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Diabetes
DR. NISHANT SINGH BENIWAL
M.B.B.S, M.D.(INTERNAL MEDICINE), DIP. DIABETES
CONSULTANT, YATHARTHA GROUP OF HOSPITALS, NOIDA
Diabetes
Prevalence of Diabetes:
Top 10 Countries
2000
Country
2030
Persons
(millions)
Country
Persons
(millions)
1. India
31.7
India
79.4
2. China
20.8
China
42.3
3. USA
17.7
USA
30.3
4. Indonesia
8.4
Indonesia
21.3
5. Japan
6.8
Pakistan
13.9
6. Pakistan
5.2
Brazil
11.3
7. Russia
4.6
Bangladesh
11.1
8. Brazil
4.6
Japan
8.9
9. Italy
4.3
Philippines
7.8
10. Bangladesh
3.2
Egypt
6.7
20
15
17.0%
10
9.7%
5.6%
0
Heavy
Moderate
Physical activity grades
Light
Pathophysiology of Diabetes
When you eat, your body
breaks food down into
glucose. Glucose is a
type of sugar that is
your bodys
main source
of energy.
Pathophysiology of Diabetes
As blood glucose
rises, the body
sends a signal to
the pancreas, which
releases insulin.
Pathophysiology of Diabetes
Acting as a key, insulin
binds to a place on the
cell wall (an insulin
receptor), unlocking
the cell so glucose can
pass into it. There,
most of the glucose is
used for energy right
away.
Type 2 diabetes
Your pancreas may not
produce enough insulin
(insulin deficiency).
13
Natural
History
of Diabetes
Natural
History
of Type 2 Diabetes
Obesity
IGT*
Diabetes
Uncontrolled
Hyperglycemia
Post-Meal
Glucose
Plasma
Glucose
Fasting Glucose
120 (mg/dL)
Relative -Cell
Function
Insulin Resistance
100 (%)
Insulin Secretion
-20
-10
10
20
30
Years of Diabetes
*IGT = impaired glucose
tolerance.
Diagnosing diabetes
Fasting plasma glucose test
(FPG) results
diabetes
28
14
Are overweight.
Are 45 or older.
Are physically inactive.
Have a parent or sibling with type 2
diabetes.
Are African American, Native American,
Hispanic American, or Pacific Islander.
Have abnormal cholesterol levels.
Have had gestational diabetes, or given
birth to a baby greater than 9 lbs.
Have high blood pressure.
Pre-meal or fasting:
2 hours post-meal:
80-120
80-140
On
insulin: 4
times per day.
Not
on insulin: 2
times per day.
Tues.
Wed.
Dinner
X
X
X
Bedtime
X
X
Maximum
CHO
Breakfast
Lunch
Dinner
CHO
CHO
CHO
Breakfast
Lunch
Dinner
Hypoglycemic Symptoms
96
45
Introduction to self-management
Key pieces of diabetes self-management:
Monitoring
blood glucose
Taking
medication
34
Following a
meal plan
Getting regular
exercise
Cant exercise?
Pools
Walking tape
Stationary bikes
Exercise videos
Yoga
Local Recreation Centers or school facilities
TV Programs on fitness
Exercise is boring.
Diabetes-CVD Facts
Nearly
ABCs
B Blood pressure
C Cholesterol
2-4 times/year
Blood pressure
At least 2 times/year
Cholesterol
1 time/year
Foot exam
At least 1 time/year
Dental exam
2 times/year
Urine microalbumin/
creatinine ratio
1 time/year
Flu shot
1 time/year
Pneumococcal vaccine
Thank You