insulin. NOT produce or properly use Insulin. � Insulin is a hormone produced by Insulin is a hormone produced by � Pancreas that is needed to convert sugar Pancreas that is needed to convert sugar into energy needed for daily life. into energy needed for daily life.
Glucose control in body Glucose control in body
Types of Diabetes Types of Diabetes � Type 1 Diabetes: Type 1 Diabetes: � - Failure to produce Insulin Failure to produce Insulin - - Usually childhood, early teenage Usually childhood, early teenage - - Always need Insulin. Always need Insulin. - � Type 2 Diabetes: Type 2 Diabetes: � - Insulin resistance, or inability to use Insulin Insulin resistance, or inability to use Insulin - - Obesity related Obesity related - - May or may not need Insulin. May or may not need Insulin. -
Types of Diabetes Types of Diabetes � Gestational Diabetes Gestational Diabetes – – Pregnancy related Pregnancy related � – 4% of Pregnant women. 4% of Pregnant women. – � Rare causes of Diabetes Rare causes of Diabetes – – Trauma, Trauma, � infection, medications, genetic defects etc infection, medications, genetic defects etc
Risk factors for Diabetes Risk factors for Diabetes � Obesity Obesity � � Ethnicity Ethnicity – – African African � Americans, Native Americans, Native Americans Americans � Age Age � � Family history Family history - - � Genetics Genetics � Sedentary Lifestyle Sedentary Lifestyle �
Obesity Obesity
Criteria for Diagnosis of Diabetes Criteria for Diagnosis of Diabetes � Normal Fasting Blood Glucose:100 mg/dl Normal Fasting Blood Glucose:100 mg/dl � or less or less � Pre Pre- -Diabetes: or Impaired fasting Glucose: Diabetes: or Impaired fasting Glucose: � 110- -126 126 110 � Diabetes: >126 Fasting or Diabetes: >126 Fasting or � >200 Non Fasting >200 Non Fasting
Pre - - Diabetes Diabetes Pre � Glucose levels that are higher than normal Glucose levels that are higher than normal � but not yet high enough to be diagnosed but not yet high enough to be diagnosed as diabetes. as diabetes. � 57 million people in the US living with 57 million people in the US living with � prediabetes. . prediabetes � You may need 2 hour fasting test called You may need 2 hour fasting test called � Glucose tolerance test. Glucose tolerance test.
Symptoms of Diabetes Symptoms of Diabetes
Symptoms of Type 1 Diabetes Symptoms of Type 1 Diabetes � Frequent urination ( Frequent urination (polyuria polyuria) ) � � Unusual thirst ( Unusual thirst (polydipsia polydipsia) ) � � Extreme hunger Extreme hunger � � Unusual weight loss Unusual weight loss � � Extreme fatigue and Irritability Extreme fatigue and Irritability �
Symptoms of Type 2 Diabetes Symptoms of Type 2 Diabetes � Any of the type 1 symptoms Any of the type 1 symptoms � � Frequent infections Frequent infections � � Blurred vision Blurred vision � � Cuts/bruises that are slow to heal Cuts/bruises that are slow to heal � � Tingling/numbness in the hands/feet Tingling/numbness in the hands/feet � � Recurring skin, gum, or bladder infections Recurring skin, gum, or bladder infections � � Often people with type 2 diabetes have no Often people with type 2 diabetes have no � symptoms symptoms
Gestational Diabetes Gestational Diabetes � Develops only during pregnancy Develops only during pregnancy � � Occurs in 4% of Pregnancies Occurs in 4% of Pregnancies � th - th week of Screening done in 24 th 28 th � Screening done in 24 -28 week of � pregnancy pregnancy � Diet and Insulin are the only treatments. Diet and Insulin are the only treatments. � � Can adversely affect baby. Can adversely affect baby. � � 25 25- -40% greater risk of developing Type 2 40% greater risk of developing Type 2 � Diabetes within 5 years, based on their Diabetes within 5 years, based on their ethnicity. ethnicity.
Metabolic syndrome Metabolic syndrome
Metabolic syndrome Metabolic syndrome Central obesity, or abdominal Central obesity, or abdominal � � fat, or BMI >30 fat, or BMI >30 kg/m² Waist kg/m² Waist over 40 inches in men over 40 inches in men Waist over 35 inches in Waist over 35 inches in women. women. AND any two of the following: AND any two of the following: � � Triglycerides: > 150 mg/ mg/dL dL Triglycerides: > 150 � � Low HDL (or good) Low HDL (or good) � � cholesterol: cholesterol: < 40 mg/ mg/dL dL in males, in males, < 40 < 50 mg/ mg/dL dL in females, in females, < 50 High blood pressure: High blood pressure: � � systolic BP > 130 or diastolic systolic BP > 130 or diastolic BP >85 BP >85 mm Hg mm Hg Fasting Blood glucose Fasting Blood glucose � � >100 mg/ mg/dL dL >100
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