Diabetes a major public health problem
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Diabetes- A Major Public Health Problem
Dr. Nayyar Raza Kazmi
Diabetes mellitus is a chronic condition that characterised by raised plasma glucose levels.
Diabetes, results from the bodys inability to produce or use insulin properly, resulting in high levels of blood sugar.
- Type 2 diabetes is caused by a combination of insulin resistance and some degree of insulin deficiency. Type 1, the body produces no insulin. More than 80% of recognised diabetes is Type 2 and most of the remainder is Type 1.
- WHO defines Diabetes as Fasting Blood Glucose more than 126 mg/dL on one single occasion
ORRandom Blood Glucose of 200mg/dL or more on 2 and/or more occasions.
Magnitude of the ProblemThe number of people with diabetes will nearly double within the first quarter of this millennium.
World Health Report, 1997; Geneva: WHO.
WHO estimate: prevalence of diabetes for all age- groups worldwide was estimated to be 2.8% in 2000 and 4.4% in 2030.Estimated rise in number from 171 million in 2000 to 366 million in 2030. 150% rise in developing countries by 2030. Number of deaths attributed to diabetes was previously estimated at just over 800,000.
- Prevalence in Pakistan approx 4.2%Highest in Urban Mohajirs (5.7%, 9.7%)Punjabis (4.6%, 7.2%)Sindhis (5.1%, 4.8%)Pushtoons (3.0%, 3.8%)Baluchs (2.9%, 2.6%)
Why TypeII Diabetis Prevlance is IncreasingAging of the population.Increased incidence due to urbanization especially in the developing countries.
More sedentary lifestyle.
Food consumption patterns, more foods with high fat content and more refined carbohydrates.
The Cost of DiabetesDirect costs:
Direct costs to individuals and their families include medical care, drugs, insulin and other supplies
Direct costs to the healthcare sector include hospital services, physician services,
Overall, direct health care costs of diabetes range from 2.5% to 15% annual health care budgets, depending on local diabetes prevalence and the sophistication of the treatment available.
The Cost of DiabetesIndirect costs:
Sickness, absence, disability, premature retirement or premature mortality can cause loss of productivity.
Estimating the cost to society of this loss of productivity is not easy. Pain, anxiety, inconvenience and other factors which decrease quality of life are intangible costs, which are just as heavy.
Facts on Prevention Diabetes
The heavy social and economic costs
of type 2 diabetes
(including its role in other diseases,
such as heart disease
and stroke) mean that primary
prevention must be a priority.
Facts on Prevention of Diabetes
pre-diabetes can prevent the development of type 2 diabetes by making changes in their lifestyle.
Effective prevention also means more cost-effective healthcare.
Facts on Prevention of DiabetesPrimary prevention protects susceptible individuals from developing diabetes. It has an impact by reducing or delaying both the need for diabetes care and the need to treat diabetes complications.
Facts on Prevention of DiabetesSecondary prevention includes early detection, prevention and treatment. Appropriate action taken at the right time is beneficial in terms of quality of life, and is cost-effective, especially if it can prevent hospital admission
Primary preventionLifestyle Changes Can Prevent Diabetes
Weight Loss Is Accompanied by Considerable Lowering of the Risk of Diabetes Physical Activity and Diabetes PreventionSmoking Predisposes to Type 2 Diabetes
Taking Action to Prevent Diabetes
Change will come more easily if everyone is involved.
Major issues to considerPolicy and Advocacy at National levelCapacity BuildingResourcesMonitoring and EvaluationDiabetes registries and Information Systems
Weight Loss Is Accompanied by Considerable Lowering of the Risk of Diabetes1. Body-Mass Index: Obesity in adults is assessed using the body-mass index (BMI = body weight in kg divided by the square of body height in meters) The higher the body-mass index, the higher the morbidity and mortality risks become. The risk of diabetes increases 15-fold as the body-mass index rises from 23 kg/m2 to 35 kg/m2.
2. Waist CircumferenceThe body-mass index does not indicate the distribution of body fat, and waist circumference is therefore also used as a measure of obesity and the associated health risks.
Treatment of obesity will prevent illness development in individuals at risk and improve quality of life and prevent late complications in those already affected.
In recent years, attention has been increasingly focused on the incidence of central obesity which has been found to strongly predict risks of type 2 diabetes and metabolic syndrome.
Physical Activity and Diabetes PreventionPhysical activity decreases insulin resistance and can aid in both preventing type 2 diabetes mellitus and managing the disease.Physical activity has an insulin-like effect -- it can help lower blood sugar levels. Epidemiological studies suggest that physical activity can reduce the risk of non-insulin-dependent diabetes by up to 50 percent.
Smoking Predisposes to Type 2 DiabetesStudies shown correlation between smoking and the risk of developing type 2 diabetes.
The risk is dose-dependent: the longer you smoke, the higher the risk.
Change will come more easily if everyone is involved.prevention diabetes can be on different levels; individuals, community, local government and national levels.
RecommendationsThe government should work to reduce health inequality and improve the environment factor by improving the deprived areas and controlling safety and making the streets safe for walking or cycling to school or the workplace, promoting and improving access to sport and leisure facilities, as well as encouraging physical activity
- Parents of overweight children should be helped to take responsibility and encourage healthy eating and physical activity. Anti- smoking behaviour should be promoted by implementing legal action.