Diabetes diagnosed. 70 110 normal blood sugar. levels (fasting) A history of gestational diabetes or having. delivered a baby weighing over 9 pounds …
Smoking Diabetes: The Double Edge Sword
Introductions Glenda Lumpmouth
Tobacco Training Specialist Inter Tribal Council of Arizona, Inc
Objectives
1 List the top 3 chemicals in cigarette smoke 2 Describe 4 risk factors associated with diabetes 3 Explain 2 ways of how smoking causes diabetes complications
What is diabetes
Food is changed into sugar in the stomach The stomach dumps sugar glucose into the blood stream Increasing blood sugar, triggers the pancreas to produce insulin
Insulin helps to bring blood sugar into all cells to use for energy If this process does not take place then we get signs symptoms of having high blood sugar levels Diabetes diagnosed
70 110 normal blood sugar levels fasting 120 considered diabetes fasting
What is diabetes
It is a condition in which the level of glucose in the blood called blood sugar is too high Normally, the body gets energy it needs from blood sugar, which comes from food Having diabetes means the body is not able to use blood sugar properly
HbA1C test
HbA1C is the most accurate measurement of blood glucose levels It tests the amount of sugar attached to the cell over the last 3 months
Types of Diabetes Type 1:
The
pancreas makes little or no insulin Insulin acts like a key to help cells use blood sugar People with type 1 diabetes need daily insulin shots to live
Type 2 The pancreas makes some insulin, but either it is not enough or the cells do not use it correctly Insulin shots are not required to live Can be controlled with a proper diet, exercise and medicine
Causes of Diabetes No one is sure what causes diabetes Research has shown the risk of diabetes may be higher for some people
Risk factors:
A history of diabetes in the family Being overweight and inactive Being over the age of 30 Being of African, Hispanic, or Native American heritage A history of gestational diabetes or having delivered a baby weighing over 9 pounds
Age and Diabetes
People of any age can get type 1 or type 2 diabetes
Signs of high blood sugar
Frequent urination Increased thirst Extreme tiredness Weight loss in spite of increased appetite Blurred vision Slow healing infections or wounds Pain, numbness or tingling in the feet Stomach pain
Signs of diabetes
Symptoms can appear suddenly or overtime Its unlikely that anyone would have all these symptoms
Signs of diabetes
It is possible to have type 2
diabetes without early symptoms
Now lets talk tobacco
Two Types of Tobacco Traditional Commercial Todays discussion
Commercial Verses Traditional
Time Over 4,000 chemicals Bad breath Addiction Cancer Cost Over 400,000 people die each year from commercial tobacco Tradition Offerings Blessing American Indians Cleanse Culture Ones well being
Commercial tobacco
Commercial tobacco has been altered with additives, chemicals and manufactured to be sold to the public
American Indians/Alaska Natives
Nationally, we have the highest prevalence of smoking among racial/ethnic groups 404 Varies widely by region and state
Alaska 451 North Plains 442 Southwest 17
1/2003 MMWR
Cigarette smoke contains
More than 4,000 chemicals And 40 to 43 chemicals are known to cause cancer
Secondhand Smoke Carcinogen
Carcinogens are substances that have been proven to cause cancer in human beings, such as asbestos
The cigarette smoke has been declared a Group A carcinogen by the US Environmental Protection Agency
US Environmental Protection Agency Group A
Human Carcinogen Sufficient evidence Cigarette smoke Secondhand smoke Probable evidence Possible evidence Not
classifiable
Group B1
Group C
Group D
Group E
No evidence
Noncarcinogenic Drinking water
Secondhand Smoke proven to cause cancer in humans
Key point:
There is NO safe level of exposure in humans to Group A carcinogens
What is in cigarette smoke?
See tobacco quiz
Some of the chemicals found in cigarette smoke: Butane Lighter fluid Carbon monoxide Car exhaust fumes Cadmium rechargeable batteries
Some of the chemicals found in cigarette smoke:
Acetone Nail polish remover Ammonia Floor/toilet cleaner
And the list goes onWhats in cigarette smoke?
Insecticide residues Urethane Isoprenoids Naphthalenes Alkanes Nicotine Nitrogen oxides Nitrosamines Phenols Acetaldehyde Nickel Acrolein Alkenes 2-nitropropane Aromatic amines Aza-arenes Polonium-210 Carboxylic acids Hydrazine
Why are certain chemicals added into cigarettes? Ammonia helps to increase nicotine absorption in the body Polonium-210
helps to keep the cigarette lit
Why are certain chemicals added into cigarettes?
Butane lighter fuel Allows cigarette to burn easier Tar
Tar provides most of the flavor of the cigarette Less tar, less flavor
What are the top 3 chemicals in cigarette smoke?
Top 3
chemicals in cigarette smoke
1 Carbon Monoxide 2 Tar 3 Nicotine
Carbon Monoxide
It is a colorless, odorless, a highly poisonous gas
When absorbed in the blood it can: Increase headaches Causes shortness of breath Reduces the amount of oxygen blood can carry
Tar in cigarette smoke
Causes irritation and reduces elasticity in the lungs alveoli air sacs As a result, lungs lose ability to transfer oxygen to the bloodstream a condition called emphysema
Nicotine
Is a highly toxic chemical, often used as a pesticide It increases the heart rate and blood pressure and respiration
It constricts the small blood vessels, impairing blood circulation
Comparison of Tar Nicot 
ine
Brands
Natural American Spirit Regular Filter Marlboro
Tar
184 mg 16 mg
Nicotine
187mg 16 mg
Per Cigarette by Federal Trade Commission Method
Comparison of Tar Nicotine
Brands
Natural American Spirit Menthol Filter Kool
Per Cigarette by FTC Method
Tar
19 mg 16 mg
Nicotine
16 mg 11 mg
Health risks from spit/chew tobacco Gingivitis Lekoplakia pre-cancer in the mouth Ulcers Bad breath Tooth loss Stomach cancer
Tartar Formation
Gum Recession
Actual Causes of Death,United States, 1990
Percentage
of all deaths
450,000 400,000 350,000 300,000 250,000 200,000 150,000 100,000 50,000 0
Aids
Alcohol
Motor Vehicle
Fires
Homicide
Illicit Drugs
e Suicide
Tobacco Use
Can you tell who the smoker is?
Premature aging of skin
Diabetes and Tobacco
The Double Edge Sword
Name one of the poisons in cigarette smoke that replaces the oxygen in blood?
Answer is: Carbon monoxide
Carbon monoxide replaces oxygen in the blood, but instead of nourishing tissues, it poisons them
When someone smokes
The cigarette produces carbon monoxide 1 And it reduces the flow of red blood cells 2 Which also decreases the oxygen getting to all the tissues that need it Resulting in: Poor resistance to infection Slow wound healing
Tobacco thickens the blood
This allows clots to form inside blood vessels Blood clots can cause heart attacks strokes
A diabetic who smokes has 3 Xs more of a chance to get a heart attack than a diabetic 3 who does not smoke 25
2 15 1 05 0 Smoker Non-Smoker
Tobacco causes deposits to build up inside blood vessels
Hardening of the arteries slows down blood flow to tissues that need it
Diabetes damages blood vessels
Diabetes can cause blood flow problems to vital organs
in the body, such as:
The brain Eyes Heart Kidneys
Smoking also decreases blood flow:
95 of all lower limb feet, toes legs amputations in diabetics are due to tobacco use
Blood vessels
A single cigarette can reduce blood supply to the toes by 40 Many diabetics dont have 40 to spare
Blood vessels
A reduction in blood flow in the eyes is called retinopathy, it causes blindness
High blood pressure
Diabetics are prone to it already Smoking makes it harder to control blood pressure and pulse High blood pressure increases the chances for developing kidney damage
Name another chemical in cigarette smoke that constricts the blood vessels, impairing blood circulation?
Answer is: Nicotine
It speeds up the heart rate It constricts the blood vessels
Smoking and chewing makes it harder to control high blood sugar levels
Blood sugar
Overtime, having high blood sugar levels ruins the elasticity of blood vessels ex A rubber band over stretched
Smoking contributes to poor blood glucose control by interfering with the timing and effects of insulin
Did you know
Infertility Smoking can cause Infertility Diabetics have a hard time getting pregnant Impotence Diabetic men cant
get or keep an erection smoking makes it worse
Osteoporosis: Thinning of the bones
Diabetics are prone to bone loss, especially in the feet Smoking affects the production of bone cells Smokers have lower levels of calcium needed for strong bones Bones loss can cause: ex Back pain
You can stay healthy with diabetes
Eat healthy foods Exercise regularly Test blood sugar levels every day Take diabetes medicines at same times every day
Remember to:
Brush and floss your teeth and gums every day For diabetics, get a dental cleaning 3 Xs a year Every 4 months Quit smoking Pick a date to quit Avoid places filled with cigarette smoke
Check your feet every day for
Blisters Sores Cuts or cracks Ingrown toenails Changes in skin color Swelling
Key Point to Remember:
If you know a person whos mom, dad, brother or sister that have diabetes then tell that person they should get screened checked every year for diabetes
Resources
American Dietetic Association http://wwweatrightorg http://wwwdiabetesorg
Resources
Arizona Department of Health Services Tobacco Education and Prevention Program http://wwwtepporg Arizona Smokers Helpline 1-800-55-66-222 wwwashlineorg
References
National
Institute of Diabetes Digestive Kidney Diseases http://wwwniddknihgov United Tobacco Free Coalition, Serving Billings and Yellowstone County, Fact Sheet on Tobacco and Diabetes http://wwwtobaccofreemontanaorg/factshtm
A thought to remember
In commercial tobacco, cigarette smoke steals breath In diabetes, cigarette smoke steals limbs
For more information contact
Glenda Lumpmouth, Tobacco Training Specialist Community Tobacco Program Inter Tribal Council of Arizona, Inc 2214 North Central Avenue, Suite 100 Phoenix, AZ 85004 602-258-4822
wwwitcaonlinecom glendalumpmouth@itcaonlinecom
Quiz Qs
1 Which of the following is a sugar: lactose, sucrose, molasses a all of above b none of above 2 What factor puts people at greatest risk of developing type 2 diabetes? Being overweight, high stress, high blood pressure or smoking
Quiz Qs
3 Gestational diabetes sometimes forms during pregnancy and usually ends when the child is born True or False 4 Name three chemicals in cigarette smoke 1 T___ 2 C 3 N 4 A
Quiz Qs
5 What is the __ of all lower limb feet, toes legs amputations in diabetics due to tobacco use a 85 b 90 c 95
Last question
6 A diabetic who smokes has Xs
more of a chance to
get a heart attack than a diabetic who does not smoke a 1 b 2 c 3
Source:mdh.org
