DIABETES

&
OBESITY

Presented by:
Richelle Anne B. Correa,
RN
 What is Diabetes?

Diabetes mellitus is
a metabolic disorder
characterized by
high levels of
glucose in the blood.
Statistics and its Occurrence
There are more than 150
million people with
diabetes worldwide, with
the number expected to
reach 300 million by
2025, with approximately
90% having type 2
diabetes.
There are 23.6 million people
in the United States, or 8% of
the population, who have
diabetes.
[Link]
An estimated 23.6 million people in the
United States -- 7.8 percent of the
population -- have diabetes, a serious,
lifelong condition. Of those, 17.9 million
have been diagnosed, and about 5.7
million people have not yet been
diagnosed. Each year, about 1.6 million
people aged 20 or older are diagnosed
with diabetes.
 What is Obesity?

Obesity is a
state of
excess body
fat.
Obesity has reached epidemic
proportions globally with more than
1 billion adults overweight, of which
at least 300 million are clinically
obese.
.The American Diabetes
Association estimates
about 21 million people
have diabetes, with
another 54 million people
diagnosed with pre-
diabetes.
 USA Obesity Rates
Reach Epidemic
Proportions
58 Million Overweight; 40
Million Obese; 3 Million
morbidly Obese
Eight out of 10 over 25's
Overweight
78% of American's not
meeting basic activity level
recommendations
25% completely Sedentary
OBESITY DIABETES
Obesity and Insulin Resistance
Type 2 diabetes is associated with insulin
resistance. Insulin is an important hormone that
delivers glucose (sugar) to our cells. When a person
is overweight, the cells in the body become less
sensitive to the insulin that is released from the
pancreas. There is some evidence that fat cells are
more resistant to insulin than muscle cells. If a
person has more fat cells than muscle cells, then
the insulin becomes less effective overall, and
glucose remains circulating in the blood instead of
being taken in to the cells to be used as energy.
Studies have shown that it can make a big
difference if people work to lose only 5 to 7
percent of their body weight. For many people,
this works out to about 7 to 10 pounds. Even if
someone already has diabetes, losing a moderate
amount of weight can dramatically slow the
progression of the disease. Blood pressure and
cholesterol levels also benefit when just this
small percentage of body weight is lost.
Excess weight and obesity lead to
adverse metabolic effects on blood
pressure, lipid levels and insulin
resistance and thus pose a major risk for
serious chronic diseases, including
hypertension, type 2 diabetes and
cardiovascular disease.
TREATMENT
1. Dietary therapy -- A low
calorie diet -- with a deficit
of 500 to 1000 calories/day
-- is recommended for
weight loss.
2. Physical activity -- Individuals
should start moderate activity for
30-45 minutes, 3 -- 5 days/week,
and aim for at least 30 minutes or
more of moderate physical
activity on most, and preferably
all, days.
•Behavior therapy -- This is a useful adjunct when incorporated into treatment for weight loss and weight maintenance.

3. Behavior Theraphy- this is a

4. Pharmacotheraphy- using
FDA approved weight loss
medications, in combination
with diet and physical
activity, results in weight loss
when used for 6 months to a
year.
5. Weight Loss Surgery- is an option for
carefully selected patents with clinically
severe obesity when less invasive
methods of weight loss have failed and
the patient is at high risk for obesity-
associated illness or death.
DIABETES
AND
DEPRESSION
Not only is
depression is one of
the worst illnesses
known to humankind,
it is also implicated in
another of one of the
worst illnesses known
to humankind -
diabetes.
 For someone with a severe case of
diabetes, the disease can amount to a
slow and painful execution extending
over years and decades. For many
years it was thought that depression
was a complication of diabetes, which
may well be the case. More recent
research, however, points to
depression as a possible cause or
trigger.
 Depression can strike anyone, but people
with diabetes, a serious disorder that
afflicts an estimated 16 million Americans,
may be at greater risk. In addition,
individuals with depression may be at
greater risk for developing diabetes.
 What is Depression?

Depression is a serious
medical condition that
affects thoughts, feelings,
and the ability to function
in everyday life. Depression
can occur at any age.
DIABETES

DEPRESSION
 SYMPTOMS OF DEPRESSION
• Persistent sad, anxious, or "empty" mood
• Feelings of hopelessness, pessimism
• Feelings of guilt, worthlessness, helplessness
• Loss of interest or pleasure in hobbies and activities that were
once enjoyed, including sex
• Decreased energy, fatigue, being "slowed down"
• Difficulty concentrating, remembering, making decisions
• Insomnia, early-morning awakening, or oversleeping
• Appetite and/or weight changes
• Thoughts of death or suicide, or suicide attempts Restlessness,
irritability
• Depression is not generally listed as a
complication of diabetes. However, it can
be one of the most common and
dangerous complications. The rate of
depression in diabetics is much higher
than in the general population. Diabetics
with major depression have a very high
rate of recurrent depressive episodes
within the following five years.
• A depressed person may not have the energy
or motivation to maintain good diabetic
management. Depression is frequently
associated with unhealthy appetite changes.
The suicidal diabetic adolescent has constant
access to potentially lethal doses of insulin.
• At this point in time, it is well
accepted that psychological
factors and psychiatric conditions
can affect the course of medical
illnesses.
 Managing Depression
• Recent studies have suggested that effective
treatment of depression can improve diabetic
control. In a study by Lustman and colleagues,
glucose levels were shown to improve as
depression lifted. The better the improvement,
the better the diabetic control. (Lustman et al.
1997a)
• The most important starting point is an accurate
diagnosis.
• There have been major advances in the treatment of
depression. There are specific medications and specific
psychotherapy techniques that have been shown to
help depression.
• Often individuals do well with a combination of
antidepressant treatment and psychotherapy.
• Be sure that your clinician is willing to take the time to
communicate with your diabetes team.
• Ideally, the mental health clinician should be familiar
with your type of diabetes.
• Examine your lifestyle for sources of stress. Are there
stressers that can be eliminated?
• Learn relaxation techniques. Yoga, meditation, prayer,
and hypnosis may help.
• Make sure that you are getting enough sleep
• Exercise. The body's primitive stress response was
designed to prepare the individual to fight or to run
away. In our society, we do not usually respond to stress
with physical activity. Exercise helps our bodies deal with
the physiological results of stress.
• Make a list of the things that are worrying you. When
you have a concrete list, the problems often look more
manageable.