Diabetes increases the chances of. having a heart attack or stroke. Some people with diabetes notice: Going to the bathroom a lot …
Kansas Behavioral Health Risk Bulletin
Kansas Department of Health and Environment
November 7, 1995 Bureau of Chronic Disease and Health Promotion Vol 1 No 12
Diabetes Mellitus in Kansas
Diabetes mellitus DM is a chronic disease in which the body is incapable of adequately producing and/or using insulin, which is necessary to convert glucose sugar into energy More than 126,000 Kansans are estimated to have diabetes1 and it is the seventh leading cause of death in Kansas resulting in over 500 deaths annually2 and contributing to another 1000 deaths; yet, only half of all Kansans who have diabetes are aware of their condition1 Persons with diabetes are 25 times more likely to become blind, 15 times more likely to have a lower extremity amputated, 17 times more likely to develop kidney disease, and twice as likely to develop cardiovascular disease3 In addition, diabetes costs the Kansas economy 890 million each year due to medical care and lost productivity Figure 1 Insulin-dependent diabetes mellitus IDDM is usually diagnosed before the age of thirty A person with IDDM is able to produce little or no insulin This absence of insulin prevents glucose sugar from entering cells, were it
can be burned to produce energy, resulting in an excess of glucose in the blood hyperglycemia When no insulin is available, body fat is used to fuel the body, which causes an accumulation of a by-product called ketones Increased blood ketones cause a serious condition called ketoacidosis a chemical imbalance in which high acid concentrations are present in the blood and body tissues4 The treatment of ketoacidosis requires hospitalization If untreated, ketoacidosis can lead to coma and death The treatment of IDDM requires daily insulin injections or use of a insulin pump, in conjunction with a planned diet, regular exercise, and daily monitoring of blood glucose Diabetes pills are not effective in the treatment of IDDM Non-insulin-dependent diabetes mellitus NIDDM is usually diagnosed after the age of thirty; 80 to 85 percent of persons with diabetes have NIDDM and approximately 88 of persons with NIDDM are overweight4 Among persons with NIDDM there is often enough insulin, or even an excess of insulin; however, their bodies are unable to properly use insulin Non-insulin dependent diabetes mellitus is characterized by weight gain and obesity due to the increase in appetite and fat
storage caused by the resistance to insulin Obesity contributes to insulin resistance and may account for 1/2 of all NIDDM The treatment of NIDMM requires daily blood glucose monitoring, exercise, and diet In some cases, diabetes pills or insulin injections are required
Diabetes is diagnosed by identifying abnormally high levels of blood glucose, which occurs when either insulin action or production is impaired Diabetes has two major forms: insulin-dependent diabetes mellitus IDDM or type I diabetes, and non-insulin-dependent diabetes mellitus NIDDM or type II diabetes
Common symptoms of diabetes mellitus include constant hunger, frequent urination, weight loss, and excessive thirst Other symptoms of diabetes mellitus may be blurred vision, itching, and the slow healing of sores or cuts, especially on the feet In 1993, the Kansas Department of Health and Environment, Bureau of Chronic Disease and Health Promotion, conducted the Behavioral Risk Factor Surveillance System BRFSS survey to assess the prevalence of health behaviors among adult Kansans aged 18 and older through a random digit-dialed telephone interview Respondents were asked Have you ever been told by a doctor that you
have diabetes? Those who answered yes are considered to have diabetes, except for women who were only told they had diabetes during pregnancy This bulletin examines diabetes among Kansans, interventions to help prevent and control diabetes, and the Healthy Kansans 2000 objectives relating to diabetes Race: According to the 1993 BRFSS survey, 44 of adult Kansans have diabetes Native American, African-American, and Hispanic Kansans are at increased risk of developing diabetes Figure 2
Kansans aged 18 to 34 report having diabetes, but the prevalence of diabetes climbs to 14 among Kansans aged 65 and older Figure 3
Education Fig 3: The prevalence of diabetes decreases with higher levels of educational attainment The prevalence of diabetes is highest among Kansans with less than a high school diploma 10 and lowest among Kansans with some college or college degrees 3 Income Fig 4: Kansans with house 
hold incomes of less than 25,000 have a greater prevalence of diabetes 6 than Kansans with household incomes of 25,000 or greater 3 Figure 4
Age Group and Gender Fig 2: The prevalence of diabetes by gender is similar with 46 of men and 43 of women reporting that they have diabetes Among
female Kansans, women who have had gestational diabetes or a baby weighing at least 9 pounds at birth are at increased risk of developing diabetes later in life The prevalence of diabetes increases with advancing age Only 1 of
Kansas Behavioral Health Risk Bulletin OverweightA Fig 5: Kansans who have diabetes have a higher prevalence of being overweight 43 than Kansans who do not have diabetes 23 Figure 5
Page 3 1 Weight loss for persons who are overweight 2 Exercise regularly, at least 3 times a week for 20 minutes each time 3 Consume 30 or less of calories from fat and less than 10 of daily caloric intake should be from saturated fats, and dietary cholesterol should be limited to 300mg or less daily 4 Focus educational efforts towards populations Native Americans, African-Americans, Hispanics, women with babies over 9 lbs or who had gestational diabetes at known increased risk for diabetes and diabetic complications 5 Preventive screenings ie foot exams, dilated retinal eye exams, blood pressure to prevent diabetic complications 6 Pregnant women should be screened for gestational diabetes between the 24th to 28th week of pregnancy 7 Improve the understanding and self-care of
diabetes among Kansans with diabetes 8 Improve diabetes care aimed at preventing complications that is offered by health care providers Healthy Kansans 2000 Objectives Table 1: There are no direct Healthy Kansans 2000 objectives for diabetes, however, diabetes-related objectives are: 1 To decrease to 20 the proportion of Kansans who are overweight 2 To increase to 40 the proportion of Kansans aged 18 and older who regularly engage in light to heavy physical activity 3 To decrease to 15 the proportion of Kansans aged 18 and older who engage in no leisure time physical activity 4 Increase to 40 the proportion of persons whose dietary fat intake constitutes less than 30 of their caloric intake
High Blood Pressure Fig 5: Kansans with diabetes have a higher proportion of persons with high blood pressure 41 than Kansans who do not have diabetes 23 Physical Activity: Kansans with diabetes are more likely to not participate in any form of leisure time physical activity 50 than Kansans who do not have diabetes 37 Conclusions: According to the information obtained from the 1993 BRFSS survey the following groups are at increased risk of developing diabetes: African-American, Hispanic, and
Native American Kansans Kansans aged 65 and older Kansans with less than a high school diploma Kansans with household incomes below 25,000 Recommendations: The following recommendations are offered to help prevent and control diabetes and the complications caused by diabetes:
A Based on body mass index BMI BMI is calculated by taking a persons weight in kilograms and dividing it by their height in meters squared kg/m2 a BMI equal to or greater than 278 and females with a BMI equal to or greater than 273 are considered overweight
Males with
Kansas Behavioral Health Risk Bulletin
References: 1 Public Health Service Diabetes in the United States: A Strategy for Prevention Washington, DC: US Dept of Health Human Services; 1994 2 KDHE, Vital Statistics 3 Perspectives in Health Promotion and Aging National Eldercare Institute on Health Promotion, AARP; 1992 Vol 7 No 2 4 Guthrie DW, Guthrie RA The Diabetes Sourcebook Los Angeles, CA: Lowell House, 1992
Page 4 Table 1: Diabetes-Related Objectives
For additional information contact: BRFSS Program Coordinator Kansas Department of Health and Environment Bureau of Chronic Disease and Health Promotion Landon State Office Building 900
SW Jackson Suite 901N Topeka, KS 66612-1290 913 296-8918
Kansas Department of Health and Environment Bureau of Chronic Disease and Health Promotion Landon State Office Building 900 SW Jackson Suite 901N Topeka, KS 66612-1290
Kansas Behavioral Health Risk Bulletin
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A Based on body mass index BMI BMI is calculated by taking a persons weight in kilograms and dividing it by their height in meters squared kg/m2 a BMI equal to or greater than 278 and females with a BMI equal to or greater than 273 are considered overweight
Males with
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