Prevention and Control of Diabetes and Obesity

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Prevention and Control of Diabetes and Obesity : 

Prevention and Control of Diabetes and Obesity By Ragini.R



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Graph showing Age wise incidence of IDDM

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Graph showing Agewise incidence of NIDDM

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Why Prevention : Type 2 diabetes is one of the fastest growing diseases in the world. Diabetes has enormous human and financial costs A leading cause of heart disease, blindness, kidney failure, and amputations

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Prediction : Prediction Ability to predict and prevent type 2 diabetes in the general population is limited. However, we can identify high risk groups of people such as: Close relatives with diabetes. Obesity and body fat distribution. Age and certain ethnic groups. Physical inactivity. Previous gestational diabetes. Elevated fasting glucose. Impaired glucose tolerance.

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Family History and Risk of NIDDM : In the U.S. Positive family history imparts 2.7 fold risk of NIDDM after adjustment of other factors (Cowie, 1993). Risk of NIDDM among Caucasians was 1.8 fold higher with one family member, 3.8 fold higher with two or more family members compared to persons with no known family history of NIDDM.

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Low Birth Weight : There is an apparent inverse relationship between birth weight and risk of type 2 diabetes. low birth weights babies have reduced beta cell function as adults, insulin resistance, and an increased incidence of type 2 diabetes.

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Impaired Glucose Tolerance {IGT}? : Impaired Glucose Tolerance? Risk factor for type 2 diabetes Increases risk of type 2 diabetes 5 - 8 fold 1- 9% per year develop type 2 diabetes Major risk factor for heart disease. IGT may be the best time to intervene.

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Gestational Diabetes Mellitus[GDM]: Gestational Diabetes The risk of type 2 diabetes is higher in women who have gestational diabetes. They have defects in both insulin secretion and insulin action. 47-50 % women with GDM may develop.

Relationship between Diabetes & BMI: : 

Relationship between Diabetes & BMI:



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Prevention Of Diabetes : CONTROL Hyperglycemia Insulin Resistance , Relative Impairment of Insulin Secretion Environmental Factors Such As Obesity

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1.Primary prevention :-Two strategies Population strategy High risk strategy Diabetes : prevention and control :-

1.Population strategy:- : 

1.Population strategy:- Maintenance of normal body weight through adoption of healthy nutritional habits and physical exercise. The nutritional habits include an adequate protien intake ,a high intake of dietary fiber and avoidance of the sweet foods. Elimination of the other less well defined factors such as protien deficiency and food toxins in some.

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Lifestyle Intervention Intensive lifestyle goals Reduction of fat and calorie intake Physical activity at least 150 minutes/week Achieve and maintain at least 7% weight loss

High risk strategy: : 

High risk strategy: Correction of sedentary life style ,overnutrition & obesity. Alcohol consumption . Diabetogenic drugs like OCPs should be avoided . Avoid the factors like Smoking , high BP , Elevated cholesterol & high Triglycerides level which promotes Atherosclerosis.

2.Secondary prevention : 

2.Secondary prevention A>Early Diagnosis . B> Early Treatment.

Early diagnosis: : 

Early diagnosis: SCREENING based on *Ethnicity *Family history *Age group 40yrs & above *History i.e,GDM,IGT,HTN,Obesity. *Life style 2.Secondary prevention

Opportunistic screening: : 

Opportunistic screening: “Screening done when opportunity exist. As in *preoperative ,*preplacement ,*periodic examination of the selected groups & *Diagnostic camps.

Secondary Prevention : 

Secondary Prevention Aims of Treatment are; * To maintain Blood glucose level , * To maintain Ideal body weight , Diet & Oral Antidiabetic drugs

Tertiary prevention: : 

Tertiary prevention: It involves Organization of Diabetic clinics & Diabetes units at strategic location . *Establishment of local & National Diabetes REGISTERS.

Obesity- prevention and control : 

Obesity- prevention and control

Obesity : 

Obesity Weight control is widely defined as *approaches to maintaining weight within the healthy range of BMI of 18.5-24.9kg/mtrs2 throughout the adulthood *prevention of the weight gain of >5kg in all people * Reduction of 5-10% in overweights

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Prevention of obesity should begin in early childhood Obesity is harder to treat in adults than in children.

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Control of obesity centers around weight reduction this can be achieved by *dietary changes increased physical activity and a combination of both

Dietary changes : : 

Dietary changes : The proportions of energy dense foods such as simple CHO and fats should be reduced . The fiber content in the diet should be increased through the consumption of common unrefined foods. Adequate levels of essential nutrients in the low energy diets should be ensured.

Cont…… : 

Cont…… *Diet should be reduced carefully monitoring the nutritional patterns. *Food energy intake should not be > what is necessary for the energy expenditure. Mainly; *Modification of patients behaviour. *Strong motivation to lose weight & maintain ideal weight.

Physical activity; : 

Physical activity; Regular physical exercise to increase energy expenditure. *Appetite suppressing drugs . *Surgical treatment. *A fruitful approach will be to identify those children who are at risk to become obese & find the way to preventing it. Others;

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References: PARK’s Text book of P&SM. Authorstream. WHO images

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