By:

NSABIMANA P. OLIVIER, B. Pharm.

NON COMMUNICABLE DISEASES(NCDs)

DIABETES

DIABETES Diabetes is a group of diseases

characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both.

The effects of diabetes include long–term damage, dysfunction and failure of various organs

What’s Occuring in the body?

Our body uses a hormone called insulin to handle glucose, which is a simple sugar that’s a main source of energy. In diabetes, something goes wrong in the body so that you can not produce insulin or are not sensitive to it. That means that your body produces high levels of blood glucose, which acts on organs to produce the symptoms of the disease.

To maintain a constant blood glucose level, the body relies on two hormones produced in the pancreas that have opposite actions: insulin and glucagon.

Pathophysiology of Diabetes

As blood glucose rises, the body sends a signal to the pancreas, which releases insulin.

MECANISM of ACTION

Glucose gets absorbed from the intestines and distributed by the bloodstream to all cells.

The body tries to maintain a constant glucose concentration in the blood.

So, when you over supply on glucose, your body stores the excess in the liver and muscles by making glycogen

When glucose is in short supply, the body makes glucose from stored glycogen or from the food that’s been eaten.

International Diabetes Federation (IDF) data indicate that by the year 2025, the number of people affected will reach 333 million –90% of these people will have Type 2 diabetes.

Today, not only are adults being diagnosed with this disease, but its also affecting today’s youth.

The annual health costs caused by diabetes and its complications account for around 6-12% of all health-care expenditure.

Burden of Diabetes

MAIN TYPES OF DIABETES

Types 1 DiabetesTypes 2 DiabetesGestational diabetes

Was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes.

Type 1 diabetes develops when the body’s immune system destroys pancreatic(IMPINDURA) beta cells, the only cells in the body that make the hormone insulin that regulates blood glucose.

This form of diabetes usually strikes children and young adults, although disease onset can occur at any age.

Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes.

Risk factors for type 1 diabetes may include autoimmune, genetic, and environmental factors.

Type 1 diabetes

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Type 1 Diabetes

· auto immune disorder

· insulin-producing cells destroyed

· age of onset: usually childhood, young adulthood

· daily insulin replacement necessary

· most prevalent type of diabetes in children and adolescents

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SYMPTOMS:

Type 1 Diabetes

increased urination

tirednessweight loss

CAUSE: uncertain, likely both genetic and environmental factors

increased thirsthungerblurred vision

ONSET: relatively quick

Was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes.

Type 2 diabetes may account for about 90% to 95% of all diagnosed cases of diabetes.

It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce insulin.

Type 2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity.

Type 2 diabetes is increasingly being diagnosed in children and adolescents.(!!!!??????)

Type 2 diabetes

Risk factors for type 2 diabetes

Are overweight. Are 45 or older. Are physically inactive. Have a parent or sibling with type 2

diabetes. Are African American, Native American,

Hispanic American, or Pacific Islander. Have abnormal cholesterol levels. Have had gestational diabetes, or given

birth to a baby greater than 9 lbs. Have high blood pressure.

Type 2 is more common in people who:

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SYMPTOMS:

Type 2 Diabetes

tired, thirsty, hunger, increased urination

A form of glucose intolerance(Extreme sensitivity) that is diagnosed in some women during pregnancy.

During pregnancy, gestational diabetes requires treatment to normalize maternal blood glucose levels to avoid complications in the infant.

After pregnancy, 5% to 10% of women with gestational diabetes are found to have type 2 diabetes.

Women who have had gestational diabetes have a 20% to 50% chance of developing diabetes in the next 5-10 years.

Gestational diabetes

Symptoms of Diabetes

Type 2 diabetes is often without symptoms in its early stages. That’s the reason there are 40% of people with Type 2 diabetes are unaware of their

disease. When there are symptoms, they may occur gradually. If present, they usually are:

feeling tired and weak passing large volumes of urine,

especially during the night having frequent infections having blurred eyesight Excessive hunger and thirst

COMPLICATION OF DIABETES

Why is the prevalence of Type 2 diabetes increasing?

Aging of the population. Increased incidence due to urbanization

especially in the developing countries.– More sedentary lifestyle.– Food consumption patterns, – more foods with high fat content – more refined carbohydrates.– Physical inactivity

Prevention of diabetes

Recommendations to reduce risk of type 2 diabetes– Regular physical activity– Interventions to reduce obesity ( Control your

BMI)– Individuals at risk should have dietary intake

assessed and receive individualised dietary advice and continued dietetic support

Evidence Based Guideline for the Prevention of Type 2 Diabetes. Australian Government NHMRC www.diabetesaustralia.com.au/education_info/nebg.html

The major components of the treatment of diabetes are:

Management of DIABETES

• Diet and ExerciseA

• Oral hypoglycaemic therapyB

• Insulin TherapyC

ADVICES

Eat more fruit and vegetables

Fresh Frozen Tinned Dried Juice

Eat starchy foods regularly

Bread Potatoes Rice Pasta Cereals Plantain Chapatis

Reduce animal or saturated fat intake

Use low fat milk Use low fat spread

instead of butter Use oil high in

unsaturated fat, eg olive oil, rapeseed oil

Cut down on sugary foods

Not a sugar free diet Cut out sweets Cut out sugary

drinks

Be Active…Often Exercise for 30 minutes or

more at least 4 days a week.

PREVENTION IS BETTER THAN CURE !!!!!!!

BUT IF ANY COMPLAINTS OCCUR TO YOU, CONSULT YOUR PHYSICIAN ASSP !!!!

MAY GOD BLESS U ALL!!!!!

THANK YOU VERY MUCH