Description
Prevention and Control Measures of Diabetes Mellitus is a critical public health focus aimed at reducing the global burden of this chronic lifestyle disease. This session will delve into evidence-based strategies for early detection, lifestyle modifications, dietary interventions, and pharmacological management. It will also highlight the role of community awareness, regular screening, and integrative approaches including traditional medicine in preventing disease progression and complications. Participants will gain practical insights into both preventive care and long-term control to improve patient outcomes and quality of life.
Summary Listen
- Diabetes mellitus is a group of metabolic disorders characterized by high blood glucose levels (hyperglycemia), resulting from either insufficient insulin production or ineffective insulin use. The World Health Organization (WHO) classifies diabetes into three main types: type 1 (insulin deficiency), type 2 (insulin resistance), and gestational diabetes (GDM, during pregnancy). Complications of diabetes include stroke, blindness, heart attack, kidney failure, and amputations.
- Classifications of diabetes also consider etiological factors, community interventions, and clinical characteristics. The American Diabetes Association (ADA) adds classifications based on autoimmune beta cell destruction (type 1), insulin resistance (type 2), and other causes like monogenic diabetes, pancreatic diseases, or drug-induced conditions. WHO's clinical classification includes hybrid forms, rare genetic disorders, and pregnancy-related diabetes.
- A key consideration in diabetes management is the presence of metabolic syndrome, characterized by low HDL cholesterol, high fasting blood sugar, visceral obesity, high blood pressure, and elevated triglycerides. Risk factors for diabetes include unhealthy diet, physical inactivity, older age, family history, GDM, high blood pressure, and sleep problems. WHO emphasizes unhealthy diet and physical inactivity as the primary modifiable risk factors.
- Globally, 589 million adults aged 20-79 have diabetes, representing 11.1% of the world's population, and projected to reach 853 million by 2050. Over US$1 trillion is spent annually on diabetes care, yet many individuals remain untreated. Type 2 diabetes accounts for over 90% of diabetes cases worldwide. Undiagnosed diabetes is a significant issue, with China and India having the largest populations of undiagnosed individuals.
- Prevention and control of diabetes involve interventions at all levels of the natural history of the disease. These include primordial prevention (preventing the emergence of risk factors), primary prevention (preventing the onset of disease), secondary prevention (early detection and prompt treatment), and tertiary prevention (disability limitation and rehabilitation). WHO recommends lifestyle modifications, blood glucose monitoring, and medical advice for individuals, and community-based healthy environments and better healthcare facilities for stakeholders.
- Strategies for diabetes prevention and control include healthy diet, regular physical activity, and maintaining a normal body weight. Lifestyle modifications encompass emphasizing whole grains, legumes, nuts, fruits, and vegetables, and limiting saturated fat and salt intake. Regular physical activity recommendations include at least 150 minutes per week of moderate-intensity exercise.
- Pharmacological interventions, such as metformin for high-risk individuals, can be used for prevention, though careful monitoring is needed. Screening programs, particularly for high-risk populations, are crucial for early detection. Diagnostic tests include fasting blood glucose, 2-hour post-prandial glucose, random glucose level, and HbA1c. Treatment modalities include oral hypoglycemic agents (OHAs) and insulin, with individualized plans considering patient characteristics and treatment choices.
- Management also includes lifestyle modifications, glycemic control, blood pressure control, and lipid control. Complications, both microvascular and macrovascular, should be screened and managed. Community-based interventions, such as health promotion programs, screening clinics, and tertiary-level care, are essential. Effective diabetes prevention and control requires a multi-tiered strategy involving individuals, healthcare providers, and policymakers, focusing on prevention, early detection, and comprehensive management.
Sample Certificate
About the Speakers
Dr. Prerna Bansal
Associate Professor of Community Medicine, College of Medical Sciences, Chairperson of Institutional Review Committee, Bharatpur, Nepal
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