Diabetes: The Modern Epidemic

Roy Buchinsky, MD

Director of Wellness

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Introduction

• Disorder of glucose utilization.• Insufficient or no insulin- Type 1- 10%• Increased resistance to insulin- Type 2-90%• Elevated blood sugar levels.• Complications

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Incidence

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Type 1 Diabetes

• Immune system destroys pancreatic beta cells. • Usually affects children and young adults.• Insulin delivered via injection or pump.• Risk factors includes genetic, autoimmune, or

environmental.

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Type 2 Diabetes

• Mainly occurs in adults.• 90-95% of all diabetes.• Characterized by insulin resistance.• Associated with obesity, family history, gestational

diabetes, and race/ethnicity.

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Diagnosis: Clinical

• Asymptomatic • Poly-dipsia, phagia, uria, • Weight loss• Visual disturbance• Diabetic ketoacidosis

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Diagnosis: Labs

1. Fasting bg > 126.

2. Sxs plus random bg > 200.

3. Abnormal GTT - bg > 200 2 hrs after load.

4. HbA1c > 6.5.

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Impaired Glucose Tolerance

• FBG 100-125• A1c 5.9-6.4 • 79 million adults in USA • Increased risk for development of DM.

– Annual re-screening.– Intensive lifestyle intervention.

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Metabolic SyndromeThe Deadly Quartet

• Obesity • Hypertension• Increased blood sugar• Elevated cholesterol

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Treatment

• Type 1- insulin delivered by pump or injection.– Daily or with meals

• Type 2- improved eating habits, increased exercise, weight loss, oral agents.

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Complications

• Retinopathy• Cardiovascular disease• Peripheral neuropathy• Nephropathy• Peripheral vascular disease

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Prevention

• Increased exercise and a healthy diet. • Treatment with metformin• DPP- reduced risk of Type 2 DM by 58% over 3 years

– Greater benefit in patients over 60.

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Diet Recommendations

• Low glycemic index foods.• 0 calorie or very low calorie drinks.• Avoid sugary drinks like fruit punch and soda. • Carbohydrate restriction

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Summary

• ↑incidence of diabetes• 2 types of diabetes• Prevention techniques• Treatment options• Complications

Thank You

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