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Prevention Of Diabetes Mellitus Ppt

Type Ii Diabetes

Type Ii Diabetes

Type II Diabetes The Roles of Race, Culture, Genetics, Environment, and Behavior Arleen Brown, MD, PhD Overview Type II diabetes mellitus (T2DM) Definition / Diagnosis Risk factors for T2DM Race/ethnicity, culture, and other demographic characteristics Behavior Environment Genetics Measurable Objectives* List the diagnostic criteria for T2DM Take a family history to understand a patient’s risk of type 2 diabetes mellitus (T2DM) Be able to explain how the following factors contribute to diabetes risk, prevention, management, and outcomes: Race/ethnicity Environment Behavior Genetic factors Use T2DM as a template for other chronic conditions * i.e., what you will be tested on Case 45 year old Latino man with hypertension, hyperlipidemia who presents to clinic with concerns about developing diabetes. He is worried because there are several members of his immediate family, including his mother, who have diabetes. His mother has been struggling with the complications of diabetes and was recently started on dialysis for end-stage renal disease. The patient would like to know if he will also develop diabetes. Additional clinical data: His waist circumference is 35†and his BMI is 27. Introduction Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from insulin resistance and/or impaired insulin secretion Complications include neuropathy, nephropathy, vascular disease, and retinopathy Classic Symptoms “Polys†– Polyuria, Polydipsia, Polyphagia Unexplained weight loss How is Diabetes Mellitus Diagnosed? Fasting plasma glucose (FPG) >126 mg/dl (7.0 mmol/l) Fasting ==> No caloric intake for at least 8 hours. Random plasma glucose >200 mg/dl (11.1 mmol/l) with classic symptoms of hyperglycemia 2-h plasma glucose >200mg/dl ( Continue reading >>

Diabetes Mellitus: Epidemiology & Prevention

Diabetes Mellitus: Epidemiology & Prevention

1. 1 2. Diabetes: Dr. S. A. Rizwan, M.D., Assistant Professor, Dept. of Community Medicine, VMCHRI, Madurai 3. At the end of this lecture you should be able to  Describe the burden of diabetes at the global and regional level  Describe the epidemiological features of diabetes  Discuss the trends in diabetes prevalence over the years  List out the strategies needed for prevention of diabetes  Appraise the diabetes scenario in India 3 5. 6 IDF Diabetes Atlas, 2015 6. Type 1 DM Type 2 DM Gestational Diabetes LADA (latent autoimmune diabetes in adults) MODY (maturity-onset diabetes of youth) Secondary DM 7 IDF Diabetes Atlas, 2015 7.  Type 2 diabetes and cardiovascular share a common antecedent.  The concept The Metabolic Syndrome  Clustering of central obesity with several other major cardiovascular disease risk factors 8 8. 9 American Diabetic Association 9. 10 Fasting Plasma Glucose Post Prandial Plasma Glucose 100 200 100 200 126110 140 Normal Impaired Fasting Glucose Impaired Glucose Tolerance Diabetes Mellitus OR 18. The Lancet 2011 378, 31-40DOI: (10.1016/S0140-6736(11)60679-X) 20 21. Indian J Med Res 125, March 2007, pp 217-230 24 22. Indian J Med Res 125, March 2007, pp 217-230 25 26. 30 Overweight and obesity Physical inactivity High-fat and low-fiber diet Ethnicity Family history Age Low birth weight Urbanisation 27. 31  Non Modifiable  Genetic factors  Age  Ethnicity  Modifiable  Obesity and physical inactivity  Metabolic factors: IGT, IFG and GDM 28. Host factors  Age  Sex  Genetic factors: HLA DR3 and DR4  Defective immune response  Central Obesity Environmental factors  Sedentary life style  High saturated fat intake  Malnutrition- failure of β cells  Excessive alcohol  Viral infec Continue reading >>

Primary, Secondary And Tertiary Prevention Of Non-insulin-dependent Diabetes.

Primary, Secondary And Tertiary Prevention Of Non-insulin-dependent Diabetes.

Primary, secondary and tertiary prevention of non-insulin-dependent diabetes. See letter " Microalbuminuria, cardiovascular risk factors, and secondary prevention of non-insulin-dependent diabetes. " in volume 71 onpage58. This article has been cited by other articles in PMC. Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.1M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References . These references are in PubMed. This may not be the complete list of references from this article. Grenfell A, Bewick M, Parsons V, Snowden S, Taube D, Watkins PJ. Non-insulin-dependent diabetes and renal replacement therapy. Diabet Med. 1988 Mar;5(2):172176. [ PubMed ] Bild DE, Selby JV, Sinnock P, Browner WS, Braveman P, Showstack JA. Lower-extremity amputation in people with diabetes. Epidemiology and prevention. Diabetes Care. 1989 Jan;12(1):2431. [ PubMed ] Tunbridge WM. Factors contributing to deaths of diabetics under fifty years of age. On behalf of the Medical Services Study Group and British Diabetic Association. Lancet. 1981 Sep 12;2(8246):569572. [ PubMed ] Leslie PJ, Patrick AW, Hepburn DA, Scougal IJ, Frier BM. Hospital in-patient statistics underestimate the morbidity associated with diabetes mellitus. Diabet Med. 1992 May;9(4):379385. [ PubMed ] Wong JS, Pearson DW, Murchison LE, Williams MJ, Narayan V. Mortality in diabetes mellitus: experience of a geographically defined population. Diabet Med. 1991 Feb-Mar;8(2):135139. [ PubMed ] Panzram G. Mortality and survival in type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia. 1987 Mar;30(3):123131. [ PubMed ] Gerard K, Donaldson C, Maynard AK. The cost of diabetes. Diabet Med. 1 Continue reading >>

Overview

Overview

The importance of both diabetes and these comorbidities will continue to increase as the population ages. Therapies that have proven to reduce microvascular and macrovascular complications will need to be assessed in light of the newly identified comorbidities. Lifestyle change has been proven effective in preventing or delaying the onset of type 2 diabetes in high-risk individuals. Based on this, new public health approaches are emerging that may deserve monitoring at the national level. For example, the Diabetes Prevention Program research trial demonstrated that lifestyle intervention had its greatest impact in older adults and was effective in all racial and ethnic groups. Translational studies of this work have also shown that delivery of the lifestyle intervention in group settings at the community level are also effective at reducing type 2 diabetes risk. The National Diabetes Prevention Program has now been established to implement the lifestyle intervention nationwide. Another emerging issue is the effect on public health of new laboratory based criteria, such as introducing the use of A1c for diagnosis of type 2 diabetes or for recognizing high risk for type 2 diabetes. These changes may impact the number of individuals with undiagnosed diabetes and facilitate the introduction of type 2 diabetes prevention at a public health level. Several studies have suggested that process indicators such as foot exams, eye exams, and measurement of A1c may not be sensitive enough to capture all aspects of quality of care that ultimately result in reduced morbidity. New diabetes quality-of-care indicators are currently under development and may help determine whether appropriate, timely, evidence-based care is linked to risk factor reduction. In addition, the scientific evid Continue reading >>

Dr. Sandhya Raghavan

Dr. Sandhya Raghavan

2 3 4 5 It was predicted by the scientists in 1990 that the number of diabetics will reach 100 million worldwide by 2013, but the actual number now is 382 million. 65.1 million Indians are diabetic & about 78 million are in pre-diabetes stage. There may be many more undetected. The number predicted for 2030 is 123 million. 6 7 As per JNC 8 on hypertension, there are more than 1 billion hypertensive globally. Indian number is 140 million & predicted number for 2030 is 214 million. 33% males & 32% females above the age of 25years are hypertensive. Many more are in pre-hypertensive stage. Rule of half: 8 Prevention of Diseases Primary prevention: Health promotion & specific protection. Secondary prevention: Early diagnosis & prompt treatment. Tertiary prevention: Disability prevention & Rehabilitation. Primordial Prevention- Relatively new concept. Prevention of development of risk factors themselves. It is very important to change the environment that promotes major risk factor development. 9 10 Diabetes & hypertension are the biggest health problem & pandemic in human history. Diabetes & hypertension is the deadly combination to have. Let us see what are the common features Both diabetes & hypertension are silent killers. Causation for both is not definitely known. Genetic & environmental factors have a lot of influence. Common Risk factors 11 12 Both have common complications: Cardiovascular & cerebrovascular complications like myocardial infarction & stroke. Nephropathy- leading cause of end stage renal disease globally. Neuropathy- peripheral & autonomic. Retinopathy- most common cause of preventable blindness worldwide. For control of hypertension, sugar must be under control & vice versa. Both the diseases & their complications are preventable by easy measures. 14 M Continue reading >>

Prevention And Control Of Diabetes And Obesity |authorstream

Prevention And Control Of Diabetes And Obesity |authorstream

Prevention and Control of Diabetes and Obesity Automatically changes to Flash or non-Flash embed The presentation is successfully added In Your Favorites . This Presentation is Public Favorites: Prevention and Control of Diabetes and Obesity : Prevention and Control of Diabetes and Obesity By Ragini.R Graph showing Age wise incidence of IDDM Why Prevention : Type 2 diabetes is one of the fastest growing diseases in the world.Diabetes has enormous human and financial costs A leading cause of heart disease, blindness, kidney failure, and amputations Prediction : Prediction Ability to predict and prevent type 2 diabetes in the general population is limited. However, we can identify high risk groups of people such as: Close relatives with diabetes. Obesity and body fat distribution. Age and certain ethnic groups. Physical inactivity. Previous gestational diabetes. Elevated fasting glucose. Impaired glucose tolerance. Family History and Risk of NIDDM : In the U.S. Positive family history imparts 2.7 fold risk of NIDDM after adjustment of other factors (Cowie, 1993). Risk of NIDDM among Caucasians was 1.8 fold higher with one family member, 3.8 fold higher with two or more family members compared to persons with no known family history of NIDDM. Low Birth Weight : There is an apparent inverse relationship between birth weight and risk of type 2 diabetes. low birth weights babies have reduced beta cell function as adults, insulin resistance, and an increased incidence of type 2 diabetes. Impaired Glucose Tolerance {IGT}? : Impaired Glucose Tolerance? Risk factor for type 2 diabetes Increases risk of type 2 diabetes 5 - 8 fold 1- 9% per year develop type 2 diabetes Major risk factor for heart disease. IGT may be the best time to intervene. Gestational Diabetes Mellitus[GDM]: G Continue reading >>

Sheet2

Sheet2

Epidemiology and Prevention of Type 2 Diabetes Edward Gregg, PhD Epidemiology and Statistics Branch Division of Diabetes Translation Centers for Disease Control and Prevention Atlanta, GA Prevalence of Total Diabetes (Diagnosed Diabetes and Undiagnosed Diabetes) in the U.S. Adult Population, Age ≥ 20, 2005-2006 According to Alternative Definitions of Undiagnosed Diabetes 21.5 million 27.0 million 19.7 million 22.4 million (> 126 mg/dl) (> 6.5%) (>126 mg/dl OR > 6.5%) (>126 mg/dl OR 2hPG > 200) Sources: Cowie et al., Diab Care, 2009; unpublished analyses, Bullard et al.; NIDDK, CDC Factors Influencing Future Incidence and Prevalence Estimates Prevalence in year 2010 (number and proportion of adults with diagnosed and undiagnosed diabetes, pre-diabetes). Incidence (Rate of new cases into the future). Mortality rates Age distribution of the population. Census projection of population growth. Migration Factors Causally Associated with Increased Diabetes Incidence in Individuals Modifiable and Prime Targets for Individual-Level Interventions Factors Explaining Population Trends in the Disease Types of Risk Factors Structured, multi-disciplinary lifestyle Metformin and other drugs Nutrition / education referral Brief Counseling Food policy incentives and restrictions; Crop subsidy policies Incentives / restrictions related to built environment Youth-targeted obesity prevention * Migration Studies: Association Between Westernization and Diabetes Prevalence in Susceptible Populations King, Diabetes Care, 1993; 1998; Diamond J, Nature, 2003 Indian Australian Aborigines Chinese Nauru New Guinea * Esas fueron lost estimaciones en los E. U. Pero hay evidencia de niveles altos en varios regiones del mundo, por ejemplo en las islas de pacifico del sur, India, la media oriente, Continue reading >>

Rebecca Pratt Gregory, Ms, Rd, Cde And Kerri Cavanaugh, Md, Mhs

Rebecca Pratt Gregory, Ms, Rd, Cde And Kerri Cavanaugh, Md, Mhs

Rebecca Pratt Gregory, MS, RD, CDE and Kerri Cavanaugh, MD, MHS Addressing The Role of Nutrition Education and Health Literacy in Diabetes Care * Learning Objectives Review of impact of CDEs and medical nutrition therapy (MNT) on diabetes outcomes Review health literacy & numeracy in diabetes self-care Describe design of new randomized controlled trial to: Examine the value of CDE in diabetes care Examine the role of different approaches to MNT Learn about study results, interpretation and applications to clinical practice * Role of CDEs in Medical Nutrition Therapy in Diabetes Care Diabetes self-management education (DSME) can improve patient knowledge, behavior, and glycemic control Medical Nutrition Therapy is an essential part of DSME Addressing carbohydrates as a nutritional strategy is endorsed by the ADA and the AADE Clinical trials have shown that MNT can improve A1C by 1-2% No studies have compared carbohydrate counting and plate method Facilitating positive behavior as well as transferring knowledge is a priority, but little research in this area exists * Summary of previous literature (bullets) about CDEs (i.e. why do we need to do this study – don’t all already think CDEs are worthwhile??!!) Components of Literacy IOM, Health Literacy, 2004 Defining Health Literacy “…ability to read, write, and speak in English, and compute and solve problems at levels of proficiency necessary to function on the job and in society, to achieve one’s goals, and develop ones knowledge and potential†“ The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.†***Highlight the functional aspects of ‘health literacyâ Continue reading >>

Phd Public Health, Suez Canal University, Egypt

Phd Public Health, Suez Canal University, Egypt

Diabetes mellitus (DM) is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. The term diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. The effects of diabetes mellitus include long–term damage, dysfunction and failure of various organs. Diabetes mellitus may present with characteristic symptoms such as thirst, polyuria, blurring of vision, and weight loss. In its most severe forms, ketoacidosis or a non–ketotic hyperosmolar state may develop and lead to stupor, coma and, in absence of effective treatment, death. Often symptoms are not severe, or may be absent, and consequently hyperglycaemia sufficient to cause pathological and functional changes may be present for a long time before the diagnosis is made. The long–term effects of diabetes mellitus include progressive development of the specific complications of retinopathy with potential blindness, nephropathy that may lead to renal failure, and/or neuropathy with risk of foot ulcers, amputation, Charcot joints, and features of autonomic dysfunction, including sexual dysfunction. People with diabetes are at increased risk of cardiovascular, peripheral vascular and cerebrovascular disease. The development of diabetes is projected to reach pandemic proportions over the next10-20 years. International Diabetes Federation (IDF) data indicate that by the year 2025, the number of people affected will reach 333 million –90% of these people will have Type 2 diabetes. In most Western societies, the overall prevalence has reach Continue reading >>

Prevention Of Diabetes Mellitus

Prevention Of Diabetes Mellitus

Tweet When people talk about prevention of diabetes, it is usually about preventing type 2 diabetes. In the majority of cases, type 2 diabetes is brought on by lifestyle factors which can often be prevented. These include an unbalanced diet, lack of activity, lack of sleep, stress, smoking and alcohol. By making lifestyles changes, you can decrease your risk of developing type 2 diabetes. Type 2 diabetes prevention overview Leading doctors and researchers point to excessive levels of insulin as the likely reason why insulin resistance and type 2 diabetes develops. Strategies such as low-carb diets and exercise help to reduce levels of insulin and are therefore effective for preventing type 2 diabetes from developing. There are a number of risk factors for diabetes, some of which are preventable, such as weight gain around the middle (central obesity), high cholesterol/triglyceride levels and high blood pressure. Losing weight, adopting more activity into your day, stopping smoking and reducing alcohol intake can also help towards lowering the risk of developing type 2 diabetes mellitus and improving your all-round health. Diet and preventing type 2 diabetes Diet is the most important part of lifestyle change. The adage that you can’t outrun a bad diet is true. It is much easier to lose weight on a good diet even if you are struggling to do exercise, than it is through exercise if you’re eating a poor diet. Effective diets to prevent type 2 diabetes are those that do not cause your body to produce a lot of insulin. Carbohydrate has the biggest demand on insulin and so any diet that helps reduce carbohydrate intake will help towards reducing your risk of type 2 diabetes. Cutting out sugary food and drink and refined grains such as white bread and white rice is a good Continue reading >>

Prevention Of Type 2 Diabetes Mellitus

Prevention Of Type 2 Diabetes Mellitus

Published by Jayson Rich Modified over 2 years ago Presentation on theme: "Prevention of Type 2 Diabetes Mellitus" Presentation transcript: Key Questions and A Call to Action This slide set focuses on prevention of type 2 diabetes mellitus, addressing key questions with respect to why such prevention is imperative Included are studies supporting how type 2 diabetes may be prevented or delayed and a call to action 2 Prevention of Type 2 Diabetes Mellitus: Table of Contents Section Topic Slide No. 1 Why is prevention of type 2 diabetes imperative? 3-5 2 What is the evidence that type 2 diabetes can be prevented or delayed? 6-23 3 Do prevention interventions have sustained effects? 24-30 4 Are we preventing type 2 diabetes or delaying it? 31-32 5 Is diabetes prevention cost-effective? 33-36 6 Can evidence-based interventions be delivered effectively in lower-cost settings? 37-40 7 Will diabetes prevention bend the curve of the epidemic? 41-42 8 How can we most effectively prevent or delay type 2 diabetes? 43-51 9 Conclusions: call to action 52-53 This slide set takes a unique approach to addressing the prevention of type 2 diabetes Each section ask questions, then provides studies and recommendations based on those questions As outlined on this slide, the sections focus on each of the following eight questions Why is prevention of diabetes imperative? What is the evidence that type 2 diabetes can be prevented or delayed? Do prevention interventions have sustained effects? Are we preventing type 2 diabetes or delaying it? Is diabetes prevention cost-effective? Can evidence-based interventions be delivered effectively in lower-cost settings? Will diabetes prevention bend the curve of the epidemic? How can we most effectively prevent or delay type 2 diabetes? The Conclusion Continue reading >>

Diabetes Mellitus: Diagnosis, Prevention And Goals Of Therapy

Diabetes Mellitus: Diagnosis, Prevention And Goals Of Therapy

Diabetes Mellitus: Diagnosis, Prevention and Goals of Therapy To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications. Diabetes is a complex disease. Residents are often challenged by its diagnosis and need to work through cases in the controlled atmosphere of the classroom to reinforce their diagnostic skills. This resource presents a set of cases that walk learners through current research on diabetes mellitus type 2. The module can be used to present the step-by-step process of diagnosis and treatment to learners. The resource includes a PowerPoint presentation reviewing how the diagnosis of diabetes is made, what exams/tests should be performed to prevent sequelae of diabetes, and how to determine goals of therapy. This presentation is used in lecture format to teach residents about the need for a systematic approach to diabetes care. Residents learn the answers to the questions posed in the presentation. The significance of the presentation lies in helping physicians learn a systematic approach. The notes section of the PowerPoint slides offers additional information. An instructor guide presents an overview of activities that can be used to consider how to address issues in working with patients with this disease. The resource is aimed at residents but could be used by students as well. Continue reading >>

File Formats Help:

File Formats Help:

Technical Notes: Please do not alter the format of the slides you download. If format is altered the CDC logo must be removed, but citation source for the data should be included. To incorporate slides into your presentation— Download the PowerPoint file to your hard drive Open the presentation into which you want to incorporate slides On the Insert menu, click Slides from Files. Click Browse to locate the file you downloaded and select the file. Then click Open. Select the Keep source formatting check box and click Insert All. Continue reading >>

Prevention Of Type 1 Diabetes

Prevention Of Type 1 Diabetes

Go to: INTRODUCTION Type 1 diabetes is an autoimmune disease in which the β cells of the pancreatic islets are destroyed rendering the individual increasingly incapable of mounting a normal insulin response to ingested nutrients1, 2. In the early 1980's Eisenbarth enunciated the main phases in the pathogenesis of type 1 diabetes (figure 1), a framework which continues to be useful in considering approaches to the prevention or cure of this disorder2: susceptibility to T1D is inherited through a series of genes, the most important of which relate to the HLA class II-locus on chromosome 6, with lesser contribution from a number of others, including the insulin gene, CTLA4 and others (see below). Susceptibility genes are essential, but insufficient in explaining the immune pathogenesis of TID, i.e. the majority of individuals with these susceptibility genes never develop the disorder. exposure to one or more environmental trigger(s) alters the immune system in such a way that susceptibility is converted to pathophysiology and destruction of β cells begins. Despite intensive searches for environmental triggers, the number of candidates being assessed in clinical trials remains quite small, e.g. cow's milk proteins, relative lack of vitamin D and supplementation with omega 3 fatty acids3-7. while attack on the β cells is mediated in large part by T cells, it is the presence of humoral (B cell) markers that punctuates the next phase: normal glucose homeostasis in the presence of one or more T1D-specific autoantibodies, ICA512/IA-2, IAA and GAD are the main ones available for measurement. The progression to clinical TID is highly predictable based on the number of antibodies present8. the earliest metabolic abnormality detected is loss of first phase insulin secretion in re Continue reading >>

Sheet1

Sheet1

Type 1 Highest prevalence in northern European populations Strong familial link – genetic factors WB30 * LTPHN/JS © 2010 Chart2 identical twin 30 sibling 6 father 4 mother 2 no family members 0.3 The risk factors for diabetes are different for type 1 diabetes and type 2 diabetes. The cause of type 1 diabetes is not well understood. Autoimmune mechanisms (the development of antibodies directed at the body's own tissues) may lead to the destruction of the beta cells in the pancreas that produce insulin. It has been suggested that infectious agents may play a role, though no specific organism has been identified. Type 1 diabetes is present in most races but it is highest in Northern European populations. Type 1 diabetes is more common in the families of people with type 1 diabetes, and genetic factors probably play an important role. If no member of the family has type 1 diabetes, the risk of a child developing type 1 diabetes before 18 years of age is about 0.3%.The risk increases to 2% chance if the mother and 4% chance if the father has type 1 diabetes. If a sibling is affected, there is 6% chance of having type 1 diabetes. Relative risks of type 2 diabetes Population factors:WB Family history; Age; Socioeconomic circumstances; Ethnicity Modifiable risk factors Obesity; Exercise; Smoking WB31 * LTPHN/JS © 2010 Chart1 Sheet1 identical twin 30 sibling 6 father 4 mother 2 no family members 0.3 OBESITY 20 age 10 ethnicity 3 socioeconomic factors 1.6 SMOKING 1.5 This slide just gives some idea of the relative contribution of different risk factors to diabetes. Modifiable risk factors are shown in caps. It illustrates just how important obesity is to development of diabetes. Type 2 diabetes is more common in the families of those with type 2 diabetes, and a numbe Continue reading >>

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