TYPE 1, TYPE 2, AND GESTATIONAL
DIABETESAMONG LATINOS IN
NEW YORK
Kevin Cabrera & Margie Perez
Type 1 Diabetes
What is Type 1 diabetes?
• Disorder of the immune system that makes it hard to produce insulin.
• The body then can not convert sugar from food into nutrients. It leads to excess sugar being built up in the blood stream.
• It can be genetic.
• People with type 1 diabetes must inject themselves with insulin to stay alive.
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Complications of Type 1 diabetes•Heart disease•Nerve damage•Amputations•Blindness•Kidney failure
Type 2 Diabetes
What is Type 2 diabetes?
• Most common form of diabetes.• The body either does not produce enough insulin or the
cells ignore the insulin. That is necessary for the body to use glucose for energy.
• Obesity can be tied to type 2 diabetes
Complications of Type 2 diabetes•Foot complications•Stroke•High Blood Pressure•Kidney Disease•Extreme fatigue
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Diabetes among race
• Among Hispanics:• Cubans : 7.6%• Mexican Americans : 13.3%• Puerto Ricans : 13.8%
(According to the American Diabetes Association)
• Race and ethnicity ages 20 years and older with diabetes:
• Non-Hispanic Whites : 7.1%• Asian Americans : 8.4%• Hispanics : 11.8%• Non-Hispanic blacks : 12.6%
(According to the American Diabetes Association)
Obesity and diabetes
• More than 80% of people with type 2 diabetes are overweight.• In 2011, Hispanic adults were 30% less likely to engage in active
physical activity as non-Hispanic whites.• From 2007-2010, Mexican American Women were 40% more likely to
be overweight, as compared to non-Hispanic whites.
Diabetes in NYC
• About 6,000 New Yorkers die every year because of obesity related illnesses.
• African Americans and Latinos are affected by diabetes. In particular Mexican Americans and Puerto Ricans.
• They get diabetes at almost twice the rate of whites. Especially in the Bronx and Brooklyn.
• In places like the upper east side, it is less likely for new yorkers to have diabetes.
• New York’s diabetes rate is ⅓ higher than the rest of the country.
Gestational Diabetes
What is gestational?
• A degree of glucose intolerance with an onset or first recognized during preganancy.
• Increases the risk of developing type 2 diabetes later in life.• Related to both maternal and fetal health• Between 2 and 10 percent of expectant mothers develop this• Develops in nearly 5% of live birth in NYC
www.babycenter.com; (Brissette, Mills), www.nyc.gov
Adult Diabetes Prevalence in New York State
Why ?
• Latinas have a greater tendency to develop diabetes, all types. • 1 in 4 have some form of this disease • 52.5% risk of developing diabetes in their life time • Many do not know they have diabetes when they get pregnant• Overall it has risen nearly 50% in about ten years • “Some arrive into their pregnancies obese and leave them more
obese”( Hackley, certified nursed-midwife)• In 2001 there 4,200 cases in New York • Ranges in age • Its a vicious cycle
Babycenter.com, Klienfiled,2006 (nytimes.com)
How does it effect the baby?
• Too much glucose (hyperglycemia)• The baby’s pancreas has to develop insulin to process it• Excess sugar and insulin cause baby to put on extra weight while in utero
• Mainly in the upper body• Leads to macrosomia
• A newborn with an excess bodyweight• May be too large to enter the birth canal• Baby’s head may enter the birth canal but the baby’s shoulders might get stuck
• Special maneuver to deliver the baby• May result in bone fracture or nerve damage
• Both heal with no permanent damage (99%)• Rare case-baby suffers brain damage
• The maneuver used to deliver can lead to injuries • Vaginal Area• A large episiotomy (incision) required Babycenter.com
Other Effects to pregnancy
• Increases the risk of still birth• Last two months
• More likely to develop preeclampsia• If obesity or blood sugar not monitored• High blood pressure and high level of protein in urine • More conditions
• Swelling of feet, legs and hands• Lead to more complications
Babycenter.com
Baby After Birth
• Continues to be overweight in childhood and adulthood• After birth, baby may have hypoglycemia
• Low blood sugar
• Breathing problems• Risk of jaundice
• Yellow discoloration of skin, mucus membrane, and whites of eyes
• Risk of baby with polycythemia • Increases in number of red cells blood
• Risk of hypocalcaemia• Low calcium in blood
• Baby’s heart function Babycenter.com
Risk Factors• History of gestational diabetes• Being overweight or obese• Older than 25• Family history of diabetes• Previously delivered baby weighing more than 9 pounds• Glucose in urine • Being African-American, Hispanic, Native American, or Asian
Terrie,2013
Preventative Methods
Preventative methods
• Informative Packets• Programs
• Nurse-Family Partnership• Newborn Home Visiting Program
• Lifestyle modification• Monitor Blood Sugar • Support• Eat-low fat, well balanced meals• Maintain a healthy weight • Lose weight • Limit alcohol
Preventative Methods (cont.)
• Breast feed your child• Have a regular doctor• Treatment if required
• Daily blood glucose monitoring• Insulin therapy• Medications
• Stick with the plan• Physical Activities
• 30 minutes of brisk walking or longer• 2 hour and 30 minutes of moderate intensity aerobic activity• 1 hour and 15 minutes of vigorous intensity aerobic activity• Combination of exercises• Muscles-strengthening
Sources
• Barowitz, J., Loeser, S., & Mullin, S. (2006, February 21). Mayor Bloomberg and Commissioner Frieden Launches Educational Campaign for Moms Who Develop Diabetes During Pregnancy : Press Releases : NYC DOHMH. Mayor Bloomberg and Commissioner Frieden Launches Educational Campaign for Moms Who Develop Diabetes During Pregnancy : Press
Releases : NYC DOHMH. Retrieved April 8, 2014, from http://www.nyc.gov/html/doh/html/pr2006/mr053-06.shtml• Adult Diabetes Prevalence in New York State. (n.d.). New York State Department of Health. Retrieved April 8, 2014, from
https://www.health.ny.gov/diseases/conditions/diabetes/docs/adult_diabetes_prevalence.pdf• Diabetes. (2010, May 18). womenshealth.gov. Retrieved April 8, 2014, from http://
womenshealth.gov/minorityhealth/latinas/diabetes.html• Diabetes. (2013, June 11). Diabetes. Retrieved April 8, 2014, from
http://www.nyc.gov/html/doh/html/living/diabetes-faq.shtml• Berlin, E. E. (2009, July 29). Gestational Diabetes and Ethnicity. EverydayHealth.com. Retrieved April 8, 2014, from
http://www.everydayhealth.com/gestational-diabetes/gestational-diabetes-ethnicity.aspx• Hispanic women and pregnancy: Gestational diabetes. (n.d.). BabyCenter. Retrieved April 8, 2014, from
http://www.babycenter.com/0_hispanic-women-and-pregnancy-gestational-diabetes_10346415.bc?page=1• Kleinfield, N. (2006, February 18). Diabetes Is Seen as a Rising Risk in Mothers-to-Be . The New York Times, p. 1. Retrieved
April 8, 2014, from http://www.nytimes.com/2006/02/18/nyregion/nyregionspecial5/18diabetes.html?pagewanted=1• Terrie, Y. C. (2013, May 6). Diabetes during pregnancy: Know your risk of gestational diabetes. NY Daily News. Retrieved April
8, 2014, from http://www.nydailynews.com/life-style/health/women-diabetes-pregnancy-article-1.1336314
Sources
• 1.Boseley, Sarah, and Jamie Wilson. "New Yorkers in Grip of Diabetes Epidemic." The Guardian. Guardian News and Media, 10 Jan. 2006. Web. 27 Feb. 2014.http://www.theguardian.com/world/2006/jan/10/usa.health
• 2."Complications - American Diabetes Association®." American Diabetes Association. N.p., n.d. Web. 23 Apr. 2014. <http://www.diabetes.org/living-with- diabetes/complications/>.
• 3."Facts About Type 2 - American Diabetes Association®." American Diabetes Association. N.p., 1 July 2013. Web. 24 Apr. 2014. <http://www.diabetes.org/diabetes-basics/type- 2/facts-about-type-2.html>.
• 4."The Big Issue." The Observer. Guardian News and Media, 09 Mar. 2003. Web. 27 Feb. 2014. http://www.theguardian.com/lifeandstyle/2003/mar/09/foodanddrink.features6
• 5."Type 1 diabetes." Complications. Mayo Foundation for Medical Education and Research, 23 Jan. 2013. Web. 23 Apr. 2014. <http://www.mayoclinic.org/diseases-conditions/type-1-diabetes/basics/complications/con-20019573>.
• 6."We're In!" Obesity and Hispanic Americans. N.p., n.d. Web. 24 Feb. 2014.http://minorityhealth.hhs.gov/templates/content.aspx?ID=6459
• 7."What is Type 1 Diabetes (T1D)?." What is Type 1 Diabetes?. N.p., n.d. Web. 23 Apr. 2014. <http://info.jdrfdsw.org/jdrf/what-is-type1diabetes.php>.