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Type 2 Diabetes – An Overview

• What is it?

• Is it common?

• What are the risk factors?

• How does it start?

• What is the best diet?

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What Is Type 2 Diabetes?

• High fasting blood sugar levels

• Excessively high non-fasting BS

levels

People with Type-2 diabetes usually have some degree of both:

• resistance to the action of insulin • decrease in the capacity to produce insulin

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True or False?

Diabetes has specific symptoms that are easy for most people to diagnose.

Answer: FalseMost people are not aware that they have diabetes

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What Are the Symptoms?• Increased thirst• Increased urination• Blurred vision• Lack of energy• More frequent infections, especially gum

disease and bladder infections

Symptoms come on gradually and are often viewed as a normal part of the aging process

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True or False?

Type 2 diabetes is the most common type of diabetes in the United States.

Answer: TrueType 2 accounts for about 90% of the 21 million Americans with diabetes

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Diabetes Doubles

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Type 2 Diabetes

What is the annual cost of treatment for type 2 diabetes?

Over $100 billion dollars

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What Are the Risk Factors?

• Increasing age• Family history of type 2 diabetes• Prior history of gestational diabetes,

impaired glucose tolerance, and/or insulin resistance

Being overweight or obesePhysical inactivityConsumption of a high fat,

high sugar, refined carbohydrate diet

Risk factors you can control

The Progression of Type 2 Diabetes

Some people who have insulin resistance or impaired glucose tolerance die of cardiovascular disease before reaching type 2 diabetes.

1. Insulin resistance

2. Impaired glucose tolerance

3. Type 2 diabetes

Cancer, heart

disease

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Insulin Resistance

• Resistance to the blood sugar lowering action of insulin

• Present for many years before fasting blood sugar levels rise above normal

Not everyone who has insulin resistance will develop diabetes but everyone with type 2 diabetes has insulin resistance

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Insulin Resistance

• A risk factor for the development of coronary artery disease and type 2 diabetes

• Fasting insulin levels are often elevated

Currently there is no cost effective, easy way to detect insulin resistance

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Insulin Resistance• Family history of diabetes• Overweight• Lack of Physical Activity• Cardiovascular disease in family• High triglycerides and low HDL (good

cholesterol)• High waist to hip ratio

These are all suggestive of the presence of insulin resistance

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Heart Disease & Type 2 Diabetes

• Even if fasting blood sugar is in normal range, risk of heart disease is elevated if insulin resistance syndrome is present

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What Is the Best Way to Reduce Insulin Resistance

• Exercise regularly• Lose excess body fat • Eat a high-fiber,

whole food diet that is low in fat, sugar and refined carbohydrates

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Impaired Glucose Tolerance

• A pre-diabetic state

• A large percentage will progress to type 2 diabetes with time

• Occurs in about 20 million Americans

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Impaired Glucose Tolerance

• Often present when fasting blood sugar is between 110-125 mg/dl

• Usually not associated with any symptoms

• Usually associated with an increased waist to hip ratio

• Often associated with a family history of type 2 diabetes

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Impaired Glucose Tolerance

• Associated with an increased risk of cardiovascular disease

• Increased blood clots• Insulin resistance is present

• Dyslipidemia is frequently present–Low HDL –High triglycerides–Small dense LDL particles

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What Is the Best Way to Reduce or Reverse Impaired

Glucose Tolerance?• Exercise regularly• Lose excess body fat • Eat a high-fiber, whole food diet that is low

in fat, sugar and refined carbohydrates

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Complications of Diabetes• Damage to small blood vessels and

peripheral nerves• Risk of dying of a heart attack is 2-3 times

greater• Number one cause of kidney failure in US

• Nerve damage• Damage to retina• Number one cause of amputations in US

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Most Important Strategies for Type 2 Diabetes

• Focus on calories so you lose weight• Eat a heart-healthy diet• Keep your blood pressure under control• Exercise regularly:

o Aids weight loss without hungero Reduces insulin resistanceo Lowers blood sugar levelso Improves blood lipidso Reduces blood pressureo Reduces risk of heart attack & stroke

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What Is the Optimal Diet for Type 2 Diabetes?

• 5 or more servings of whole grains

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What Is the Optimal Diet for Type 2 Diabetes?

• 5 or more servings of vegetables

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What Is the Optimal Diet for Type 2 Diabetes?

• 3-5 servings of fresh or whole fruit

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What Is the Optimal Diet for Type 2 Diabetes?

• 2-3 servings of nonfat dairy products

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What Is the Optimal Diet for Type 2 Diabetes?

• 1-2 servings of heart-healthy, protein-rich food such as beans, fish, nuts, tofu, lean poultry, etc.

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What Is the Optimal Diet for Type 2 Diabetes?

• Choose whole, carbohydrate-rich foods that are satiating and low in calorie density

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What Is the Optimal Diet for Type 2 Diabetes?

• Limit foods that are high in refined carbohydrates

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What Is the Optimal Diet for Type 2 Diabetes?

• Eat a low salt diet, especially if blood pressure is high

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Important Dietary Strategies for Type 2 Diabetes

• Choose whole, carbohydrate-rich foods that are satiating and high in fiber

• Limit refined carbohydrate foods such as cookies, cake, baked goods with white flour, etc.

• Limit foods that are high in saturated fat and hydrogenated fat

• Eat a low salt diet, especially if blood pressure is high

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“Make no little plans; they have no magic to stir men's blood... Make big plans, aim high in hope and work.”

-- Daniel H. Burnham