Diabetes 101. Francisco J. Prieto, M.D. American Diabetes Association National Advocacy Committee Latino Diabetes Action Council

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1 Diabetes 101 Francisco J. Prieto, M.D. American Diabetes Association National Advocacy Committee Latino Diabetes Action Council

2 DIABETES

3 DIABETES

4 Age-Adjusted Prevalence of Diagnosed Diabetes Among U.S. Adults 1994 Missing data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% 9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

5 Age-Adjusted Prevalence of Diagnosed Diabetes Among U.S. Adults 1995 Missing data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% 9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

6 Age-Adjusted Prevalence of Diagnosed Diabetes Among U.S. Adults 1996 Missing data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% 9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

7 Age-Adjusted Prevalence of Diagnosed Diabetes Among U.S. Adults 1997 Missing data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% 9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

8 Age-Adjusted Prevalence of Diagnosed Diabetes Among U.S. Adults 1998 Missing data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% 9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

9 Age-Adjusted Prevalence of Diagnosed Diabetes Among U.S. Adults 1999 Missing data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% 9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

10 Age-Adjusted Prevalence of Diagnosed Diabetes Among U.S. Adults 2000 Missing data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% 9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

11 Age-Adjusted Prevalence of Diagnosed Diabetes Among U.S. Adults 2001 Missing data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% 9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

12 Age-Adjusted Prevalence of Diagnosed Diabetes Among U.S. Adults 2002 Missing data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% 9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

13 Age-Adjusted Prevalence of Diagnosed Diabetes Among U.S. Adults 2003 Missing data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% 9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

14 Age-Adjusted Prevalence of Diagnosed Diabetes Among U.S. Adults 2004 Missing data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% 9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

15 Age-Adjusted Prevalence of Diagnosed Diabetes Among U.S. Adults 2005 Missing data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% 9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

16 Age-Adjusted Prevalence of Diagnosed Diabetes Among U.S. Adults 2006 Missing data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% 9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

17 Age-Adjusted Prevalence of Diagnosed Diabetes Among U.S. Adults 2007 Missing data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% 9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

18 Age-Adjusted Prevalence of Diagnosed Diabetes Among U.S. Adults 2008 Missing data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% 9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

19 Age-Adjusted Prevalence of Diagnosed Diabetes Among U.S. Adults 2009 Missing data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% 9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

20 Age-Adjusted Prevalence of Diagnosed Diabetes Among U.S. Adults 2010 Missing data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% 9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

21 Number and Percentage of U.S. Population with Diagnosed Diabetes, CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

22 Burden of Diabetes in the United States Currently, diabetes affects 25.8 million people, 8.3% of the U.S. population (Centers for Disease Control and Prevention 2011) By 2050 as many as 1 in every 3 adults will have diabetes Total direct and indirect cost of diagnosed diabetes is $245 billion a year 1 in 5 health care dollars is spent caring for someone with diagnosed diabetes 1 in 10 health care dollars is attributed directly to diabetes

23 Components of Medical Expenditures Hospital inpatient Care 9% 8% Prescriptions to treat complications 12% 43.00% Antidiabetic agents and diabetes supplies Physician visits 18% Nursing/residental care

24 Breakdown of the $69 Billion in Indirect Costs Absenteeism $18.5 $5.0 $20.8 Reduced productivity (employed) Reduced productivity (unemployed) Disability Early Mortality $21.6 $2.7

25 DIABETES

26 What is Diabetes? After eating, most food is turned into blood glucose, the body s main source of energy.

27 Normal Blood Glucose Control In people without diabetes, glucose stays in a healthy range because Insulin is released at the right times and in the right amounts Insulin helps glucose enter cells

28 High Blood Glucose (Hyperglycemia) Too little insulin is made In diabetes, blood glucose builds up for several possible reasons Liver releases too much glucose Cells can t use insulin well

29 Before and After Insulin Treatment Discovery of insulin in 1921 changed type 1 from a death sentence to a chronic disease 7-year-old child before and 3 months after insulin therapy

30 DIABETES

31 Main Types of Diabetes Type 1 diabetes Pancreas makes too little or no insulin Type 2 diabetes Cells do not use insulin well (insulin resistance) Ability for pancreas to make insulin decreases over time Gestational Diabetes

32 Type 1 Diabetes Symptoms (usually sudden) Weight loss Loss of energy Increased thirst Frequent urination Diabetic ketoacidosis (emergency condition of nausea, vomiting, dehydration, could lead to coma) 1 in 10 people with diabetes have type 1 Many people are under age 20 when diagnosed Body can no longer make insulin Insulin is always needed for treatment

33 Managing Type 1 Diabetes Blood glucose monitoring Insulin Education Healthy food choices Physical activity

34 Type 2 Diabetes 9 in 10 people with diabetes have type 2 diabetes Many people are over age 40 when diagnosed, but type 2 is becoming more common younger adults, children and teens Type 2 is more likely in people who: Are overweight Are non-caucasian Have a family history of type 2 Many people with type 2 may have no Symptoms!! Increased thirst & urination Blurry vision Feeling tired Slow healing of cuts or wounds More frequent infections Weight loss Nausea, vomiting and abdominal pain

35 Treatment for Type 2 Diabetes May Change Over a Lifetime Always Includes: Education Physical Activity Healthy eating May Include: Blood glucose monitoring Oral Medications Insulin

36 Gestational Diabetes Found in pregnant women without pre-existing diabetes May affect the babies development Usually resolves after the pregnancy is over, but without intervention, women have a 40 to 60 % chance of developing type 2 diabetes within 5 to 10 years DIABETES

37 Pre-Diabetes 1 in 3 American adults (79 million) have pre-diabetes Occurs before type 2 diabetes Blood glucose levels are higher than normal but not yet diabetes increases the risk of developing diabetes Most people with prediabetes don t know they have it

38 DIABETES

39 DIABETES

40 Complications Normal Eye Diabetes Eye Disease 40

41 Complications Kidney Disease Foot deformity associated with diabetic neuropathy 41

42 Complications Heart Attack Clogged Artery 42

43 Burden of Diabetes in the United States The leading cause of: new blindness among adults kidney failure non-traumatic lower-limb amputations Increases the risk of heart attack and stroke by 2-4 fold 7th leading cause of death (more deaths than breast cancer and AIDS combined) Mortality rates 2-4 times greater than non-diabetic people of the same age Source: Centers for Disease Control and Prevention

44 DIABETES

45 Can We Prevent Type 2 Diabetes? YES Be Active 30 minutes most days a week Eat Healthy Lose Weight if needed Lose 5 to 7 percent of your body weight if you are overweight Get Tested if You Are at Risk! DIABETES

46 DIABETES

47 Physical Activity Managing Diabetes Health Coping Taking Medications Healthy Eating Problem Solving Monitoring DIABETES

48 Preventive Efforts Are Key Most of the diabetes costs are due to end-stage complications Investment of resources into early diagnosis, patient education, prevention and treatments pays off in: Longer lives Increased productivity Reduced costs over the long term

49 DIABETES

50 The American Diabetes Association: What We Do - Research In 2010, the Association made $34.1 million available to support diabetes research This funding supported 338 grants at more than 125 leading research institutions Over the years, the Association has invested more than $530 million in diabetes research

51 The American Diabetes Association: What We Do - Education DIABETES receives 25,000 calls a month Health fairs, programs, camps and other events target millions of people around the country Award-winning books and Diabetes Forecast magazine for consumers Journals, books, and clinical guidelines for professionals Scientific Sessions: Largest diabetes meeting in the world

52 The American Diabetes Association: What We Do - Advocacy Seek increased funding for diabetes prevention, treatment and research Promote public policies to prevent diabetes Advocate to improve the availability of accessible, adequate and affordable health care Fight discrimination people with diabetes face at school, work, and elsewhere in their lives.

53 State Legislative Focus Areas Adequate and affordable health insurance for people with diabetes Safe at School legislation-csg Suggested State Legislation Enacted in 21 states including Arizona and Missouri this year Prevention Efforts Reduce Prediabetes, Type 2 diabetes and complications associated with diabetes School based physical education requirements and school food policies Diabetes Action Plan legislation-csg Suggested State Legislation Funding for diabetes research, surveillance and prevention Reducing consumption of sugar-sweetened beverages, access to recreational space, and other prevention legislation

54 More Information Call DIABETES Social media information: Web: California Diabetes Program

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