1. DIABETES MELLITUS
AND COMMUNITY
HEALTH

3. Diabetes Mellitus: Introduction
 A major health issue facing the nation and
individual communities is the epidemic of
diabetes.
 According to Healthy People 2020, Diabetes
affects over 23.6 million people in the United
States and is the 7th leading cause of death.
 Diabetes affects individual communities by
decreasing life expectancy by 15 years,
increases the risk for heart disease 2 to 4
times and is the leading cause of kidney
failure, limb amputation and adult onset
blindness.

4. Diabetes Pathophysiology
 Diabetes is due to either a relative or absolute
deficiency of insulin which results in
hyperglycemia and glucose intolerance.
 Insulin is a hormone secreted by the pancreas
and is necessary for glucose to enter into cells.
Without insulin, cells go through glucose
starvation.
 There is a correlation between obesity and
diabetes mellitus. Obesity causes cellular
insulin resistance which causes cell starvation
and hyperglycemia.

5. Insulin function in our body

6. Populations at greater risk
 Minority populations and communities are at
greater risk for diabetes. Minorities make up 25%
percent of individuals who have diabetes.
 African Americans, Hispanic/Latino Americans,
Pacific islanders, Alaskan natives and Asian
Americans are at high risk for type 2 diabetes.
 Prevalence rates among certain minorities can be
two times higher than caucasians.
 Hispanic males are at a lifetime risk of developing
diabetes of 54.5% for while it is 31% for white
men.

7. At risk populations continued
 African Americans are 1.7 times as likely as
caucasians to develop diabetes.
 Nearly 18 percent of Alaskan natives have
diabetes.

8. Financial costs of Diabetes
 In 2007, the financial cost of Diabetes was
$174 million which includes medical care,
disability and death costs.
 By 2012, diabetes healthcare costs rose to
$245 billion.
 A newly diagnosed diabetic incurs an average
annual medical bill of $13,000, 2.3 times the
national average (American Diabetes
Association).

10. Diabetes health costs continued

11. Diabetes Health Costs continued

12. Healthy people 2020 goals
 The goal of Healthy People 2020 is to “reduce the
disease and economic burden of diabetes mellitus
and improve the quality of life for all persons who
have or are at risk for diabetes mellitus.”
 Specifically, healthy people 2020 seeks to reduce
the number people with diabetes mellitus
diagnoses, reduce lower extremity amputations,
improve glycemic control, reduce deaths related
to cardiovascular disease.
 Increase the proportion of individuals who have an
A1c value under seven and decrease the number
of people with an A1c value over nine.

13. Diabetes Signs and Symptoms
 Polyphagia (frequent hunger).
 Polydipsia (frequent thirst).
 Polyuria (frequent urination).
 Sexual problems.
 Vaginal infections
 Poor wound healing.
 Numbing and/or tingling in hands and/or feet.
 Sudden weight loss.

14. Diabetes Signs and Symptoms

15. Diabetes diagnosis
 Diabetes Mellitus is diagnosed is in several
ways:
 A1C test which measures serum blood
glucose levels over several months.
 Fasting plasma glucose measures serum
glucose while fasting.
 Oral glucose tolerance test measures how fast
glucose is cleansed from your blood.

16. Diabetes Management
 The most efficient means of diabetes
management is to control blood sugar. Eating
a healthy diet is essential for diabetes control.
 Exercise will also help diabetes control
 When a healthy diet and exercise are not
sufficient by themselves, insulin and other
medications which are designed to lower blood
sugar are utilized.

17. Diabetes often requires insulin
management

18. Culture and politics
 African Americans often consume “soul food”
which often has meat that is deep fried. African
Americans often fry their food due to the ease of
cooking meat quickly during hot summers.
 Amelia Montes, Professor of Ethnic studies at the
University of Nebraska-Lincoln states 'Genes are
passed from one generation to another, but
basically it's our way of eating. And how can
populations of Mexican descent along the border
or in working class neighborhoods take the time to
exercise or have the means to maintain a healthy
diet when a half dozen tacos or a hamburger with
fries and a coke is half the price of a pound of
organic spinach?”

19. Diabetes and culture: Junk food

20. Diabetes and culture: Fried
Twinkies

21. Diabetes complications
 Diabetes is the number one cause of adult
onset blindness.
 Diabetes causes cellular damage to the
vascular system resulting in neuropathy,
kidney damage, diabetic ulcers, blindness.
 Individuals with diabetes are at greater risk for
stroke and heart disease.

22. Diabetes complications: foot
ulcers

23. Diabetes and Politics continued
 On a national level, legislation has been
proposed to develop a committee composed of
private and public individuals whom will make
recommendations to improve diabetes
healthcare.

24. Community Resources
 In Alaska, most farmers markets accept food
stamps in effort to get healthier food to the
individuals at greatest risk for poor diabetes
control and obesity.
 In addition, Anchorage has the “Get out and Play
Every Day” program which encourages kids to
exercise daily and to eat healthy diets.
 Alaska has the Indian Health Services (IHS) which
has specific programs aimed at helping people
lose weight and decrease diabetes risks and
complications. The IHS has established the
special diabetes program to teach people to
minimize diabetes risks and then to control
diabetes.

25. Get out and play everyday-Alaska
style!

26. Get out and play everyday in
Alaska

27. Alaska: Get out and play everyday-
Play on glaciers!

28. Points for patients to
understand
 Diabetes often can be controlled through a
healthy diet and exercise.
 When a healthy diet and exercise are not enough
to control serum glucose levels, medications such
as metformin and insulin may be necessary.
 Diabetes has serious complications that need to
be taken seriously such as adult onset blindness,
amputations, renal failure, diabetic ulcers.
 Individuals with diabetes need to understand daily
monitoring and healthy habits are necessary to
maximize health.

29. References
 http://www.ameliamontes.com/2011/08/how-
mexicans-are-made-diabetic---.html
 American Diabetes association
 Alaskan Department of Health and social
services