Diabetes

Course Instructor: Munia Zain Islam

Department of Public Health
School of Health and Life Sciences
North South University
munia.islam01@northsouth.edu
A Global Perspective
• 7th leading cause of deaths globally, with rates similar in women and men
• As of 2019:
• An estimated 463 million people had type 2 diabetes worldwide (~90% of the cases of diabetes)
• More than 1.1 million children and adolescents are living with type 1 diabetes
• More than 20 million live births (1 in 6 live births) are affected by diabetes during pregnancy
• Diabetes at least doubles a person's risk of early death
• In 2019, diabetes resulted in approximately 4.2 million deaths
• 80% of diabetes deaths occur in low- and middle-income countries. And 80% of
people with diabetes live in low- and middle-income countries.
• In Bangladesh, the prevalence of diabetes in adults is 8.1% with a total number of cases at 8.3
million in adults
What is Diabetes?
Diabetes mellitus (DM)
• A chronic condition that is characterized by raised blood glucose levels
(hyperglycemia) with disturbances of carbohydrate, fat and protein metabolism
from defects in insulin production, insulin action, or both
• due to either the pancreas not producing enough insulin or the cells of the body not
responding properly to the insulin produced
• The effects include long–term damage, dysfunction and failure of various organs
Risk Factors
• Family history of Diabetes
• Genetically (type 1 diabetes, pre-diabetes, gestational)
• Overweight or obesity
• Unhealthy diet
• Physical inactivity
• Gestational Diabetes
Symptoms of Diabetes
People with diabetes often have typical complaints/symptoms
• Thirst and frequent drinking (polydipsia)
• More frequent urination, particularly at night (polyuria)
• Unexplained weight loss
• Constant hunger
• Fatigue
• Blurred or change in vision
• Frequent infections (e.g. skin, genital)
Insulin and Diabetes
• Normal Insulin Function
• Blood sugar and glucose are sources of energy for the body
• Food and drinks are absorbed into the blood
• Insulin is produced by the pancreas when blood sugar is high to keep blood sugar
levels within the normal range for good health
• Insulin Function in Diabetics
• Insufficient insulin to meet the body’s needs, which can be either a complete lack
(type 1) or relative lack (type 2) of insulin causing raised blood glucose levels
• Untreated diabetes results in short-term symptoms and serious long-term
complications
• Treatment aims to keep blood glucose levels as close to the normal range as
safely possible
Types of Diabetes
• Pre-diabetes
• Starts with unhealthy eating habits & inadequate exercise
• Above average blood glucose levels, not high enough to be classified under type 1
or type 2 diabetes
• Type 1 Diabetes
• Usually diagnosed in childhood and affected by hereditary
• Caused by a pancreas's failure to produce enough insulin due to loss of beta cells,
which is caused by an autoimmune response
• Frequently called the ‘insulin-dependent’ group since patients with type 1
diabetes need insulin daily to survive the body makes little or no insulin
Types of Diabetes
• Type 2 Diabetes (most common)
• Usually occurs in adulthood but diagnosis is increasing in the younger
generations
• Begins with insulin resistance, a condition in which cells fail to respond to insulin
properly
• Rates rising due to increased obesity and failure to exercise and eat healthy
• Gestational Diabetes
• Blood sugar levels are high during pregnancy in women and usually resolves after
having the baby
• Oftentimes these women give birth to children over 4 kg (9 lbs.)
Type 1 vs Type 2 Diabetes
Type 1 Type 2
Onset Sudden Gradual
Age of onset (usually) Childhood Adult
BMI Normal Often overweight/obese
Insulin Low or absent, therefore Normal, high or low,
required therefore not necessarily
required
Prevalence ~10% ~90%
Untreated Diabetes
• Acute complications:
• Diabetic ketoacidosis
• body starts breaking down fat at a rate that is much too fast causing blood to become acidic
• Hyperosmolar hyperglycemic state
• person’s blood glucose (sugar) levels are too high for a long period, leading to severe dehydration
(extreme thirst) and confusion
• Death
• Serious long-term complications:
• Cardiovascular disease
• Stroke
• Chronic kidney disease
• Foot ulcers
• Damage to the nerves
• Damage to the eyes and cognitive impairment
Management of Diabetes
• Maintain a healthy diet such as through heathy meal planning
• Weight-loss surgery can help those with severe obesity
• Adhere to treatment options
• Type 1 diabetes must be managed with insulin injections
• Type 2 diabetes may be treated with medications such as insulin sensitizers with or
without insulin
• Regular Exercise
• To maintain a normal weight
• Test blood sugar regularly
• Avoid usage of tobacco and control blood pressure and maintain proper food and
eye care
Nutritional Management of Diabetes
• Type I Diabetes
• Consistency and timing of meals
• Timing of insulin
• Monitor blood glucose regularly
• Type II Diabetes
• Weight loss
• Smaller meals and snacks
• Physical activity
• Monitor blood glucose and medications
Prevention of Diabetes
• At present, type 1 diabetes cannot be prevented
• Eating healthier
• diet rich in whole grains and fiber, and choosing good fats, such as the polyunsaturated fats found
in nuts, vegetable oils, and fish
• limiting sugary beverages and eating less red meat and other sources of saturated fat
• Being active (more than 90 minutes per day) and taking care of your body
• Check feet to make sure there is no nerve damage or interruption of blood flow
• Take care of teeth
• Control blood pressure and high
• No smoking
• Regular check-ups with the doctor including blood sugar checked along with weight, blood
pressure, and feelings
Key Summary Points
• Diabetes is due to an absence of producing or responding to insulin and
can have an onset across age groups.
• Although type 1 diabetes cannot be prevented, pre-diabetes, type 2
diabetes and gestational diabetes can be prevented through lifestyle and
behavioral changes.
• Treatment and management of diabetes can help to prevent acute and
serious long-term complications.