DIABETES AS A GLOBAL PROBLEM
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Diabetes as a global problem, foot care and nutrition management as presented by clinical nutritionist. Cheruiyot Sambu at Kapkatet county hospital. stay tuned
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DIABETES AS A GLOBAL PROBLEM
- 1. Ministries of Health PRESENTED BY SAMBU CLINICAL NUTRITIONIST DIABETES AS A GLOBAL PROBLEM
- 2. Ministries of Health Definition Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia (high blood glucose) due to:- ◦ Defects in insulin production usually caused by destruction of beta cells (autoimmune or otherwise) ◦ Insulin resistance - impaired action of insulin on target cells ◦ Both of these mechanisms
- 3. Ministries of Health The Classification of Diabetes Based on Etiology (WHO) Type 1 diabetes Results from destruction of the pancreatic beta cells most commonly autoimmune. Insulin is required for survival. Type 2 diabetes Characterized by insulin resistance and/or abnormal insulin secretion, either of which may predominate, but both of which are usually present. It is the most common type of diabetes. Other specific types of Diabetes These are less common and include genetic disorders, infections, and diseases of the exocrine pancreas, endocrinopathies or as a result of drugs. Gestational diabetes Diabetes diagnosed in the second or third trimester in a woman who was previously not known to have diabetes. It typically resolves after delivery..
- 4. Ministries of Health Epidemiology of diabetes Globally: Diabetes is one of the largest global health emergencies of the 21st century Over 415 million people are living with diabetes (1 out of 11 of adults) 75% of people with diabetes live in low and middle income countries More than 46.5% of adults with diabetes are undiagnosed Every 6 seconds someone dies from diabetes
- 5. Ministries of Health Epidemiology of diabetes In Kenya: Prevalence of DM is 4.7% (2.7% in the rural and 10.7% in urban areas), expected to rise to 7% by 2030 6 out of 10 adults with diabetes are undiagnosed
- 6. Ministries of Health Global projections; International Diabetes Federation (IDF Atlas) 171 million 194 million 247 million 415 million 642 million 2000 2003 2007 2015 2040 285 million 2010
- 7. Ministries of HealthRisk factors for diabetes Risk factors for type 1 DM are not well known. Type 2 diabetes has several risk factors divided into: ◦ Non-modifiable risk factors ◦ Modifiable risk factors
- 8. Ministries of HealthRisk factors for diabetes A. Non-modifiable risk factors − Age > 40 years − Family history/genetic predisposition − Member of high risk population (Ethnicity /race e.g. Pima Indians) − History of impaired glucose tolerance, impaired fasting glucose − History of gestational diabetes or delivery of a macrosomic baby − Polycystic ovary disease
- 9. Ministries of Health Risk Factors - Modifiable 9 Unhealthy diet Tobacco use Excessive alcohol consumption Physical inactivity Overweight and Obesity Increasing age
- 10. Ministries of Health Signs and symptoms 10 Excessive thirst Extreme hunger Frequent urination Blurred vision Increased fatigue Impotence
- 11. Ministries of Health Signs and symptoms 11 Unexplained weight loss Irritability Non healing wounds Numbness or tingling sensation of the feet
- 12. Ministries of Health Benefits of healthy eating and active living? Those who do not find time for exercise will have to find time for illness. (Edward Smith-Stanley)
- 13. Ministries of Health Commercial ‘Diabetic’ foods There are many commercially prepared diabetic food substances in the market They are not recommended because: –They are expensive –They are high in trans fatty acids –They contain sugars other than glucose/sucrose –They do not have a role in a healthy eating plan Before using these foods, one must consult with a dietician Avoid chronic use of artificial sweeteners
- 15. Ministries of Health What Do You Think Of This Meal ????
- 17. Ministries of Health Environment Think for a minute about the food: ◦ in grocery stores ◦ in corner stores ◦ in movie theatres ◦ at fast food restaurants ◦ at sports events ◦ at school You pray for good health and a body that will be strong in old age. Good — but your rich foods block the gods’ answer and tie Jupiter’s hands. (Persius)
- 18. Ministries of Health Today we find… Majority addicted to excessive drinking, smoking, totally sedentary, overeating “wrong” foods, overly stressed. Others may occasionally exercise have a high ego. A minority try to follow all the rules of eating, exercise, sleep etc. Almost extinct - exceptionally knowledgeable & disciplined. Analyse your lifestyle
- 19. Ministries of Health The Plate Model The plate model is a simple way to planning a balanced diet through appropriate portion sizes without measuring Fill the plate (20 cm diameter) to match the amount of ◦ Vegetables- ½ of the plate ◦ Starches ¼ of the plate ◦ Meat ¼ of the plate ◦ Then add a piece of fruit and/or a glass of milk
- 21. Ministries of Health Foot wear Acceptable Not acceptable Not acceptable Not acceptable
- 22. Ministries of Health 22 Assessment of the foot - 8 Clinical features 1. Neuropathy 2. Ischemia 3. Deformity 4. Callus 5. Swelling 6. Skin breakdown 7. Infection 8. Necrosis Reference from managing the Diabetic foot : M Edmonds and A Foster
- 23. Ministries of Health Foot Care
- 24. Ministries of Health 24 The Neuropathic Foot Reference from managing the Diabetic foot : M Edmonds and A Foster