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 � Continue reading

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Laws that Protect People with Type 1 Diabetes

Federal Legislation has forever changed the way that individuals live with Type 1 diabetes and other disabilities. The fight to have governmental involvement in advocacy across the globe has been a slow and sometimes frustrating process, however it continues to progress.
The United States: Americans with Disabilities Act
The most far-reaching legislation for those with disabilities is the Americans with Disabilities Act (ADA). Passed in 1990, the ADA prevents discrimination against qualified individuals on the basis of disability.
Under Title I of the ADA, private employers with 15 or more employees, states, and local governments cannot require a medical examination before offering a new employee a job. This means your future employer cannot ask you whether you have diabetes before hiring you. Furthermore, once hired, an employee with diabetes can request reasonable accommodations, such as extra breaks to eat, test blood sugar levels, or take medication. If such accommodations are not an undue hardship to the employer, the employer must fulfill the requests.
Under Title II of the ADA, state and local governments must provide you with services that are not any different from those they provide people without a disability. They must not screen out or exclude you because of your disability and they must modify their policies and provide reasonable accommodations if necessary. For example, a courthouse should permit you to carry your diabetes supplies with you even if it means a modification of a general policy against allowing sharp objects and food.
Under Title III of the ADA Continue reading

Innovative Type 1 Diabetes Approach Licensed to Encellin

Encellin, a San Francisco–based biotechnology company, has obtained exclusive worldwide rights from UC San Francisco for a proprietary cell encapsulation technology aimed at improving physicians’ ability to perform cell transplants without the need for immunosuppressive drugs.
Based on ongoing preclinical trials in animal models, the technology – in the form of a pouch approximately the diameter of a quarter, made of an ultrathin nanoporous membrane – represents a significant advance towards the ability to transplant donated cells without danger of immune rejection or harmful fibrosis at the transplant site, while also ensuring that transplanted cells cannot infiltrate other parts of the body.
Encellin first aims to apply this technology – originally developed in the laboratory of Tejal Desai, PhD, chair of the Department of Bioengineering and Therapeutic Sciences in UCSF’s schools of Pharmacy and Medicine – to treat type 1 diabetes, an autoimmune disease affecting over 1 million Americans, with over 9,000 young people newly diagnosed each year.
Type 1 diabetes is caused by the loss of the islet cells of the pancreas, which normally secrete the hormone insulin to coordinate the body’s use of blood glucose. The transplantation of functional, insulin-producing pancreatic islet cells from a donor has shown clinical efficacy as a treatment for some people with type 1 diabetes, but – like most transplantation techniques – this treatment requires lifelong immunosuppression to prevent patient immune systems from destroying the donor cells. However, these immuno Continue reading

Handling diabetes in the workplace

There are around 4.5 million people living with diabetes in the UK and approximately 700 diagnoses per day, the equivalent of one person every two minutes. In the last 20 years, the number of people diagnosed with diabetes in the UK has more than doubled and it is estimated that there are around 1.1 million people in the UK who have diabetes but have not been diagnosed.
This week is Diabetes week which aims to raise awareness of the condition, and we, therefore, thought it would be a good opportunity to consider an employer’s obligations and how they can help employees who have this lifelong condition.
Is diabetes a disability?
“Disability” is defined in the Equality Act 2010 as a physical or mental impairment that has a substantial and long-term adverse effect on a person’s ability to carry out normal day-to-day activities.
There are 2 types of diabetes: type 1, which is an autoimmune condition affecting around 10% of sufferers and type 2, which is caused by a complex interplay of genetic and environmental factors and affects around 90% of sufferers.
There is no straightforward answer as to whether diabetes amounts to a disability for the purposes of the Equality Act. Each case would be assessed on its own facts, and would focus on the impact the condition has on the employee’s ability to carry out day to day activities and whether a treatment or correction or a coping or avoidance strategy was applied to manage it.
If a condition is treated or corrected, guidance suggests the effect of that treatment or correction should be ignored when assessing the condition a Continue reading

Update: Belgian Biotech Starts Human Trials for a Potential Type 1 Diabetes Cure

Update (15/11/2017): Imcyse has officially started recruiting patients to test its therapy for type 1 diabetes. The clinical trial will recruit up to 40 patients across 15 European centers, and the first patient has already enrolled at the Steno Diabetes Center in Copenhagen.
Originally published on 30/05/2017
Imcyse will run its first clinical trial testing a specific immunotherapy that could finally provide a cure to autoimmune diseases.
Imcyse, a Belgian biotech spun out from the Katholieke Universiteit Leuven in 2010, just announced it has received approval from Belgian and British regulatory authorities to launch a Phase Ib trial in patients with type 1 diabetes. The study is backed with funding from the EU through the EXALT program, which has a budget of €6M over 5 years to promote the development of a cure for type 1 diabetes.
The trial, run in collaboration with the French Inserm, will be run in 18 sites across Belgium, Denmark, France, Germany, and the UK. It will be the first study in humans testing Imcyse’s immunotherapy technology, which is aimed at stopping the destruction of insulin-producing beta pancreatic cells in patients diagnosed with the disease within 6 months before the trial, when not all beta cells have yet been eliminated. Results are expected at the end of 2018.
Imcyse develops Imotopes, modified peptides that induce cytolytic CD4 T cells to kill other immune cells involved in the destruction of a specific target, in this case insulin-producing cells, without affecting any other functions of the immune system. The peptides are composed of an e Continue reading