Patient Services Diabetes and Heart Disease
Diabetes Mellitus (DM) is a worldwide epidemic. Its prevalence is rapidly increasing in both developing and developed countries. The number of Americans with DM is projected to increase 165% from 11 million people in 2000 to 20 million people in 2025. Coronary heart disease (CHD) is highly prevalent and is the major cause of morbidlity and mortality in diabetic patients. The prevalence of CHD rises from 2% to 4% in the general population to as high as 55% among adult diabetic patients. Diabetes mellitus is an independent risk factor for Cardiovasucular disease (CVD) in both men and women. Cardiovascular disease represents over one-half of all deaths in both type 1 and type 2 DM. Excess risk for CVD can be found in patients with type 1 and type 2 DM, in patients in the prediabetic stages, and in patients with obesity and with the metabolic syndrome. The metabolic syndrome is a common metabolic disorder that is characterized by increases in waist circumference, blood pressure and triglyeride levels combined with a reduction in high-density lipoprotein cholesterol (HDL-C) levels and evidence of glucose intolerance.
Patients with CHD and prediabetic states should undergo lifestyle modifications aimed at preventing DM. Type 2 DM is a multifactorial disease that combines hereditary and environmental factors. There are two major metabolic abnormalities that define DM: decreased insulin secretion by the pancreatic beta cells and peripheral resistance to the action of insulin or insulin resistance. Insulin resistance results from environmental factors such as detrimental lifestyle habits, with progresssive reduction of physical activity and energy expenditures and increased input of dietary calories, fats, and saturated fatty acids as well from genetic or congenital abnormalities. Eighty percent of patients with type 2 DM are either obese or overweight.
Many studies have shown that type 2DM is preventable by at least two types of interventions; lifestyle modification by dietary measures and physical exercise aiming at weight loss. Nutritional therapy coordinated by dieticians has had an important role in the lifestyle intervention and individualized therapy is highly recommended in type 2 DM.
The Outpatient Diabetes Program is an important first step toward better diabetes management. Those who are newly diagnosed, or whose diabetes is poorly controlled, receive personalized assistance from a nurse practitioner and a dietician who are certified diabetes educators.
Diabetes is a chronic disorder that requires a lifetime of self-management. Learning all you can about diabetes and following a prescribed regimen can have a significant, positive impact on your long-term health.
The Outpatient Diabetic Program is currently every other week for eight consecutive weeks. Time and availability varies due to enrollment.