Diabetes is a group of metabolic diseases where a person has high blood glucose due to either inadequate insulin production or cells not responding properly to insulin. Type 1 diabetes occurs when the pancreas does not produce insulin, while type 2 occurs when the body does not produce enough insulin or cells do not respond properly to insulin. Symptoms of diabetes include increased urination, thirst, hunger, weight loss, fatigue, and changes in mood or vision. Treatment involves physical activity, healthy diet, and potentially insulin injections or tablets. Uncontrolled diabetes can lead to complications affecting the eyes, feet, heart, kidneys and other organs.

1. HEALTH AND NUTRITION
BY
CHERUIYOT SAMBU
MSCN/BSCN/DCN
CLINICAL NUTRITIONIST
DIABETES

2. DİABETES
 Diabetes describes a group of metabolic
diseases in which the person has high
blood glucose (blood sugar), either because
insulin production is inadequate, or
because the body's cells do not respond
properly to insulin, or both.

3. INSULİN PRODUCTION
Pancreas produce insulin
according to the blood
glucose level

4. What happens if there is a problem with
the production of insulin?
 Glucose in blood is not able to go into the cells.
 The cells can’t meet energy needs and energy is
tried to be provided from ‘fat’ and protein’.
 Using ‘fat’ as the energy source results the
increasing of keton in the body.

5.  With the usage of protein as energy
source,the patient feels themselves tired
and sluggish.
 If blood glucose is to high,It is tried to be
thrown away by kidneys so the patients
begin to urinate so often.
 As a result, the patients feel thirsty and
start to drink a lot.

6.  On the other
hand,despite eating
so often and a
lot,the patients lose
weight.

7. THE TYPES OF DIABETES
 While type 1 and type 2 are the most common form of
diabetes, there are others that you may hear
about.Impaired Glucose Metabolism or Pre-diabetes
 There are two pre-diabetes conditions:Impaired glucose
tolerance (IGT) is where blood glucose levels are higher
than normal but not high enough to be classified as
diabetes.
 Impaired fasting glucose (IFG) is where blood glucose
levels are escalated in the fasting state but not high
enough to be classified as diabetes.

8. Clinical Manifestations ( Signs and Symptoms)
- Polyuria - weakness
- Polydipsia - fatigue
- Polyphagia -  blood sugar / glucose level
- weight loss - (+) glucose in urine (glycosuria)
- nausea / vomiting
- changes in LOC (severe hyperglycemia)
(sleepiness, drowsiness  coma)
- recurrent infection, prolonged wound healing
- altered immune and inflammatory response, prone to
infection (glucose inhibits the phagocytic action of WBC 
resistance)
- genital pruritus – (hyperglycemia and glycosuria favor fungal
growth : candidal infection – resulting in pruritus, common
presenting symptom in women)

9. RISK FACTORS
 Obesity
 Race
 History of CVD
 HTN
 Physical inactivity
 Familial history
 Polycystic Ovary Syndrome
 Gestational Diabetes
? ? ?
?

10. GLYCOSELATED HEMOGLOBIN
(HBA1C)
HbA1c is a test that measures the
amount of glycated hemoglobin in your
blood. Glycated hemoglobin is a substance
in red blood cells that is formed when blood
sugar (glucose) attaches to hemoglobin.

12.  Teyp 1
Diabetes:Type 1
diabetes is usually
diagnosed in children
and young adults.
Only 10% of people
with diabetes have
this form of the
disease.
 In type 1 diabetes,
the body does not
produce insulin.

13. INSULININSULIN
INJECTIONINJECTION
SITESSITES

14. Types
1.Type I
 formerly known as Insulin – Dependent
Diabetes Mellitus (IDDM)
Autoimmune (Islet cell antibodies)
•Early introduction of cow’s milk and
cereals
•Intake of medicine during pregnancy
•Indoor smoking of family members
destruction of beta cells of the pancreas
 little or no insulin production
requires daily insulin admin.
 may occur at any age, usually appears
below age 15

15.  Patients with type 1 diabetes will need
to take insulin injections for the rest of
their life. They must also ensure proper
blood-glucose levels by carrying out
regular blood tests and following a special
diet.

16.  Type 2 diabetes:
 The body does not produce enough insulin
for proper function, or the cells in the body
do not react to insulin.
Approximately 90% of all cases of diabetes
worldwide are of this type.

17. 2. Type II
 formerly known as Non Insulin–Dependent
Diabetes Mellitus (NIDDM)
 probably caused by:
 disturbance in insulin reception in the cells
  number of insulin receptors
 loss of beta cell responsiveness to glucose
leading to slow or  insulin release by the
pancreas
 occurs over age 40 but can occur in children
 common in overweight or obese
 w/ some circulating insulin present, often do
not require insulin

18.  Some people may be able to control their
type 2 diabetes symptoms by losing
weight, following a healthy diet, doing
plenty of exercise, and monitoring their
blood glucose levels.
 However, type 2 diabetes is typically a
progressive disease .
 it gradually gets worse and the patient
will probably end up have to take insulin,
usually in tablet form.

19.  Overweight and obese people have a much
higher risk of developing type 2 diabetes
compared to those with a healthy body weight.
 The risk of developing type 2 diabetes is also
greater as we get older.
 Men whose testosterone levels are low have also
been found to have a higher risk of developing
type 2 diabetes.

20. GESTATIONAL DIABETES
This type affects females during pregnancy.
The majority of gestational diabetes patients can control
their diabetes with exercise and diet. Undiagnosed or
uncontrolled gestational diabetes can raise the risk of
complications during childbirth. The baby may be bigger
than he/she should be.

21. WHAT CAUSES DİABETES?
 Diabetes causes vary depending on your
genetic makeup, family history, ethnicity,
health and environmental factors.
 There is no defined diabetes cause because
the causes of diabetes vary depending on the
individual and the type.

22. Clinical Manifestations ( Signs and Symptoms)
- Polyuria - weakness
- Polydipsia - fatigue
- Polyphagia -  blood sugar / glucose level
- weight loss - (+) glucose in urine (glycosuria)
- nausea / vomiting
- changes in LOC (severe hyperglycemia)
(sleepiness, drowsiness  coma)
- recurrent infection, prolonged wound healing
- altered immune and inflammatory response, prone to
infection (glucose inhibits the phagocytic action of WBC 
resistance)
- genital pruritus – (hyperglycemia and glycosuria favor fungal
growth : candidal infection – resulting in pruritus, common
presenting symptom in women)

23. THE SYMPTOMS OF
DİABETES

24. HOW ARE DIABETES AND
PRE-DIABETES
DIAGNOSED?
 Blood tests are used to diagnosis diabetes
and pre-diabetes . Lab analysis of blood is
needed to ensure test results are
accurate.
 Glucose measuring devices used in a
health care provider’s office, such as
finger-stick devices, are not accurate
enough for diagnosis but may be used as
a quick indicator of high blood glucose.

25. DİABETES TREATMENT
 Prevention and treatment often involve :
 physical exercise,
 being a normal body weight.
 Healthy diet

26. DİET PLAN
 Daily nutritional
needs should be
taken frequently
but small portions.

28. BELOW ARE SOME DİABETES
MYTHS:
 People with diabetes should not exercise –
not true!!
 Exercise is important for people with diabetes, as
it is for everybody else.
 Dıabetes patients should discuss exercise with
their doctors before starting the exercise.
 Fat people always develop type 2 diabetes
eventually - this is not true.
 Being overweight or obese raises the risk of
becoming diabetic, they are risk factors, but do
not mean that an obese person will definitely
become diabetic.

29.  Children can outgrow diabetes - this is not true.
 Nearly all children with diabetes have type 1; insulin-
producing beta cells in the pancreas have been
destroyed. These never come back. Children with type
1 diabetes will need to take insulin for the rest of
their lives, unless a cure is found one day.
 Only older people develop type 2 diabetes -
things are changing.
 A growing number of children and teenagers are
developing type 2 diabetes due to the explosion in
childhood obesity rates, poor diet, and physical
inactivity.

30.  If you have diabetes you cannot eat
chocolates or sweets - people with diabetes can
eat chocolates and sweets if they combine them
with exercise or eat them as part of a healthy
meal.
 Diabetics cannot eat bread, potatoes or
pasta - people with diabetes can eat starchy
foods. However, they must keep an eye on the
size of the portions.

31.  Diabetes diets are different from other
people's - the diet doctors recommend healthy
nutritions; healthy for everybody.Meals should
contain plenty of vegetables, fruit, whole grains,
and they should be low in salt and sugar, and
saturated or trans fat.

32. SOME COMPLİCATİONS LİNKED TO BADLY CONTROLLED DİABETES:
 Eye complications - glaucoma, cataracts, diabetic retinopathy, and
some others.
 Foot complications - neuropathy, and sometimes gangrene which
may require that the foot be amputated
 Heart problems - heart disease when the blood supply to the heart
muscle is diminished
 Hypertension - common in people with diabetes, which can raise
the risk of kidney disease, eye problems, heart attack and stroke
 Mental health - uncontrolled diabetes raises the risk of suffering
from depression, anxiety and some other mental disorders
 Hearing loss - diabetes patients have a higher risk of developing
hearing problems
 Gastroparesis - the muscles of the stomach stop working
properly
 Stroke - if blood pressure, cholesterol levels, and blood
glucose levels are not controlled, the risk of stroke
increases significantly

33. WHAT CAN BE DONE FOR DİABETES
AT SCHOOL?

 Brochures and films should be prepared to
inform the students about diabets
 Students should be informed about the
importance of healthy eating and doing
exercises.

34.  School canteens shoul be controlled and warned
to sell healthy food and healthy drinks rather
than fast food and fizzy drinks.

35.  Students should be
informed about not
eating fast food
 Parents should be
informed about
healthy nutrition and
the importance of
home made food in
children's bag.

36.  Teachers should follow their students about their
health problems.If they have some symptoms
with any diseases ,they should contact with the
parents .
 They also should inform the students about the
importance of their health.