Diabetes Megamas Training Company OPITO BOSIET NEBOSH IOSH HSE

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Diabetes Megamas Training Company OPITO BOSIET NEBOSH IOSH HSE Powered By Docstoc
					                               SUMMARY
•   What is diabetes?

•   What causes diabetes?

•   Type of diabetes.

•   What causes it?

•   Diabetes symptoms.

•   Treatments for Diabetes.

•   What type of nutrition do you plan when you have diabetes? And how do you
    normalize or maintain a good weight with diabetes?
                       What Is Diabetes?
The Balance of Glucose and Insulin:

Diabetes is a disorder that affects the way your body uses food for energy. Normally, the sugar you
take in is digested and broken down to a simple sugar, known as glucose. The glucose then
circulates in your blood where it waits to enter cells to be used as fuel. Insulin, a hormone
produced by the pancreas, helps move the glucose into cells. A Healthy pancreas adjusts the
amount of insulin based on the level of glucose. But, if you have diabetes, this process breaks
down, and blood sugar levels become too high.

There are two main types of full-blown diabetes:
• People with Type 1 diabetes are completely unable to produce insulin. Type 1 is typically
    diagnosed in children and young adults, and the cause is still unknown.

•   People with Type 2 diabetes can produce insulin, but their cells don't respond to it. In either
    case, the glucose can't move into the cells and blood glucose levels can become high. Over
    time, these high glucose levels can cause serious complications. Type 2 diabetes is the most
    common form of diabetes and it is usually caused by lifestyle factors.
                     What Causes Diabetes?
To understand diabetes, first you must understand how glucose is normally processed in the body.

                                       How glucose normally works?
                                       Glucose is a main source of energy for the cells that make up your muscles and other
                                       tissues. Glucose comes from two major sources: the food you eat and your liver. During
                                       digestion, sugar is absorbed into the bloodstream. Normally, sugar then enters cells
                                       with the help of insulin.

                                      The hormone insulin comes from the pancreas, a gland located just behind the
                                      stomach. When you eat, your pancreas secretes insulin into your bloodstream. As
                                      insulin circulates, it acts like a key by unlocking microscopic doors that allow sugar to
                                      enter your cells. Insulin lowers the amount of sugar in your bloodstream. As your blood
                                      sugar level drops, so does the secretion of insulin from your pancreas.
Your liver acts as a glucose storage and manufacturing center. When you haven’t eaten in a while, for example, your liver
releases stored glucose to keep your glucose level within a normal range.

Causes of type 1 diabetes
In type 1 diabetes, your immune system — which normally fights harmful bacteria or viruses — attacks and destroys the
insulin-producing cells in the pancreas. This leaves you with little or no insulin. Instead of being transported into your cells,
sugar builds up in your bloodstream.

Causes of prediabetes and type 2 diabetes
In prediabetes — which can lead to type 2 diabetes — and in type 2 diabetes, your cells become resistant to the action of
insulin, and your pancreas is unable to make enough insulin to overcome this resistance. Instead of moving into your cells,
sugar builds up in your bloodstream. Exactly why this happens is uncertain, although excess fat — especially abdominal fat
— and inactivity seem to be important factors.

Causes of gestational diabetes
During pregnancy, the placenta produces hormones to sustain your pregnancy. These hormones make your cells more
resistant to insulin. As your placenta grows larger in the second and third trimesters, it secretes more of these hormones —
making it even harder for insulin to do its job. Normally, your pancreas responds by producing enough extra insulin to
overcome this resistance. But sometimes your pancreas can’t keep up. When this happens, too little glucose gets into your
cells and too much stays in your blood. This is gestational diabetes.
                              Type of Diabetes
Type 1 Diabetes:
•   A person with Type 1 diabetes can't make any insulin. Type 1 most often occurs before age 30, but may
    strike at any age. Type 1 can be caused by a genetic disorder. The origins of Type 1 are not fully
    understood, Scientists believe that it may be a virus that triggers the immune system to attack the cells
    and permanently destroy them. But all of the possible causes still have the same end result: The
    pancreas can no longer make the insulin necessary to transport sugar from the blood into the other cells
    of the body for energy. Sugar builds up in the blood and over time can damage internal organs and blood
    vessels. Frequent insulin injections are needed for Type 1.

Type 2 Diabetes:
•   A person with Type 2 diabetes has adequate insulin, but the cells have become resistant to it. Type 2
    usually occurs in adults over 35 years old, but can affect anyone, including children. The National
    Institutes of Health state that 95 percent of all diabetes cases are Type 2. Why? It's a lifestyle disease,
    triggered by obesity, a lack of exercise, increased age and to some degree, genetic predisposition.


Gestational Diabetes:
•   Gestational diabetes (GDM) is defined as a carbohydrate intolerance that normally develops during the
    24th through the 32nd week of pregnancy. This condition affects 2 percent to 5 percent of all pregnant
    women and is the most common disease affecting pregnancy (2). Gestational diabetes often can be
    controlled by diet, but insulin is sometimes necessary to maintain glycemic control. An elevated blood
    glucose level during pregnancy is associated with an increase in complications for both mother and child.
    Following pregnancy, normal blood glucose tolerance usually returns. Women who have had gestational
    diabetes have a 40% to 60% chance of developing diabetes in the next 5-10 years.
                            Diabetes Symptoms
Type 1 Diabetes Symptoms
The symptoms of Type I diabetes often come on suddenly and very severely. They include: being
exceptionally thirsty
•    dry mouth
•    the need to urinate often
•    weight loss (even though you may be hungry and eating well)
•    feeling weak and tired
•    blurry vision

Type 2 Diabetes Symptoms
Sometimes, people with Type II diabetes don't notice any symptoms or the symptoms are experienced
gradually. They include: blurry vision
•   cuts or sores that are slow to heal
•   itchy skin, yeast infections
•   increased thirst
•   dry mouth
•   need to urinate often
•   leg pain

Gestational diabetes Symptoms
•   Generally, gestational diabetes may not cause any symptoms, however, the woman
    may experience excessive weight gain, excessive hunger or thirst, excessive urination
    or recurrent vaginal infections.
                     Treatment for Diabetes
Treatment of Type 1 Diabetes
•    At diagnosis, the immediate goals of treatment are to treat diabetic ketoacidosis (also called DKA) and high blood
     glucose levels. Because of the sudden onset and severity of symptoms in type 1 diabetes, treatment for newly
     diagnosed people may involve hospitalization.
•    The long-term goals of treatment are to prolong life, reduce symptoms, and prevent diabetes-related complications
     such as blindness, kidney failure, and amputation of limbs.
•    These goals are accomplished through education, insulin use, meal planning and weight control, exercise, foot
     care, and careful self-testing of blood glucose levels.

Treatment of Type 2 Diabetes
•    Each individual diagnosed with Type 2 Diabetes will have a different treatment plan. One specifically tailored for
     that individual's needs. Overall, there are four main goals for a diabetic.
•    Lowering your blood sugar
•    Keeping your blood sugar as close to normal as possible
•    Controlling blood pressure and blood cholesterol
•    Preventing serious health problems related to diabetes
•    Below you will find some things that can help you achieve these goals.
•    Diet - eating vegetables, whole grain foods, and lean protein will help you with your blood sugar levels.
•    Exercise - Exercising regularly can also help control your blood sugar levels.
•    Medication - if a change in diet doesn't control your blood sugar levels, there is the possibility that
     medication can help bring your blood sugar levels under control.

Treatment of Gestational diabetes
•    Treatment for gestational diabetes includes eating a carefully planned diet, getting plenty of
     exercise, maintaining a healthy pregnancy weight, monitoring glucose levels and, if necessary,
     daily insulin injections.
Diabetes Symbols
32 new symbols to support talking about Diabetes and healthy living. The Communicate: In Print
update will install a new wordlist called diabetes.cwl. You will need to load this wordlist as your
subsiduary list to access the symbols.
    What type of nutrition do you plan when you have
    diabetes? And how do you normalize or maintain a
               good weight with diabetes?
•   This is a difficult question for many. To complicate matters more, there is really no certain diet for diabetics
    to follow. Many people do not understand the needs of diabetes nutrition guidelines. And many people
    also can't understand how closely tied to good diabetic control the food you eat can be.For some great
    nutrition tips and easy healthy recipes, check out The Healthy Eating Guide

•   The American Diabetes Association has what is referred to as the Diabetic Food Pyramid. This pyramid was
    designed much like the old one, but provides better information on diet guidelines to help you stay in
    control of your blood glucose levels, and weight. This new food pyramid is divided up into six groups. The
    size of the groups varies. The larger the group, the more servings per day you can consume.

•   The grains and starch allowances are of the largest group. This includes foods such as whole grains, pastas,
    breads, cereals, potatoes, corn, beans and peas. The alloted number of servings per day is between 6-11.
    To lose weight, you should stick with the lower number of 6 servings.

•   The next group down is vegetables. Vegetables are naturally low in fat, of course. This makes them good
    food for everyone. Cabbage, cauliflower, carrots, tomatoes, lettuce, and cucumbers are examples of the
    vegetable group. The alloted number of servings is between 3-5 every day, though it does not hurt to go
    above that number.
Diabetes and Nutrition
Gestational Diabetes Sample Menu:                                  Today’s Type 2 Diabetes Diet Recipe:
Herbed Grilled Chicken and rice with strawberry salad                                                                    Mozzarella Cauliflower Bake
                                                                   Cinnamon French Toast
                                                                                                                         Sent in by Stacey
                                                                   (Cinnamon Helps Control Sugar Levels in Type
Herbed Grilled Chicken                                                                                                   YIELD: Serves 2
                                                                   2 Diabetics)
Ingredients:                                                                                                             Per portion:
4 oz. boneless chicken breast                                                                                            GI: 0
                                                                   Ingredients:
½ tbsp olive oil                                                                                                         GL: 0
                                                                   1 whole egg plus 2 egg whites
½ tsp. dried oregano                                               1/2 cup fat-free skim milk
¼ tsp. fresh thyme                                                                                                       Ingredients
                                                                   1/4 tsp. vanilla extract
½ tsp. dried rosemary                                                                                                    •½ head of Cauliflower, rinsed and
                                                                   1/8 tsp. cinnamon
Directions: Preheat either grill or broiler. Rinse and pat dry                                                           chopped into 1 inch floweret’s – 2 cups
                                                                   8 slices bread
chicken. Combine olive oil and herbs together to form a                                                                  •1 Large Fresh Tomato, rinsed and
                                                                   Butter
paste and rub on chicken to coat. If possible, cover with                                                                chopped
plastic wrap and let marinate, refrigerated, for about 30                                                                •¼ cup Mozzarella Cheese – shredded
                                                                   1. In a shallow dish, whisk together egg and egg
minutes. Grill or broil chicken, approximately 6-8 inches from                                                           •1 Extra Large egg, beaten
                                                                   whites, milk, vanilla, and cinnamon. Dip each
heat source, for 4-6 minutes on each side until cooked.                                                                  •¼ cup Parmesan Cheese – grated
                                                                   slice of bread quickly in egg mixture to coat one
                                                                                                                         •1 Tbsp Extra Virgin Olive Oil
                                                                   side, flip over with a fork, and quickly coat other
Brown Rice                                                         side.
Ingredients:                                                                                                             Preparation
                                                                   2. Place slices of bread in large nonstick fry pan
3 tbsp brown rice                                                                                                        •Spread Extra Virgin Olive Oil over
                                                                   coated with butter and warmed over medium
¾ cup water                                                                                                              bottom and sides of 6 x 8 inch glass
                                                                   heat. Cook until golden, turn over, and continue
Directions: Place rice in a small pot with tight-fitting lid and                                                         baking dish
                                                                   cooking until other side is golden. If cooking
cover with about 2 1/2 times the amount of water (4                                                                      •In a medium sized bowl, beat egg and
                                                                   French toast in two batches, re-coat fry pan with
tablespoons of rice, about 3/4 cup water). Bring to a boil,                                                              add cheeses, stirring until combined
                                                                   cooking spray between batches.
uncovered, on high heat; reduce heat to low, cover tightly                                                               •Arrange cauliflower and tomato in
and cook for about 40-45 minutes, or until water is absorbed                                                             baking dish
                                                                   Nutrition Facts for Cinnamon French Toast:
and rice is tender.                                                                                                      •Pour egg and cheese mixture over
                                                                   Servings – 4
                                                                                                                         cauliflower/tomato combination
                                                                   Serving Size – 2 slices
Strawberry Salad                                                                                                         •Bake at 325 degree oven for 20 minutes.
                                                                   Preparation Time – 5 minutes
Ingredients:                                                       Starch Exchanges – 2
2 cups mixed green salad                                                                                                 Nutrition Facts
                                                                   Calories – 167
5 cherry tomatoes                                                                                                        Calories: 164; Carbohydrates: 7g; Fiber:
                                                                   Calories From Fat – 27
2/3 cup sliced cucumber                                                                                                  3g; Protein: 12g; Fat: 9g; Saturated Fats:
                                                                   Total Fat – 3 g
1 1/3 tbsp Italian low fat dressing                                                                                      0g; Sodium: 273mg.
                                                                   Saturated Fat – 1 g
1 cup sliced fresh strawberries                                    Cholesterol – 54 mg
Directions: Add cherry tomatoes, sliced cucumber, and fresh        Sodium – 302 mg
strawberries to mixed green salad. Mix dressing in salad and       Carbohydrate – 27 g
enjoy.                                                             Dietary Fiber – 1 g
                                                                   Sugars – 3 g
Nutrition Information per serving: 437 calories; 33 gm             Protein – 8 g
protein; 49 gm carbs; 13 gm fat; 8 gm fiber; 400 gm sodium
Ripas Hospital To Introduce Diabetes Education Project - this April to decrease the
number of diabetes patients, which has hit younger patients.
(Written by Rasidah H A B Monday, 15 March 2010 08:33 The Brunei Times)
www.brudirect.com/.../ripas-hospital-to-introduce-diabetes-education-project.html -

World Diabetes Day at JPMC - IN CONJUNCTION with World Diabetes Day, Jerudong
Park Medical Centre (JPMC) held a public forum to disseminate information on the
disease. The theme for this year’s World Diabetes Day is ‘Understand Diabetes and
Take Control’. Dr Arvind Bamanikar, Senior Consultant Physician at JPMC highlighted
that the current scenario of diabetes in Brunei has a prevalence status of about 25 per
cent of the figures from screening health figures.
 (written by Edwin Eng Nov 14th, 2009 The Brunei Times)
news.brunei.fm/.../world-diabetes-day-at-jpmc

Keeping women's health in check - WITH diabetes ranked as third leading
cause of death in Brunei, the public were advised to take better care of their
health.
(Written by Syed Rory Malai Hassan , Monday, March 15, 2010 The Brunei Times)
www.bt.com.bn/.../keeping-womens-health-check
                                                          Quiz
1. What percentage of all people with diabetes have         5. The population group with increased risk for
Type 2 diabetes?                                            developing type 2 diabetes is which of these?
A.10%                                                       A.Caucasians
B. 25%                                                      B. Latinos
C. 90 to 95%                                                C. Native Americans
D. 50%                                                      D. B and C

2. Uncontrolled diabetes can damage which of these          6. Gestational diabetes occurs only during pregnancy.
organs?                                                     Why?
A. eyes and kidneys                                         A.hormones related to the fetus cause insulin resistance
B. Liver                                                    B. pancreas can't produce enough insulin
C. Kidney                                                   C. fetus manufactures excessive sugar
D. heart                                                    D. A and B

3. What does insulin do?                                    7. How does gestational diabetes affect the baby?
A. changes sugar into usable form                           A.causes birth defects
B. helps cells take in sugar                                B. baby produces more insulin
C. helps cells keep out sugar                               C. immediately after birth, the baby develops low blood
D. triggers adrenaline                                      sugar
                                                            D. B and C
4. Which is the most significant risk factor for type 2
diabetes?                                                   8. How does exercise benefit people with diabetes?
A.Obesity                                                   A.improves oxygen flow
B. race                                                     B. reduces insulin resistance
C. gender                                                   C. regulates blood pressure
D. age                                                      D. all of the above
                                                         Quiz
                                                               13.Early management and control of diabetes will help avoid
                                                               complications that may arise later. People with diabetes are at
                                                               increased risk of developing which of these?
9. Diabetes mellitus results from which of these?              A. heart disease
A. bacterial infection                                         B. cancer
B. high cholesterol                                            C. neurological damage
C. body chemistry errors                                       D. a and c
D. too much salt
                                                               14.Why are controlled eating and exercise so important if you
10. There are two categories of diabetes: type 1 and type      have diabetes?
2. How many people with diabetes have type 2?                  A. they keep depression at bay
A. 10 to 15 percent                                            B. eating raises blood sugar; exercise lowers it
B. 30 to 35 percent                                            C. being overweight can be dangerous for people with
C. 45 to 50 percent                                               diabetes
D. 90 to 95 percent                                            D. b and c

11. A certain gland or organ malfunctions in a person          15.Type 1 diabetes occurs when the beta cells in the pancreas
with diabetes. Which gland or organ is it?                     are destroyed. What destroys them?
A. pituitary gland                                             A. the immune system
B. pancreas                                                    B. environmental toxins
C. adrenal glands                                              C. free radicals
D. kidneys                                                     D. bacteria

12. Why is insulin critical in the chemistry of blood sugar?   16.A reversible diabetic condition can develop as a side effect
A. it enables glucose to enter cells                           of some drugs. Which of these can cause elevated blood
B. it lowers blood pressure                                    sugar?
C. it raises cholesterol                                       A. Ibuprofen
D. it stabilizes sucrose levels                                B. antidepressants
                                                               C. thyroid medications
                                                               D. oral steroid medications
                                        Quiz Answer
1. What percentage of all people with diabetes have       5. The population group with increased risk for
Type 2 diabetes?                                          developing type 2 diabetes is which of these?
A.10%                                                     A.Caucasians
B. 25%                                                    B. Latinos
C. 90 to 95%                                              C. Native Americans
D. 50%                                                    D. B and C

2. Uncontrolled diabetes can damage which of these        6. Gestational diabetes occurs only during pregnancy.
organs?                                                   Why?
A. eyes and kidneys                                       A.hormones related to the fetus cause insulin resistance
B. Liver                                                  B. pancreas can't produce enough insulin
C. Kidney                                                 C. fetus manufactures excessive sugar
D. heart                                                  D. A and B

3. What does insulin do?                                  7. How does gestational diabetes affect the baby?
A. changes sugar into usable form                         A.causes birth defects
B. helps cells take in sugar                              B. baby produces more insulin
C. helps cells keep out sugar                             C. immediately after birth, the baby develops low blood
D. triggers adrenaline                                    sugar
                                                          D. B and C
4. Which is the most significant risk factor for type 2
diabetes?                                                 8. How does exercise benefit people with diabetes?
A.Obesity                                                 A.improves oxygen flow
B. race                                                   B. reduces insulin resistance
C. gender                                                 C. regulates blood pressure
D. age                                                    D. all of the above
                                          Quiz Answer
                                                               13.Early management and control of diabetes will help avoid
                                                               complications that may arise later. People with diabetes are at
                                                               increased risk of developing which of these?
9. Diabetes mellitus results from which of these?              A. heart disease
A. bacterial infection                                         B. cancer
B. high cholesterol                                            C. neurological damage
C. body chemistry errors                                       D. a and c
D. too much salt
                                                               14.Why are controlled eating and exercise so important if you
10. There are two categories of diabetes: type 1 and type      have diabetes?
2. How many people with diabetes have type 2?                  A. they keep depression at bay
A. 10 to 15 percent                                            B. eating raises blood sugar; exercise lowers it
B. 30 to 35 percent                                            C. being overweight can be dangerous for people with
C. 45 to 50 percent                                               diabetes
D. 90 to 95 percent                                            D. b and c

11. A certain gland or organ malfunctions in a person          15.Type 1 diabetes occurs when the beta cells in the pancreas
with diabetes. Which gland or organ is it?                     are destroyed. What destroys them?
A. pituitary gland                                             A. the immune system
B. pancreas                                                    B. environmental toxins
C. adrenal glands                                              C. free radicals
D. kidneys                                                     D. bacteria

12. Why is insulin critical in the chemistry of blood sugar?   16.A reversible diabetic condition can develop as a side effect
A. it enables glucose to enter cells                           of some drugs. Which of these can cause elevated blood
B. it lowers blood pressure                                    sugar?
C. it raises cholesterol                                       A. Ibuprofen
D. it stabilizes sucrose levels                                B. antidepressants
                                                               C. thyroid medications
                                                               D. oral steroid medications
                          Useful links

• Ministry of Health
http://www.moh.gov.bn/healthpromotions/healthtopics.htm


www.bt.com.bn/en/archive/all/2008/1?page=6

				
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