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2004 HSTA Summer Institute Inquiry Experience: |
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Audience: Teachers and Students
Faculty: Irma Ullrich M.D., Dan Bonner M.S., Guyton Hornsby PhD.
-Participants will understand how common diabetes is in the WV, the USA, and the world;
-They will be able to distinguish among the types of diabetes, and factors which predispose individuals to develop diabetes,
-The various methods of treatment, including lifestyle and insulin pump therapy, will be discussed.
- Obesity and a sedentary lifestyle and the medical complications will be reviewed.
-Participants will learn the significance of exercise testing and how to do it.
-They will be able to assess a person’s degree of obesity.
Content:
Diabetes affects some 15million persons in the US and is increasing annually. West Virginia has one of the highest national rates of diabetes, and diabetics in WV appear to have more frequent and more severe complications. Type 1 diabetes is more common in children, but can occur at any age. It is due to an absolute deficiency of insulin which is due to destruction of the pancreatic islets. This is most likely due to some kind of infection. On the other hand, Type 2 disease is believed to be due in large part to lifestyle factors. It requires the presence of two abnormalities to develop: insulin resistance and relative or absolute insulin deficiency. Obesity and inactivity contribute greatly to increased diabetes incidence due to impaired insulin action--insulin resistance.
Those with diabetes have a decreased life span. The presence of abnormal glucose regulation results, or is accompanied by increased vascular disease which causes heart disease, stroke and impaired circulation to the legs which may result in amputation. Complications which are believed to be due primarily to high blood sugars are: eye disease (which is the leading cause of blindness in US adults), kidney disease (which may result in kidney failure and require dialysis) and nerve malfunction which may cause severe pain and numbness in the feet.
The treatment of diabetes is directed toward 1) normalizing the blood sugar, 2)achieving a blood pressure of 120/80 or less and 3) correcting abnormal blood fats—cholesterol, triglycerides.
High blood sugars may be improved by dietary modifications—to promote weight loss in those overweight, or to manipulate carbohydrate type and content in those of normal weight. Exercise functions much as insulin in that it lowers blood sugar by increasing its utilization by muscles. Medications may be required and are directed toward increasing insulin effectiveness or secretion. As diabetes duration increases, the pancreatic stores of insulin become depleted; insulin is then required to treat hyperglycemia. Insulin must be given by injection; usually optimum treatment requires multiple daily doses of insulin or use of an insulin pump. Those with diabetes must participate in their therapy by doing daily assessment of their blood sugar level by pricking their finger or arm and measuring the sugar with a small portable device.
Hypertension (elevated blood pressure) is sometimes improved to normal levels by restriction of dietary salt-whether added to food in cooking or already incorporated (snack foods, convenience foods, fast food). Chronic exercise also improves blood pressure levels. If medication is necessary, specific agents, ACE-inhibitors and ARB’s are the best choice.
Abnormal blood fats are especially important in promoting or worsening vascular disease. Dietary therapy, low fat and low cholesterol diets are effective as a single therapy, or improve the effects of drugs. Statins are drugs which inhibit the production of cholesterol is the liver and are very effective drugs. Other classes of drugs may also be necessary. Exercise increases the “good” cholesterol (HDL) and should also be prescribed; it also increases the sense of well-being.
Obesity is an epidemic. Obesity has increased greatly in all ethnic groups, both genders, and all ages. The medical and social problems related to it are costly in dollars and lack of contentment. Many factors contribute to obesity, and abnormal regulation of eating behavior has been linked to hormones (leptin) as well as social factors (entertainment). In many obese persons, the lack of physical activity is also important in promoting and maintaining obesity. Several medications are available, and surgery is a final option when others have not been successful. The National Weight Registry has emphasized the importance of both diet and exercise in those who have lost (and maintained) at least 30 pounds for at least one year.
Handouts will be given at the time of the sessions
Procedures:
Learning will occur in a small group session, led by the faculty with group participation. Demonstrations of physical activity and fatness measures will be done in the Human Performance Lab with students, teacher and faculty participation.
Possible surveys of families (of students, or volunteers) to note pattern of diabetes occurrence and its relationship to exercise and obesity. Devise methods to increase measurable physical activity in those at risk (pedometers, DDR?).
Developed on June 26, 04 by Sohail Khan