Diabetes Basics: Food for Thought

Trinette Stanford, NP-C, CDE, MBA

Objectives – by the end of the workshop participants should be able to:

Identify the different types of diabetes

What does diabetes look like?

The Face of Diabetes in the United States

What does diabetes look like in Alabama?

Determine how diabetes will affect industry recruitment

Healthy People 2020

• Healthy People 2020 is the federal government's prevention agenda for building a healthier nation. It is a statement of national health objectives designed to identify the most significant preventable threats to health and to establish national goals to reduce these threats. The vision of Healthy People 2020 is to have a society in which all people live long, healthy lives. The overarching goals of Healthy People 2020 are to: attain high-quality, longer lives free of preventable disease, disability, injury, and premature death; achieve health equity, eliminate disparities, and improve the health of all groups; create social and physical environments that promote good health for all; and promote quality of life, healthy development, and healthy behaviors across all life stages.

Healthy People 2020 -

Diabetes

Decrease diabetes and its economic costs

1Improve quality of life for all with diabetes

2Diminish development of diabetes in those diagnosed with prediabetes

3

Types of Diabetes

• Type 1 – Autoimmune condition. Pancreas is not producing insulin. Sudden onset

• Type 2 – Metabolic condition. Develops overtime. Can take years to be diagnosed

• Gestational – Develops during pregnancy

• Prediabetes – abnormal blood sugar but not high enough to be classified as diabetes

• Diabetes insipidus – Metabolic condition characterized by urinating large volumes up to 20 liters. Fluid restriction does not affect it. Defect in the pituitary and or hypothalamus in brain. Antidiuretic hormone is defective

Etiology -What causes Diabetes

• Type 1 diabetes – old terminology –juvenile diabetes. Autoimmune condition, infection, cancer, or accident that causes pancreas to stop functioning

• Type 2 diabetes – old terminology Adult Onset Diabetes. Metabolic, body becomes insulin resistant, can be caused by medications such as steroids, retrovirals, psychotropic medications

• Prediabetes – old terminology borderline diabetes. Metabolic compromise but is reversible and treatable at this point.

• Gestational diabetes – woman that did not have diabetes prior to pregnancy Placental hormones trigger increase blood sugar and her body does not produce enough insulin to metabolize the glucose. This elevated glucose affects the mother and baby.

Additional Causes of T2DM

• Niacin

• Diuretics

• Anti-seizure meds

• Psychotropic meds

• HIV meds

• Pentamidine – treatment for pneumonia

• Steroids

• Anti-rejection meds

Hormonal diseases

• Cushings disease

• Acromegaly

• Hyperthyroidism

Risk Factors

Modifiable

• Weight

• Inactivity

• Tobacco use

• Processed foods

Nonmodifiable

• Age - >45 yrs old and older

• Gender

• Genetics/heredity – 1st degree relative w/T2DM

• Female with H/O gestational diabetes or PCOS

Industry recruitment, job development, healthy workforce/job pool

economic level, housing, accessibility to healthy foods, accessibility to medications and quality

healthcare

Many circumstances contribute to community health

T2DM in the United States

• 30.1 million – 9.4% people have T2DM

• 7.2 million are undiagnosed

• 7th leading cause of death

• 300,000 fatalities a year

2014 Stats

• T2DM cost U.S. $245 Billion in 2012

• $176 Billion in direct medical costs (medical goods and services)

• $69 Billion in indirect costs from lost work days, restricted activity, disability, and early death

What About Alabama?Alabama dominates the list of top 10 counties in

the nation with the highest rates of diabetes:

• Lowndes County, Alabama - 21 percent

• Todd County, South Dakota - 19.4 percent

• Perry County, Alabama - 19.3 percent

• Bullock County, Alabama - 18.1 percent

• Sumter County, Alabama - 18.1 percent

• Greene County, Alabama - 17.8 percent

• Marengo County, Alabama - 17.4 percent

• Allendale County, South Carolina - 17.4 percent

• Oglala Lakota County, South Dakota - 17. 3 percent

• Buffalo County, South Dakota - 17 percent

Other Alabama counties in the top 50 were:

11. Dallas County - 16.9 percent

12. Barbour County - 16.9 percent

14. Wilcox County - 16.7 percent

16. Macon County - 16.5 percent

19. Escambia County - 16. 2 percent

20. Colbert County - 16.1 percent

25. Marion County - 15.8 percent

27. Henry County - 15.7 percent

36. Butler County - 15.4 percent

37. Washington County - 15.4 percent

46. Monroe County - 15.2 percent

Build a Healthy Community – One Person at a Time

• Meet Healthy People 2020 Target

• Annual Dilated Eye Exam

• Foot Exam by Health Professional

• A1C twice a year

• Daily Self-monitoring

• Attendance in DSMES (Diabetes Self-Management Education & Support)training

Healthy Person

Health Literacy

Macronutrients(Fancy Term for Fats, Protein, Carbohydrates)

Healthy Fats (9 calories/Gm)• Olive oil

• Coconut oil

• Nuts

• Avocados

• Coconut

• Nut butters

Protein (lean vs fat)

4 calories/Gm• Lean beef, chicken, turkey, pork

• Beans, lentils

• Soy

• Eggs

Carbohydrates4 Calories/Gm

Non Starchy• Green vegetables

• Greens

• Celery

• Cucumber

• Cabbage – all colors

• Tomatoes

• Carrots

• Cauliflower

Starchy• Potatoes

• Corn

• Pasta

• Peas

• Grains (rice, quinoa, couscous)

• Butternut squash

• Acorn squash

Carbohydrates

Complex Carbs• Takes longer for the body to digest

• Contains more fiber

• Does not spike the blood sugar

• Examples – whole wheat/whole grain bread, whole grains, oatmeal

• Resistant starch – acts like fiber in the body.

• Fiber – slows down digestion and decreases sugar absorption.

Simple Carbs• Body digest quickly

• Can cause blood sugar to spike

• Timing is important

• Examples – cakes, pies, candy, fruit juices, grits

Macronutrients (cont’d)

Dairy and non Dairy• Milk

• Cheese

• Yogurt

• Cottage cheese

Fruits• Apples

• Pears

• Oranges

• Berries (all varieties)

Processed FoodsAvoid as much as possible

Lunch meat

Frozen Dinners

Canned Products

Granola Bars

Fast foods

Meal Planning

•Protein, Complex Carbohydrate , Healthy Fat

•Protein – 3-4 ounces.

•Carbohydrates – one carb serving is 15 Gms. Usually allowed 3 carbs per meal

•Healthy Fat – small amounts

Medications – for Diabetes