DIABETES AWARENESS PROGRAMME ROTARY DISTRICT 3220 / DASL PRESENTED BY RTN PP PHF RANJAN ALLES

DIABETES AWARENESS PROGRAMME

ROTARY DISTRICT 3220 / DASL

PRESENTED BY RTN PP PHF RANJAN ALLES

THE PISS MANNEQUIN IN BRUSSELS

• DIABETES WAS DISCOVERED IN ANCIENT EGYPT IN THE 16TH CENTURY BC.

• IT IS DERIVED FROM THE GREEK WORD “DIABEINEIN” WHICH MEANS TO PASS THROUGH OR SIPHON.

• MELLITUS MEANS SWEET AS HONEY IN LATIN.

• ANCIENT HINDUS USED TO REFER TO IT AS “MADHU MEHA” WHICH MEANS SWEET WATER.

HISTORY OF DIABETES

WHAT IS

IS A CONDITION WHERE YOUR BLOOD SUGAR LEVEL IS TOO HIGH AND IS CAUSED BY THE LACK OF OR INSUFFICENT PRODUCTION OF INSULIN. THIS CONDITION IS DETRIMENTAL TO HEALTH AND IF LEFT UNTREATED CAN LEAD TO MANY COMPLICATIONS INVOLVING THE KIDNEYS, LIVER, EYES, HEART, NERVES, GUMS ETC AND EVEN DEATH.

(A fasting blood sugar level of 75 - 100 mg/dl is considered normal)

DiagnosisDiagnosis

Main Types of Diabetes Main Types of Diabetes

Type 1 Diabetes (T1DM)Type 1 Diabetes (T1DM)

Type 2 Diabetes (T2DM)Type 2 Diabetes (T2DM)

Gestational Diabetes (GDM)Gestational Diabetes (GDM)

HOW WOULD YOU GET HIGH BLOOD SUGAR?

The food you eat provides the cells with the sugar necessary to Generate the energy required by you. The body converts most of the food you eat into sugar and the blood carries this sugar to the cells.

Sugar needs the insulin( a hormone) produced bythe “Islets of Langerhann” which is in the pancreas to be absorbed by the cells. If your body does not produce any or enough insulin or if the Insulin you produce does not work right the sugar cannot getabsorbed into the cells. At this point the sugar remains in the blood and causes an elevation of the sugar level causing DIABETES.

ComplicationsComplications Heart disease & strokeHeart disease & stroke

50% diabetics die of heart disease 50% diabetics die of heart disease

Kidney failureKidney failure

20% diabetics die of kidney failure20% diabetics die of kidney failure

Blindness Blindness

2.5 million diabetics go blind 2.5 million diabetics go blind annuallyannually

Amputation Amputation

1 million amputations annually1 million amputations annually

Global Prevalence - >20yrsGlobal Prevalence - >20yrs

20112011 2030 2030

Population Population 7.0 b7.0 b 8.3 b 8.3 b

DMDM 366 m (8.3%)366 m (8.3%) 552 m (9.9%)552 m (9.9%)

IGT(IGT(IIMPAIRED GLUCOSEMPAIRED GLUCOSE) 280 m (6.4%)) 280 m (6.4%) 398 m 398 m

(7.1%)(7.1%)

50% undiagnosed Diabetes Atlas – 5th Edition – Nov 2011

Prevalence - Sri Lankan >20yrsPrevalence - Sri Lankan >20yrsUrbanUrban RuralRural

1990 5% 1990 5% 2% 2%

2000 12%2000 12% 7% 7%

2010 2010 16.4% 16.4% 8.7% 8.7%

Katulanda et.al.

Diabetes - 10.3% - 2 million

Pre-diabetes - 11.5% - 2.3 million

Prevalence of Risk Factors in Prevalence of Risk Factors in 22,507 – Diabrisk-SL22,507 – Diabrisk-SL

WHAT ARE THE SYMPTOMS OF DIABETES?

HIGH THIRST FREQUENT URINATION WEIGHT LOSS FOR NO APPARENT REASON FEELING VERY HUNGRY/ TIRED OFTEN SLOW HEALING WOUNDS BLURRY VISION LOSS OF SENSATION OR TINGLING IN THE FEET

Causes of T2 Diabetes Causes of T2 Diabetes Interaction ofInteraction of GeneticsGenetics Foetal OriginsFoetal Origins Lifestyles-ObesityLifestyles-Obesity StressStress

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1989BRFSS, 1989

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Body mass index

Weight in KGS- -Height in metre squared

18.5 - 24.9 Normal25 - 29.9 Overweight30 - 34.9 Obese35 - 39.9 Severely Obese40 - < Morbidly Obese

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1990BRFSS, 1990

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1991BRFSS, 1991

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1992BRFSS, 1992

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1993BRFSS, 1993

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1994BRFSS, 1994

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1995BRFSS, 1995

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1996BRFSS, 1996

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1997BRFSS, 1997

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1998BRFSS, 1998

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1999BRFSS, 1999

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 2000BRFSS, 2000

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 2001BRFSS, 2001

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 2002BRFSS, 2002

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 2003BRFSS, 2003

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Montana

Colorado

Arizona

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 2004BRFSS, 2004

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 2005BRFSS, 2005

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 2006BRFSS, 2006

Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

colorado

No Data <10% 10%–14% 15%–19% 20%-24% 25%

Source: Behavioral Risk Factor Surveillance System, CDC

Obesity* Trends Among U.S. AdultsObesity* Trends Among U.S. AdultsBRFSS, 2007BRFSS, 2007

(*BMI 30, or about 30 lbs overweight for 5’4” person)

No Data <10% 10%–14% 15%–19% 20%-24% 25%

Source: Behavioral Risk Factor Surveillance System, CDC

Obesity* Trends Among U.S. AdultsObesity* Trends Among U.S. AdultsBRFSS, 2008BRFSS, 2008

(*BMI 30, or about 30 lbs overweight for 5’4” person)

Kansas

Montana

Texas

Sri Lanka –Obesity in Urban Sri Lanka –Obesity in Urban School ChildrenSchool Children

7 schools in Colombo7 schools in Colombo 8-12 years old8-12 years old 50 students in each Yr 4 -7 (1224)50 students in each Yr 4 -7 (1224) Obesity 4.3% boys, 3.1% girlsObesity 4.3% boys, 3.1% girls 66% obese from high income66% obese from high income

Wickramasinghe VP, Lamabadusuriya SP, Atapattu N, Sathyadas G, Kurunarathne P. Nutritional status of schoolchildren in an urban area of Sri Lanka. Ceylon Med J. 2004 Dec;49(4):114-8.

How do you Prevent Diabetes How do you Prevent Diabetes

1.Identification of risk factors

a. Physical - early

Increased BMI Increased waist Low physical activity Family history

b. Biochemical - late

FBC/ IGT/DM

How do you prevent How do you prevent DiabetesDiabetes2. Lifestyle Modification

Correct Nutrition

Adequate exercise

Stress Control

Correct Nutrition Correct Nutrition

What is good for a diabetic is good for What is good for a diabetic is good for allall

Golden rule:Golden rule: Quality, Quantity & Quality, Quantity & TimingTiming

QualityQuality - Healthy, balanced diet - high fiber - Healthy, balanced diet - high fiber natural foods - low in calorie natural foods - low in calorie

QuantityQuantity – To ensure ideal body weight – To ensure ideal body weight

Timing Timing - Do not delay or skip meals – 4 small - Do not delay or skip meals – 4 small

meals recommended for school kidsmeals recommended for school kids

What is Adequate What is Adequate ExerciExercise se

• Exercise is essential for all persons of Exercise is essential for all persons of all ages on a regular basis all ages on a regular basis

• Golden rule: It should be continuous Golden rule: It should be continuous and regular and of your choiceand regular and of your choice

• Try to exercise with family and Try to exercise with family and friends to minimizes boredom friends to minimizes boredom

• Sedentary activities (e.g. sleeping, Sedentary activities (e.g. sleeping, reading, playing computer games, reading, playing computer games, watching TV) should be minimized watching TV) should be minimized

30 min x 5 times a week or more – Good30 min x 5 times a week or more – Good

30 min x 3 times a week – minimum 30 min x 3 times a week – minimum required required

<30 min and/or <3 times a week – <30 min and/or <3 times a week – Inadequate Inadequate

Children should play daily at least for 1 Children should play daily at least for 1 hour hour

To burn fat - continuous exercise 45-60 To burn fat - continuous exercise 45-60 min 3-5 times a week essentialmin 3-5 times a week essential

Exercise Regimes

How do you reduce stress?How do you reduce stress? Stress is common in modern Stress is common in modern

lifestylelifestyle

• Be calm and positive – avoid negative Be calm and positive – avoid negative thoughtsthoughts

• Avoid extreme responses – middle path Avoid extreme responses – middle path • Meditation – Yoga Meditation – Yoga • Set realistic goals / expectationsSet realistic goals / expectations• Adapt to changing situationsAdapt to changing situations• Do not fear to fail – Success is always round Do not fear to fail – Success is always round

the cornerthe corner

ROTARY CLUB OF MEMPHIS CENTRALTYPE ONE DIABETES INITIATIVE

Dream Factory-wish for Skylar Bolton- 9 years with diabetes sniffing Black labrador Denali - Rotarian magazine aug 2009

Lets save our Lets save our childrenchildren

CHECK LISTCHECK LIST•

Seeni Meanie Campaign Check list for RotariansSeeni Meanie Campaign Check list for Rotarians Appoint a Seeni Meanie (SM) co-ordinator and inform the Appoint a Seeni Meanie (SM) co-ordinator and inform the

contact details i.e name, address and mobile number to contact details i.e name, address and mobile number to secretariat by email: secretariat by email: seenimeanie@sltnet.lk or 0777703707 or 0777703707 (contact persons: Laksha / Dhanya)(contact persons: Laksha / Dhanya) ImmediatelyImmediately

   Read the details in the file given on the day of the briefing Read the details in the file given on the day of the briefing

or the file sent to you. The big SM sticker in the President’s or the file sent to you. The big SM sticker in the President’s file is for you to fix same on your Rotary flag! Confirm file is for you to fix same on your Rotary flag! Confirm acceptance of the 2 Action Kits to the SM secretariat – acceptance of the 2 Action Kits to the SM secretariat – ImmediatelyImmediately

   Identify 2 (two) foster schools – Inform the secretariat of Identify 2 (two) foster schools – Inform the secretariat of

the names and addresses of the school – the names and addresses of the school – Immediately Immediately

CHECK LIST CONTINUED

Once the Secretariat has registered the schools, you are advised to contact the Medical Officer of Health as well as the Zonal Educational Director of the respective area (Please take a copy of the Education Ministry letter from the Director Nutrition) and inform them of the Diabetes Awareness and Prevention Campaign you hope to conduct in the respective schools- Before 31st July 2012.

Meet with the Principal to obtain his or her support. Hand over the letter in the chosen language along with the Education Ministry letter and request the Principal to appoint the SM team (up to 12) including the team leader – Before 3rd August 2012

CHECK LIST CONTINUED

• 

If your foster school has an Interact club, they can spearhead the campaign. If your club is supervising an Interact club, they may assist you in the implementation of the project.

 Rotary club to get the SM team to conduct pre evaluation by photocopying 50 questionnaires (in the preferred language) and return the completed forms to the Secretariat – Before 14th August 2012

Rotary club to get the SM team to formulate Campaign Ideas and submit the proposal to the Secretariat in the preferred language. This should be done as per the prescribed format in action kits. - Before 14th August 2012

Rotary club will receive the screened proposal with the approval and recommendations from the Secretariat – 15th to 31st August 2012

CHECK LIST CONTINUED

•   Implementation of Seeni Meanie Campaign – 1st September 2012 – 28th February 2013

 Rotary club to get the SM team to conduct post evaluation questionnaire and return same to the Secretariat – 14th -28th February 2013

 Assistant Governor’s to evaluate and judge regional cluster campaigns and choose regional winners –1st March 2013 – 14th March 2013

 Final evaluation and judging of the Regional winners to choose the National winner and the 1st and the 2nd runner up – 15th March 2012 – 31st March 2013. Awards Nights – Date, Time and Venue to be informed.

THANK YOU

FOR YOUR ATTENTION