Contribution of urban life style for causation of diabetes mellitus

Definition.

Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced.

The current WHO diagnostic criteria for diabetes– fasting plasma glucose ≥ 7.0mmol/l (126mg/dl) or 2–h plasma glucose ≥ 11.1mmol/l (200mg/dl).

Why it should be controlled ? Diabetes kills 3.8 millions persons yearly, which is

higher than HIV Aids. Every 10 seconds a person dies due to diabetes-

related causes There is a reduction of life expectancy of 5-10 years 50% of persons with diabetes die of cardio

vascular disease, heart and strokes. Diabetes in the developed world is ranked as the

leading cause of blindness, renal failure and lower limb amputations.

It has been estimated that between 5-10% of the total healthcare spending of the world is spent on diabetes related conditions.

Urban life style

Earlier people used to walk from one place to another to buy all the stuff they want. But nowadays all things can be purchased at one stop; the supermarket.

Consuming high sugar diets. Lack of unintentional physical exercises; earlier people

used to grind flour , and do various kitchen chores using manual ways. But nowadays urban people are using various machines for theses things.

Stressful life style. Consuming highly processed foods with low fibers such as

instant foods. Entertainment gained through passive ways.Eg: watching TV ,browsing facebook; doing these activities for

longer hours Not eating fresh fruits and vegetables.

The cause and effect

Urban life style

Sedentary jobs &

fast foods

ObesityInsulin

resistance

Diabetes mellitus :

type 2

Facts speak….

Causes.......

Sedentary urban life styles combined with easy availability of overly processed food items have made people give up the normal exercise that ,the body gets from hard physical work.

The consumption of highly processed and artificially flavored food items all through the day has overwhelmed the human body with a flood of carbohydrates .

the consequent overdose of insulin, to which the body develops a resistance, by turning off its insulin receptors, as a continuous overdose of insulin is toxic to the body.

Manifestation of type 2 DM Obesity increased adipocyte mass

increased levels of free fatty acids and increased production of adipokines free fatty acids impair glucose utilization in skeletal muscle, promote glucose production by the liver, and impair beta cell function The increased production of free fatty acids and some adipokines may cause insulin resistance in skeletal muscle and liver.

Therefore this combination of poor physical exercise and faulty eating habits leading to insulin resistance has led to what is called Type-2 diabetes which is spreading very fast among urban dwellers all over the world.

Prevalence all over the world

Urbanization is associated with a drastic decrease in physical activity, changes in dietary habits, and additional psychological stress.

The local situation

A Cross –sectional study conducted between 2005 and 2006.

Standardized  prevalence  for Sri Lankans aged ≥20 years – 10.3%

Prevalence in the urban population was 16.4%

Prevalence in the rural population  was 8.7% Prevalence of pre-diabetes in urban and

rural population was 11.5%  Overall prevalence of some form of

dysglycaemia (sugar problems) was 21.8% Ceylon Medical Journal

Situation in our country

Children die before their parents..

Recently, type 2 diabetes has increasingly been reported in children and adolescents, so much so that in some parts of the world type 2 diabetes has become the main type of diabetes in children. The global rise of childhood obesity and physical inactivity is widely speculated to play a crucial role. Healthy eating and lifestyle habits are a strong defense against the disease.

Type 2 diabetes (sometimes called non-insulin-dependent or adult-onset diabetes) happens when the body cannot effectively use the insulin it produces. Often preventable, it can result from excess body weight and physical inactivity, and sometimes, a genetic predisposition.

Genetic factors

Environmental factors

Type 2 DM has a strong genetic component.

The disease is polygenic and multifactorial since in addition to genetic susceptibility, environmental factors (such as obesity, nutrition, and physical activity) modulate the phenotype.

why not ?

Can I escape my fate

Genetic predispositio

n

Environmental factors

What should I do ?

The major lifestyle alterations usually advised in persons with diabetes are:

Relief of stress by relaxation exercises or yoga Increased physical activity Stop smoking and tobacco consumption in any form Stop alcohol consumption or limiting it to small quantities Eating at regular intervals, and in proper quantities and

composition that ensures a balanced intake of all nutrients

Drastically reduce intake of saturated fats and simple sugars

Weight reduction if you are overweight

Adopting a healthy diet and increasing physical activity can prevent the development of Type 2 Diabetes up to 80%.

Thank you !!!

Acknowledgement

LIG

Group memebers

N.D. Masakorala O.G.W. Muthukumarana K.R.D.O. Nadeera K.K.M. Nethmini