TRENDS IN DIABETES PREVALENCE

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TRENDS IN DIABETES PREVALENCE

• The number of people with diabetes has increased
  frighteningly during the past 20 years.
• According to WHO the number of people worldwide
  with diabetes increased from 30 million in 1985
  to 171 million in 2000. We are currently
  standing at 16 above the predicted global rate
  of diabetes for the year 2010 where will we be
  by then?
• A new frightening statistic by the year 2025
  diabetes could be the only non-cpmmunicable
  disease to cause a negative growth rate!!
• WHO has predicted that the global diabetes
  prevalence in adults will reach 6.4 by 2030,
  representing a 60 increase since 1995 and a 39
  rise from 2000 to 2030.
• Type 2 previously known as adult onset
  diabetes now found in children as young as 6
  years. REASON FOR THIS is the change in diet and
  lack of exercise. Obesity due to bad eating
  habits and lack of exercise. Westernised diet
  causing major problems!

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DIABETES FACTS FIGURES

• There are as many people dying of diabetes
  complications as there are of AIDS
• Every 10 seconds a person dies from
  diabetes-related causes.
• Every 10 seconds two people develop diabetes.
• Every 3 seconds a lower limb is amputated
  worldwide.

• At least 50 of all people with diabetes are
  unaware of their condition. In some countries
  this figure may reach 80.
• Diabetes is the fourth leading cause of global
  death by disease.
• At least 50 of all people with diabetes are
  unaware of their condition. In some countries
  this figure may reach 80.
• .

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DIABETES FACTS FIGURES

• Up to 80 of type 2 diabetes is preventable by
  adopting a healthy diet and increasing physical
  activity
• Diabetes is the largest cause of kidney failure
  and blindness 
• People with type 2 diabetes are twice as likely
  to have a heart attack or stroke

• Cardiovascular disease is the major cause of
  death in diabetes, accounting for some 55 of all
  diabetes fatalities
• All damage caused by elevated blood glucose
  levels is not reversible
• People with Diabetes face the certainty of
  premature death.

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DIABETES FACTS FIGURES

• 95 of Diabetics are type 2 Diabetics
• 90 of the complications are in type 2 diabetics.
• There is a recommendation to commence Type 2
  patients on insulin sooner to alleviate the risk
  of complications.

• People with Type 1 diabetes are as much at risk,
  but better control is obtained by utilising
  insulin.
• There is, as yet, no known cure for type 1 or
  type 2 Diabetes
• If in doubt have yourself checked!!

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WHAT IS DIABETES?

• Diabetes is a condition in which the body is
  unable to use sugar correctly.
• Our body cells need to provide energy for living
  just as a car needs petrol!
• Our fuel comes from the food we eat, which is
  digested in the stomach and flows into the blood
  stream as glucose, a form of sugar
• To get into the body cells, the glucose needs the
  assistance of a hormone, called INSULIN.
• Normally the pancreas makes the insulin which
  carries the glucose in the blood into the cells.
  In diabetes the pancreas fails to supply enough
  insulin, or the insulin does not work properly.
• When the body cannot utilise the glucose in the
  food, sugar levels start rising and medical
  intervention is necessary.

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Diabetes Action
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Main symptoms of Diabetes

• Tired and listless
• Frequent urination
• Thirsty
• Hungry
• Mood swings
• Sores and bruises that take longer to heal
• Constipation
• Diarrhea
• Erectile Dysfunction
• Difficulty conceiving

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DIABETES IN CHILDREN

• The alarming increase in the development of
  Diabetes in Children is due mainly to obesity and
  lack of exercise amongst our children.
• Take-aways, unhealthy foods and drinks, lack of
  exercise are some of the major contributing
  factors.
• Commence a healthy eating plan as soon as
  possible.
• We are very much an add water and mix society
  and we are poisoning our children.

• There is no such thing as a Diabetic DIET just a
  HEALTHY way of living.
• 5 fruits and veges a day!!
• Sugar not the enemy but FAT especially hidden
  fat!!
• Become a label detective!!

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Pancreatic Beta Cell Function
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Blood Glucose
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DIABETES COMPLICATIONS

• Short term acute complications
• Hypoglycemia (or low blood sugar)
• When the blood sugar falls too low a person can
  no longer function normally. Symptoms include
  irritability, confusion, shakiness, extreme
  hunger, numbness in arms and hands, slurred
  speech. It can be treated in the early stages by
  eating/drinking a simple sugar. If left
  untreated, this condition can become severe and
  lead to unconsciousness.
• Ketoacidosis
• A severe, VERY dangerous condition caused by
  lack of insulin. It is marked by very high blood
  glucose levels and ketones in the urine. Ketones
  are the toxic acids produced when the body breaks
  down fat for fuel. It occurs almost exclusively
  in Type 1 diabetics and requires immediate
  medical attention.

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DIABETES COMPLICATIONS (2)

• LONG TERM COMPLICATIONS
• HYPERGLYCAEMIA (high blood sugar gt 9mmol/l
• Living with high blood glucose levels for a long
  period of time can cause serious damage to the
  vital parts of your body this is because the
  large and small blood vessels and the nerve
  endings become damaged. If unchecked the
  problems caused can lead to blindness, kidney
  failure, heart attacks, strokes and amputations.
• Eye damage (Retinopathy). Have your eyes
  investigated by an OPTHALMOLOGIST Type 1 every
  year, and Type 2 immediately you are diagnosed
  and every year thereafter
• Kidney damage (Nephropathy) can be detected by
  testing the urine for protein (microalbuminurea).
  All people with diabetes should have this test
  EVERY year.

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DIABETES COMPLICATIONS (3)

• Vascular damage The main arteries become stiff,
  choked and stressed. Blood pressure increases
  and the heart becomes stressed and circulation to
  the hands and feet becomes compromised. Check
  for BP levels and ensure your exercises increase
  blood flow.
• Heart Attacks and Strokes One of the most
  devastating complications.
• Nerve damage (Neuropathy) This leads to loss
  of sensation in the feet and they become
  particularly vulnerable to wounds and infection
  often leading to amputation.
• Sexual dysfunction Nerve damage can also affect
  sexual health, causing impotence in men and
  inability to achieve an orgasm in women.
  Difficulty falling pregnant.
• Infections are common as high blood glucose
  inhibits the action of the white blood cells
  the bodys main germ fighters.

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Foot lesions
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Infections
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Stroke
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MEDICATION

• Type 2
• If diet and exercise fail to bring your glucose
  levels down, your doctor may prescribe diabetes
  tablets, which can act in 3 ways.
• They may stimulate the pancreas to produce more
  insulin they may make the insulin you already
  have work better or they may slow down
  digestion. When neither pills, nor diet and
  exercise bring down your glucose levels to
  acceptable levels, it may be necessary to start
  using Insulin.

• Type 1
• Insulin is injected. The reason being that it
  is a protein and would be destroyed by the
  digestive juices if taken orally. Very fine
  needles are used and there is little discomfort.
  The aim is to balance your insulin with your meal
  plan and exercise programme to mimic the work of
  the normal pancreas, as closely as possible.

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REGULAR TESTING

• Blood sugar levels should be tested regularly
  preferably EVERY day
• Day 1 on rising
• Day 2 2 hours after breakfast
• Day 3 before lunch
• Day 4 2 hours after lunch
• Day 5 before dinner
• Day 6 2 hours after dinner
• Day 7 Random test between midnight 05h00
• A HbA1c should be conducted at least every SIX
  Months. A cholesterol test should also be
  conducted regularly as should you Blood Pressure.

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UNite for diabetes

• Diabetes is a silent killer that kills one person
  every 10 seconds
• Diabetes is a global problem with devastating
  human, social and economic impact. Today more
  than 200 million people worldwide are living with
  diabetes. This number is increasing by 6 million
  people every year. The growing pandemic is set
  to overwhelm healthcare resources in every
  country and in many is disabling or killing
  people of working age. To do nothing is no
  longer an option. We have the cost effective
  strategies to prevent or delay the onset of
  diabetes complications. It is time for
  Government to act
• The time is right for a United National
  Resolution on Diabetes. The United Nations
  General Assembly has today (20/12/2006) passed a
  landmark Resolution recognizing the global threat
  of the diabetes epidemic. For the first time,
  governments have acknowledged that a
  non-infectious disease poses as serious a threat
  to world health as infectious diseases like
  HIV/AIDS, Tuberculosis and Malaria
• This United Nations Resolution on Diabetes will
  focus the attention of the world on the need for
  urgent action that goes beyond the scope of
  government departments responsible for
  healthcare. Workable solutions will require
  whole-of-government implementation and the
  attention of the global community of the United
  Nations

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The Diabetes Team
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Diabetes Action our role

• We are a Diabetes Support Group
• The annual membership of Diabetes Action is
  R240.00 p.a. which includes a monthly newsletter.
  Notices and articles of general interest are
  sent to members regularly. A database is kept to
  remind all members to attend to their vital
  health checks. Notification of Support Groups.
  No Government figures available! So it is
  essential to develop some kind of register.
• We offer a basic course in coping with your
  Diabetes for the newly diagnosed diabetic and
  their family, as well as any person whose
  Diabetes is not under control!! R300.00 for 2
  hour appointment.
• We refer our members to other relevant members of
  the Diabetes team.

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PRIVATE vs. STATE

• STATE
• A state patient does not see the doctor at every
  visit
• Strips are not always available
• Glucometers are not given out the patient has
  to purchase a Glucometer (Cost implication).
• The nursing staff are not trained diabetic nurse
  educators
• The dietician is not always available and the
  diets are outdated
• There is no referral to a, podiatrist,
  ophthalmologist, psychologist
• Complications such as strokes, heart attacks,
  amputations, kidney failure and blindness then
  have to be borne by the state.

• PRIVATE
• Non Medical Aid
• Similar to the State patient.
• Cannot afford the cost of medication, Glucometers
  strips
• Does not visit vital supplementary doctors, e.g.
  podiatrist, dietician, ophthalmologist,
  psychologist
• When complications set in has to become a patient
  of a State hospital
• MEDICAL AID
• The best position to be in, but only about
  15-20 are in this fortunate position. Many
  patients exceed their limits and then become as
  above.

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COST IMPLICATIONSDiabetes Action/ PATIENT STATE

• Patients get referred by their GPs, state
  hospitals and clinics, to Diabetes Action
  offices
• Cost to Diabetes Action is not borne by anyone
  fund raising required
• No concessions to Diabetes Action on the prices
  of Glucometers or strips for state or non-medical
  aid patients
• Patient is not referred to the correct medical
  personnel hence they become a badly controlled
  person with diabetes with all the inherent
  complications.
• Our appeal to you, is to assist us to educate the
  thousands of people with diabetes, especially the
  children adolescents. Create awareness and
  educate.
• Allow for proper treatment and training in your
  budget!
• Diabetes is already impacting on the population
  and will, in future, impact even more with the
  HIV/Aids patients whose immune system is
  compromised.

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• A person with diabetes should consult with the
  following medical personnel
• A doctor/specialist at least once every 6 months
• A Podiatrist at least once a year
• A Dietician, on diagnosis and annually thereafter
• A Diabetes Nurse Educator on diagnosis and
  thereafter as often as is necessary.
• To see an Ophthalmologist at least once a year
• To have regular BP, Cholesterol and HbA1c
  testing.
• Purchase a Glucometer VITAL FOR CONTROL

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DIABETES AND HIV/AIDS

• DUE TO THE COMPROMISE OF DIABETES ON THE
  ENDOCRINE SYSTEM HIV/Aids PATIENTS ON
  ANTI-RETROVITALS ARE AT RISK OF DEVELOPING TYPE 1
  DIABETES!!

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THANK YOU

• In human and economic terms, diabetes is one of
  our most costly diseases and threatens to become
  the greatest public health problem of the modern
  era.
• For every 1 a persons HbA1C IS LOWERED the
  following results occur
• Deaths are reduced by 21
• Heart attacks are reduced by 14
• Microvascular Complications by 37
• (kidneys eyes)
• Peripheral vascular disorders 43
• LET US FIGHT TOGETHER FOR A BETTER WORLD FOR OUR
  PEOPLE SUFFERING WITH DIABETES. THERE IS NO SUCH
  THING AS MILD DIABETES!