EPIDEMIOLOGY

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EPIDEMIOLOGY OF DIABETES MELLITUS - Treasa
Joseph
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Definition

• Diabetes is a heterogeneous group of diseases,
  characterized by a state of chronic
  hyperglycemia, resulting from a diversity of
  etiologies, environmental and genetic, acting
  jointly.

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Clinical Classification

• Diabetes Mellitus (DM)
• Insulin-dependent DM (IDDM, Type 1)
• Non Insulin dependent DM
• (NIDDM, Type 2)
• Malnutrition related DM (MRDM)
• Other types
• Impaired Glucose Tolerance (IGT)
• Gestational DM (GDM)

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• Prevalence of Diabetes Mellitus
• 2000 171 million
• 2030 366 million
• By 2025 India with most number of diabetic
  cases - 79 million

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Problem Statement

• Iceberg Disease
• Increased prevalence in newly industrialized and
  developing countries.
• Disease acquired in the most productive period of
  their life.
• 20 of current global diabetic population resides
  in the SEAR.
• Indian population has increased susceptibility to
  DM.

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• Undiagnosed or inadequately treated patients
  develop multiple chronic complications.
• Lack of awareness about interventions for
  prevention and management of complications.

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Age-Wise Distribution of Diabetes Mellitus
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Prevalence of type 2 diabetes rural-urban
combined- Kerala
Age standardised prevalence Men - 14.9 Women
-13.2 Age standardised for Kerala
population 2001
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Prevalence of type 2 diabetes in different
geographic strata
Coastal Highland Midland Urban
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Epidemiological Determinants

• AGENT FACTORS
• Pancreatic disorders
• Defects in formn of insulin
• Destruction of beta cells
• Decreased insulin sensitivity
• Genetic defects
• Autoimmunity

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• HOST FACTORS
• Age
• Sex
• Genetic factors
• Genetic markers HLA-B8, B15, HLA DR3
  DR4
• Immune mechanisms
• Obesity
• Maternal diabetes

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• ENVIRONMENTAL FACTORS
• Sedentary lifestyle
• Diet
• Dietary fibre
• Malnutrition
• Alcohol
• Viral infections
• Chemical agents
• Stress
• Others

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Screening for DM

• Urine Examination
• 2 hrs after meal
• Lack of sensitivity
• Blood Sugar Testing
• fasting, PPBS, RBS
• TARGET POPULATION

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Prevention And Care

• PRIMARY PREVENTION
• Population Strategy
• High Risk Strategy
• SECONDARY PREVENTION
• TERTIARY PREVENTION

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Why Study the Epidemiology

• Long term disease
• Global epidemic
• Modifiable risk factors
• Multiple complications
• Contributes to 5.2 of total deaths

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WORLD DIABETES DAY 14TH NOVEMBER 2007
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THANK YOU