Irina Bubnova,Erica Navarro, Stephanie Knippa

PUBLIC HEALTH PROJECT: DIABETES

DM occurs when the body cannot produce or respond appropriately to insulin. Insulin is a hormone that the body needs to absorb and use glucose (sugar) as fuel for the body’s cells. Without a properly functioning insulin signaling system, blood glucose levels become elevated and other metabolic abnormalities occur, leading to the development of serious, disabling complications (Office of Disease Prevention and Health Promotion, 2015, para. 1).

DIABETES MELLITUS

Type 1 diabetes: previously called insulin-dependent diabetes mellitus or juvenile-onset diabetes account for about 5% of all diagnosed cases

Type 2 diabetes: previously called non-insulin-dependent diabetes mellitus or adult-onset diabetes account for about 90% to 95% of all diagnosed cases of diabetes. 

Gestational diabetes: a type of diabetes that only pregnant women get. If not treated, it can cause problems for mothers and babies. develops in 2% to 10% of all pregnancies but usually disappears when a

pregnancy is over. Other specific types of diabetes:  as a result from specific genetic

syndromes, surgery, drugs, malnutrition, infections, and other illnesses. account for 1% to 5% of all diagnosed cases of diabetes.

TYPES OF DIABETES

29 million or 9.3% of the U.S. population have been diagnosed with Diabetes.

86 million people have pre-diabetesIt is estimated that almost 1/3 of people who have

diabetes may be undiagnosed.

WHY DIABETES IS A PUBLIC HEALTH CONCERN

2010 2013

DIABETES PROGRESSION IN THE U.S.

Diabetes is the seventh leading cause of death in the United States

Contributing to a total of 234,051 deaths in 2012

Lowers life expectancy by up to 15 years.

Increases the risk of heart disease by 2 to 4 times.

Is the leading cause of kidney failure, lower limb amputations, and adult-onset blindness.

WHY IS DIABETES IMPORTANT TO PUBLIC HEALTH?

Growing concerns for diabetes in the US due to a steady rise in cases.

Increase in diabetes-related complicationsEarlier onset of diabetes mellitus type 2 (DM2)Possibility that the increase in the number of individuals

with DM and the complexity of their care might overwhelm existing health care systems

The need to complement improved diabetes management strategies with efforts in primary prevention among those at risk.

UNITED STATES HEALTH CONCERNS

The cost for diabetic care can range from $55,000 to $130,000 Cost variation is due to sex and age at which diabetes was

diagnosed Average cost is $ 85,000

Spending breakdown for diabetic care: Treatment for diabetes Treatment for comorbidities due to diabetes

ECONOMIC IMPACT OF DIABETES

Obesity is the number one reason diabetes is on the rise

Lack of exerciseRisk of heighted blood sugar Increased risk of heart attack Increased risk of stroke

Poor diet/nutritionAffected by educationRegion of residence

WHY IS DIABETES ON THE RISE?

Obesity Diabetes

OBESITY CONTINUED

Studies have shown that stress may play a significant role in the rise of type 1 diabetes in children Death or illness in the family Divorce Family conflicts

Environmental factors Enteroviruses High birth weight Exposure to complex proteins

RISE OF DIABETES IN CHILDREN

Hypertension Macrovascular

Coronary artery disease Myocardial infarction Congestive heart failure Stroke Peripheral vascular disease

Microvascular Retinopathy Nephropathy (Kidney Disease) Neuropathy

COMORBIDITY OF DIABETES

Cancer Shared risk factors:

Obesity Age Reduced physical activity

Depression Anti-depressants can contribute to cardiovascular disease Causes poor care Causes non-adherence to treatment plan

COMORBIDITY OF DIABETES CONTINUED

Working more than 55 hours at a low socioeconomic job can lead to the development of Type 2 diabetes.

Working long hours in general can: Increase stress levels Cause an unhealthy life style

YOUR JOB AND THE RISK FOR DIABETES

Maintaining a healthy weight

Being physically activeEating a healthy dietDecreasing sugar intakeAvoiding tobacco useDecreasing alcohol

consumption

KEY PREVENTIVE MEASURES

Video game called “Escape From Diab”Video game created for childrenNemesis is evil diabetes In order to escape nemesis wise food decisions must be made

INNOVATIVE STRATEGY FOR PREVENTION

Healthy eatingWeight controlRegular physical activityBlood glucose level

managementMedicationsInsulin injections

Preventive screeningsFoot careSupport groups

TREATMENT & MANAGEMENT OF DIABETES

Insulin is needed when diet, exercise, and medications are ineffective at controlling blood sugar levels.

Insulin has two primary delivery methods Injection under the skin with syringe Injection under the skin with pump

TREATMENT – INSULIN

Bi-hormonal therapyArtificial pancreasOral delivery system for Insulin

FUTURE INSULIN DELIVERY ALTERNATIVES

Mobile health application created by Alere™ Health LLC and AT&T

Patients will have ability track medications, eating habits, exercise, and glucose measurements

Application is Integrated system with real-time clinical access

ALTERNATIVE SOLUTION – DIABETESMANAGER®

American Diabetes Association. (2014). Statistics about Diabetes . Retrieved from http://www.diabetes.org/diabetes-basics/statistics/

AT&T. (2012). Alere and AT&T team up to tackle diabetes. Retrieved from http://www.att.com/gen/pressroom?pid=23187&cdvn=news&newsarticleid=35057

Brody, J. (2015, April 28). Rise in Type 1 diabetes can't be explained . Retrieved from http://health.heraldtribune.com/2015/04/28/rise-in-type-1-diabetes-cant-be-explained/

Busko, M. (2013, August 13). Lifetime Cost of Treating Diabetes in US: Around $85,000. Retrieved from http://www.medscape.com/viewarticle/809547

Centers for Disease Control and Prevention [CDC], (2015). Basics About Diabetes. Retrieved from http://www.cdc.gov/diabetes/basics/diabetes.html

Centers for Disease Control and Prevention. (2015). Type 2 Diabetes Prevention and Control . Retrieved from http://www.cdc.gov/workplacehealthpromotion/implementation/topics/

REFERENCES

ClinicalTrials.gov. (2015). Video games for obesity and diabetes prevention-Diab & Nano (G4H-DiabNano) . Retrieved from https://clinicaltrials.gov/ct2/show/NCT01846377

Hagan, C. (2012, November 15) . Diabetes diagnoses increasing at alarming rate. Retrieved from http://thechart.blogs.cnn.com/2012/11/15/diabetes-diagnoses-increasing-at-alarming-rate/

Joslin Diabetes Center. (2015). Will diabetes go away? Retrieved from http://www.joslin.org/info/will_diabetes_go_away.html

Long, A. N., & Dagogo- Jack, S. (2011). The Comorbidities of Diabetes and Hypertension: Mechanisms and Approach to Target Organ Protection. Journal of Clinical Hypertension (Greenwich, Conn.) , 13(4), 244–251. Retrieved from http://doi.org/10.1111/j.1751-7176.2011.00434.x

Macgill, M. (2015, October 13). Insulin pumps for controlling diabetes. Medical News Today. Retrieved from http://www.medicalnewstoday.com/info/diabetes/insulinpump.php

REFERENCES

Office of Disease Prevention and Health Promotion. (2015). Diabetes. Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/diabetes

The New York Times (2015). Type 2 diabetes. Retrieved from http://www.nytimes.com/health/guides/disease/type-2-diabetes/overview.html

Whiteman, H. (2014, September 24). Long hours in low-paid jobs linked to increased diabetes risk . Retrieved from http://www.medicalnewstoday.com/articles/282978.php

Wood, M., Bliss, R. M., (2010). Diabetes: Nutrition research tackles widespread disease. Agricultural Research, 58 (6), 16-17. Retrieved from http://www.ars.usda.gov/is/ar/archive/jul10/diabetes0710.pdf

World Health Organization. (2015). Diabetes. Retrieved from http://www.who.int/mediacentre/factsheets/fs312/en/

REFERENCES