Diabetes: Beyond Sugar

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Diabetes Beyond Sugar
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CHAOS

• C - Coronary artery disease
• H - Hyper-tension, -glycaemia, -insulinaemia
• A - Atherosclerosis
• O - Obesity
• S - Stroke

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Top 5 co-existing conditionsDiabetes in Europe,
2000
Type 1 - 1531, Type 2 - 7911
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Top 5 co-existing conditionsDiab Care Asia, 2000
Type 2 - 2238
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Management of T2DM Extends Beyond Glucose Control
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Therapeutic Lifestyle change

• Healthy Eating,
• Time management,
• Regular exercise
• 30 min daily brisk walking.

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Lipid control

• DIFFICULT!
• Target is changing
• What level is safe?
• Multifactorial
• (Hyperglycaemia leads to hyperlipidaemia )

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Hypertension Complications
End Stage Renal Failure
Peripheral vascular disease
HT
Congestive Heart Failure
Coronary Heart Disease 43
Stroke 18
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Hypertension- Interesting Facts

• 5-6 mm reduction in DBP lowers stroke risk by 33
  and CHD risk by 15
• Hypertension Optimal Study (HOT) Study- DBP ? 85
  mm Hg associated with lower risk of CVS events
  than reduction to ? 90 mm Hg

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Hypertension in India

• CODI Study
• BP was measured in 54.5 of patients with DM,
• In 40 BP was found to be high,
• 10 were on treatment
• BUD Study
• 24 of people with high BP were currently
  checking.

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Clinical and Experimental Studies
Treatment -Target Organ Protection
CNS protection
Cardioprotection
Antiatherosclerosis
Renoprotection
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Recommended Treatment Goals for Hypertension
With Diabetes Without Diabetes
lt130/80 mm Hg lt140/80 mm Hg
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SMOKING
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How to manage all?
Sp. Doctor
Dietitian
Govt.
PATIENT
Sp. Nurse
Podiatrist
Pr. Nurse
Pharms.
Fm. Doctor