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HKIN 115Day 12
October 5, 2010
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Overview What do you know about diabetes?
Type 1 vs. Type 2 Diabetes
Diabetes and disease Managing and preventing diabetes
Risk factors for type 2 diabetes
Managing and preventing diabetes The role of physical activity
Your role as future HKIN grads
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What do you know
about diabetes?
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On a piece of paper, jot down a
responseto each ofthe following: What is the difference between type 1 and
type 2 diabetes?
What are the risk factors for type 2 diabetes? Type 2 diabetes was previously called adult-
onset diabetes; why the name change?
What is the role of physical activity in each?
What is your role, as a future HKIN grad in
preventing type 2 diabetes?
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Type 1 vs.Type 2 Diabetes Metabolic disorder characterized by high blood
glucose levels
Type 1 = insulin dependent (10% of all cases) Due to abnormally low levels of insulin Cause (?) immune systems destruction of insulin
producing cells in the pancreas
Type 2 = non-insulin dependent (90% of all cases) Reduced ability of insulin to transport glucose from the
blood to the cells Diminished tissue response to insulin (insulin resistance)
resulting in high blood glucose levels (hyperglycemia)
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Whatabout gestational diabetes? Develops during pregnancy
Although disappears after pregnancy,
women have increased risk within 5-10yrs of giving birth
Particularly if pregnancy weight is not lost
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Whatabout Pre-diabetes (type 2) May occur 10-20 years before diagnosis
Blood glucose is higher than normal
b/c of the relevant tissues inability to respondto the insulin (i.e., insulin resistance) which
causes the pancreas to produce more insulin
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Type 2 Diabetesand Disease WHO in 1994 reported that 100 million people worldwide were
diagnosed with diabetes AND that by 2010, that number wouldrise to 230 million Better diagnosis
More cases In Canada the number of people with diabetes doubled from
1996/97 to 2005 (most recent data available) to 4.9% of thepopulation > 35 yrs of age, males are more likely than females
Diagnoses increases with age 10.1% of 55-64 yrs
14.6 % > 65 yr
Age and sex-adjusted prevalence rates for Aboriginal peoples is3x higher
Diabetes is also diagnosed earlier 48.7 vs. 61.4 years in Aboriginalpeoples
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Type 2 Diabetesand Disease As many as 40% of Canadians may have
pre-diabetes
FYI pre-diabetes cannot be felt; so oftenunder diagnosed!
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Type 2 Diabetesand Disease The 7th leading cause of death in Canada
Deaths due to type 2 diabetes are thought to be underestimated underlying cause ofheart disease, stroke, kidney disease, blindness,and lower limb amputations
80% of individuals with type 2 diabetes die from heart disease individuals with diabetes have 6x the risk ofheart disease orstroke Why? high cholesterol, high blood pressure, inactive
Diabetes was the number one cause of endstage renal disease
In 1988, 22% of people with type 2 diabetes were on dialysis.In 1997, 29%
Lower limb amputations are 11x greater in individuals withtype 2 diabetes
Type 2 diabetes is the leading cause of blindness
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Risk factors fortype 2 diabetes: Age ( 45 yrs)
Overweight (BMI 25)
Genetics (family history)
Eth
nicity/Biologic origin (African, Indian, Asian,Aboriginal)
Gestational diabetes
Hypertension
Low HDLs; High TGs
Impaired fasting glucose, impaired glucose tolerance
Polycystic ovary syndrome
Vascular disease
Inactive lifestyle (< 3x per week)
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Managing (and preventing) Diabetes Dietary intake (Type 1 and 2)
Reduce fat intake to < 30%; saturated fat to < 10%
Increase fibre to > 15 g/1000 kcal/day
Physical activity (Type 1 and 2) Moderate intensity > 30 min/day
Insulin (Type 1)
Weight loss (Type 2) as little as 5 to 7% weight loss when combined with
lifestyle changes (PA, dietary intake) reduced incidence by
58% in high-risk individuals
90% of type 2 diabetes may be prevented by eating welland engaging in physical activity
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How Physical Activity benefits
Diabetes Physical activity helps control blood glucose
by improving glucose transportation into cells
reducing insulin requirement
Improve insulin resistance and glucose intolerance Physical activity helps control body weight generallyhigher blood glucose levels, high blood lipids and highblood pressure are found in obese, (inactive) individuals
Provides protection from heart disease (i.e., strengthensh
eart, etc.) Positive psychological and social benefits improves
self-confidence, self control, self-esteem, vigour andwellness in general
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Physical Activity for Individuals
withType 1 Diabetes First manage resting blood glucose
levels
Physical activity lowers blood glucose levels
Generally, the same activities as for
someone without
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Physical Activity for Individuals
withType 1 Diabetes However:
Daily for consistent blood glucose regulation
With a partner
Limit to 20-30 minutes Consume a meal 1-3 hours prior and a snack after
? Reduce insulin prior to activity (if so advised byphysician)
Avoid/limit using the muscle in which insulin wasinjected
Avoid late-evening physical activity
Monitor blood glucose response before, during, andafter physical activities
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Physical Activity for Individuals
withType 2 Diabetes Length and time the most important
factors
Main objective is to reduce body fat Work up to 60 minutes/session and 3-5
days per week
Intensity because of the time and
frequency, lower end (40-60% of aerobiccapacity)
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Dietary Intakeand Diabetes Type and amount of nutrients in the diet
influence blood glucose levels
high in total fat, animal fat, protein, or simple sugar
low in carbohydrate
A dietary intake that is consistent with Eating
Well with Canadas Food Guide is
recommended Emphasize low fat, high in fibre-rich foods
(vegetables, whole grains, legumes)