The Certificate Course in Evidence Based Diabetes Management(CCEBDM) is based on the principles of Evidence Based Medicine.
|
44 lakh Indians don't know they are diabetic
|
http://timesofindia.indiatimes.com/india/44-lakh-Indians-dont-know-they-are-diabetic/articleshow/17274366.cms?
|
Nearly 44 lakh Indians in their most productive years — aged 20 to 79 years — aren't aware that they are diabetic, a disease that exposes them to heart attack, stroke, amputations, nerve damage, blindness and kidney disease.
The diabetes epidemic in the country, that killed 10 lakh people in 2011, has also thrown up an interesting trend. Contrary to popular belief, diabetes affects more people in rural India (34 million) than affluent urban Indians (28 million). The gap between the number of diabetic men and women in India is also diminishing. While 33 million men are diabetic, 29 million women are affected by high blood sugar.
The latest global figures on diabetes, released by the International Diabetes Federation (IDF), has raised a serious alarm for India by saying that nearly 52% of Indians aren't aware that they are suffering from high blood sugar.
India is presently home to 62 million diabetics — an increase of nearly 2 million in just one year. India is second only to China which is home to 92.3 million diabetics. By 2030, India's diabetes numbers are expected to cross the 100 million mark.
India is also way ahead when it comes to number of diabetics when compared to its immediate neighbours. Bangladesh has the second highest number of diabetics after India but the number stands at just 5.5 million. Sri Lanka has 1.1 million diabetics, Nepal 5.06 lakh, Mauritius 1.4 lakh, Bhutan 22,362 and Maldives 15,908.
Globally 183 million people (50%) with diabetes are undiagnosed. Diabetes also caused 4.6 million deaths in 2011 and caused $465 billion in healthcare expenditures in 2011. IDF president Jean Claude Mbanya, who was recently in India, spoke exclusively to TOI. He said the diabetes burden was getting worse in India.
"In 2011, there were already 61 million diabetes cases, we predict this to rise to 101 million by 2030. In India, the existing health care infrastructure and system is inadequate to deal with the challenge of diabetes. 80% of the investment in health sector comes from private funds (94% of these funds come from individual pockets), only 20% investment comes from public sector. Given the lifelong costs associated with diabetes, many people in the lower income segment are unable to cope with the economic and disease burden," Mbanya said.
The prevalence of diabetes in the age group of 20 to 79 years stood at nearly 9% of the population in India. Globally, 366 million people had diabetes in 2011; by 2030, this will have risen to 552 million. The greatest number of people with diabetes is between 40 to 59 years of age.
|
Diabetes and you
|
http://www.thehindu.com/health/rx/diabetes-and-you/article4105641.ece
|
Almost every organ in the body can be adversely affected with the onset of diabetes, say medical specialists. But with timely intervention and care, the disease can be kept under check
India houses over 61 million diabetics and the forecast is that there will be 100 million diabetics by 2030. China is the world capital for diabetes with India a close second. More than 70 per cent of middle aged Indians will suffer with non-insulin dependent diabetes during their lifetime. Results of a 10-year analysis from Southern India (1994 - 2004) reveal a trend towards increasing prevalence in both urban and rural population with more number of younger persons, particularly women, afflicted with diabetes.
"Though diabetes is caused by a complex interaction of genetic and lifestyle factors, the most obvious reason for this increase in the number of young diabetics is their frenetic lifestyle", says Rajesh Shah, consulting physician and cardiologist, Better Health Foundation.
"Diabetes is one of the diseases that affects the endocrine system. The pancreas produces the hormone insulin. In Type 1 diabetes, the insulin producing cells in the pancreas are destroyed. In Type 2 diabetes, insulin is still produced but the body becomes resistant to it," explains M. Ravi Kiran, endocrinologist, Agada Health Care. "Endocrinologists can help you manage your diabetes, by prescribing insulin and/or medications, and offering diet plans," he says.
Kidney trouble
According to Soundarajan, head of the Department of Nephrology, SRMC, "Diabetes may damage almost every tissue and organ of the body, the kidney being one of them. If neglected, a person could go into diabetic nephropathy. Albumin in the urine, blood urea and creatinine levels should be checked once a month. Diabetics should avoid painkillers. They should watch out for swelling of the feet, extreme fatigue, weakness and breathlessness. Obese children should also be screened for diabetes," he advises.
Feet first
A diabetic should take special care of his feet, says V.Ramnarayan, consultant orthopaedic surgeon SRMC. "Watch out for numbness, foot ulcers and carefully examine spaces between the toes and the soles of the feet. Socks should be washed regularly and changed every day and one should use footwear, preferably with ankle support. Nails should not be cut short and sharp edges should be filed," he says.
Special care should be taken by those who plan to go on temple visits and have to walk barefoot. "Trivial foot lesions precede 85 per cent of leg amputations in India. Almost 75 percent of amputations are carried out in neuropathic feet with secondary infection, which are potentially preventable."
The eyes of a diabetic also need special attention and care. Regular eye check-ups are a must says Amar Agarwal, chairman and managing director, Agarwal's Eye Hospital. "The retina could get affected, and blood vessels in the eye could leak blood. Diabetes also produces early cataract. In extreme cases, the patient can lose eyesight."
Depression and anxiety
There is also a link between depression and diabetes. According to Dr. Thara, Psychiatrist and Director, SCARF, "... Research studies have also demonstrated that the chances of developing diabetes was more amongst persons with current depressive and/or anxiety disorders. Some of the newer drugs used in the treatment of mental disorders might increase blood sugar levels. It is now important to monitor all patients on such drugs for their blood sugar levels," she says.
Heart matters
Diabetics have a higher risk of cardio vascular disease (CVD). "Diabetes is a generalised micro and macro vascular disease, affecting various organs" says S. Thanikachalam, Chairman & Director of Cardiac Care Centre, Prof Emeritus, Sri Ramachandra University. "A concerted attempt to identify pre-diabetics and intervene to reverse the metabolic abnormality will prevent further increase in the prevalence of diabetes."
According to M. Thanikachalam, cardiac surgeon, (American Board of Thoracic Surgery) preventive health check-up and a year-round management of health and wellness customised to one's health profile and screening are absolutely essential. This led him to follow his dream project Agada, a one stop institute for comprehensive therapy with the focus on preventive treatment. It was established in association with the world leader in Diabetes Prevention Management and Care, Joslin Diabetes Centre, Harvard Medical School, Boston USA. "We believe in empowering you with skills to take ownership and manage your health optimally," he says.
Look out
* Symptoms could be excessive thirst, excessive appetite and excessive urination and swelling of feet. Delayed wound healing, frequent infections, nausea, vomiting and weight loss may be other symptoms
* Neglected, diabetes will affect the heart, eyes, kidneys and all major organs.
* With proper treatment, counseling and personal management, diabetes can be controlled.
|
Vitamin D deficiency linked to Type 1 diabetes risk
|
http://www.newkerala.com/news/newsplus/worldnews-103920.html#.UKnuoKCDEVg
|
Low levels of Vitamin D in the blood can contribute to a person's risk of developing Type 1 diabetes, new research has found.
A study led by researchers from the University of California, San Diego School of Medicine has found a correlation between vitamin D3 serum levels and subsequent incidence of Type 1 diabetes.
The six-year study of blood levels of nearly 2,000 individuals suggests a preventive role for vitamin D3 in this disease.
"Previous studies proposed the existence of an association between vitamin D deficiency and risk of and Type 1 diabetes, but this is the first time that the theory has been tested in a way that provides the dose-response relationship," said Cedric Garland, DrPH, FACE, professor in UCSD's Department of Family and Preventive Medicine.
This study used samples from millions of blood serum specimens frozen by the Department of Defense Serum Registry for disease surveillance. The researchers thawed and analyzed 1000 samples of serum from healthy people who later developed type 1 diabetes and 1000 healthy controls whose blood was drawn on or near the same date but who did not develop type 1 diabetes.
By comparing the serum concentrations of the predominant circulating form of vitamin D - 25-hydroxyvitamin D (25(OH)D) - investigators were able to determine the optimal serum level needed to lower an individual's risk of developing type 1 diabetes.
Based mainly on results of this study, Garland estimates that the level of 25(OH)D needed to prevent half the cases of type 1 diabetes is 50 ng/ml. A consensus of all available data indicates no known risk associated with this dosage.
"While there are a few conditions that influence vitamin D metabolism, for most people, 4000 IU per day of vitamin D3 will be needed to achieve the effective levels," Garland suggested. He urges interested patients to ask their health care provider to measure their serum 25(OH)D before increasing vitamin D3 intake.
"This beneficial effect is present at these intakes only for vitamin D3," cautioned Garland. "Reliance should not be placed on different forms of vitamin D and mega doses should be avoided, as most of the benefits for prevention of disease are for doses less than 10,000 IU/day."
The study has been published in the December issue of Diabetologia, a publication of the European Association for the Study of Diabetes (EASD).
|
Diabetes could also turn you deaf
|
http://www.newkerala.com/news/newsplus/worldnews-103489.html#.UKXpuKCDEVg
|
Diabetics, who were warned for years that their illness could cause blindness, are in for more bad news, as doctors have claimed that the patients are more likely to lose their hearing, too.
Japanese research has found that hearing problems are far more common in diabetics than their healthy counterparts, even when other factors such as ageing and a noisy environment are taken into account, the Daily Mail reported.
Lead author of the study, Chika Horikawa of Niigata University, said: "We found that people with diabetes had more than two times higher prevalence of hearing impairment than those without diabetes."
Several studies have investigated the relationship between diabetes and hearing impairment but their findings were inconsistent.
However, links have been made between hearing loss and other conditions such as dementia and depression.
"The association of hearing impairment with diabetes is controversial, but it is believed that over time, high blood glucose levels can damage vessels [causing hearing loss]" Horikawa said.
It's thought that glucose damages the nerves and tissues in the ear, diminishing the ability to hear.
"Our results propose that diabetic patients be screened for hearing impairment from earlier age compared with non-diabetics, from the viewpoint of prevention of several health problems such as depression and dementia caused by hearing impairment," Horikawa said.
Around a third of over-60s have significant permanent hearing loss, rising to about two-thirds of 70-year-olds.
American research published earlier this year found that women in particular are likely to suffer from hearing loss if they are diabetic and their condition is not well controlled with medication.
The findings are set to be published in the Journal of Clinical Endocrinology and Metabolism.
|
Top 6 survival skills for diabetes
|
http://timesofindia.indiatimes.com/articleshow/17215915.cms
|
Diabetes affects millions of people and is a very serious lifelong health problem. However, keeping diabetes in control is a difficult task as more than half of the care for diabetes is self driven.
This makes it important to be self-aware, and skilled in these care methods. Today, on World Diabetes Day 2012, Ms. Sunita Pathania - Sr. Registered Dietician and Diabetes Educator, Healthy Living Diet Clinic, Mumbai, shares a few steps to help you manage diabetes better.
Survival step 1: Diabetes and its treatment
Diabetes is a condition that causes high blood sugar. It cannot be completely cured but it can definitely be managed. There are basically two types of diabetes, the first being Type 1 diabetes, wherein the body's immune system destroys the insulin producing cells in the pancreas. Due to low insulin level, it is treated with daily insulin injections and a healthy diet. The second type is Type 2 diabetes, here the pancreas does not produce enough insulin or does not use insulin efficiently. It is treated by implementing a diet modification, exercise plan or oral medication.
Survival step 2: Time-to-time medication
Medicines and injections are very important to manage your diabetes level. Whichever medicines your doctor prescribes for you, take detailed information about its dosage, and follow it the way advised by your doctor. Whenever you make any appointment with any healthcare professional, take the list of all the medicines you have been advised to manage your diabetes level, to avoid any medicinal complications.
Survival step 3: The right FOOD
You need to take heed to what you eat to manage diabetes. Follow a diet planned for you by your dietician to maintain your weight and to lower your blood sugar. Never skip meals and eat three small meals to keep blood sugar level in control.
Survival step 4: Self-tests
Testing your blood sugar is the next important thing to do. This will give your healthcare the necessary information required so that he can balance between your diet, physical activity and medications accordingly. If your blood sugar falls below 70 or is above 240 more than two times in a week then call your doctor.
Survival step 5: High and low blood sugar
An unbalanced blood sugar level can lead to serious complications. If your blood sugars are low (less than 70) treat it immediately with 15 grams of carbohydrates like 3-4 glucose tablets, ½ juice or 1 cup skimmed milk. After this wait for 15 minutes and retest your blood sugar level. If it is still low then treat it again with 15 grams of carbohydrate. Whereas, if you have high blood sugar level, then test your blood sugar every 4 hours, drink at least 8 glasses of water to prevent dehydration and consume 45-50 grams of carbohydrates every four hours. Examples of 45-50 grams of carbohydrates are orange or grape juice 1 ½ cups, canned fruit 1 ½ cups, toast 3 slice and regular yoghurt 1 cup.
If you have type 1 diabetes and your blood sugar is greater than 240, test for ketones at every meal.
Survival step 6: Preventive exams
Prevent small cuts to convert it into major complications. If you are a diabetic patient even tiny cuts can develop into a major infection that may require amputating that part of your body. Hence, check your feet daily. Go for an eye check up and complete body check up to prevent long term complications.
|
50 million people in India have diabetes
|
http://www.indianexpress.com/news/-50-million-people-in-india-have-diabetes-/1030869/
|
Endocrinologists suggest the use of an innovative technology called continuous glucose monitoring system for patients with diabetes and planning during pregnancy to get a correct picture of their blood sugar pattern
The World Health Organisation (WHO) estimates that nearly 200 million people all over the world suffer from diabetes and this number is likely to be doubled by 2030. Even as nations prepare to mark World Diabetes Day on November 14, WHO says about 80% of the diabetes deaths occur in middle-income countries.
In India, there are nearly 50 million diabetics, according to the statistics of the International Diabetes Federation. As the incidence of diabetes is on the rise, doctors say, there is a proportionate rise in the complications that are associated with diabetes. They point out that it is a very crucial stage and awareness on the part of people and administration about diabetes is very essential, adding that people should be made aware and educated about their health and fitness level to reduce the number of patients in India.
Dr Abhijeet Joshi, a diabetic foot surgeon, says when diabetes is not well controlled there is damage to the organs and the immune system is impaired. Foot problems occur in people with diabetes and can get serious very fast. Recent statistics show that approximately a quarter of all people with diabetes worldwide at some point during their lifetime will develop sores or breaks (ulcers) in the skin of their feet, adds Dr Joshi. Those with long standing diabetes are at the risk of developing diabetic neuropathy and complications of diabetic foot. Round-the-year foot care can ensure that the chances complications are minimised.
According to Dr Abhay Mutha, senior consulting physician at Ruby Hall Clinic, diabetes can cause difficulties during pregnancy such as a miscarriage or a baby born with birth defects.
Out of an estimated 62.4 million diabetics in India, 4 to 21 per cent women suffer from gestational diabetes mellitus (GDM) — also called glucose intolerance or carbohydrate intolerance. It is a temporary form of diabetes in which the body does not produce adequate amounts of insulin to deal with sugar during pregnancy. Pregnant women who are obese or have a history of abortions are more prone to gestational diabetes. It is, however, treatable through diet modification, taking the essential medications as well regular exercise.
Endocrinologists suggest the use of an innovative technology called continuous glucose monitoring system for patients with diabetes and planning pregnancy to get a correct picture of their blood sugar pattern. If a patient with diabetes is planning to go the family way, it is absolutely vital that blood sugar is very tightly controlled throughout the pregnancy.
|
Australian researchers claim to find cure for Type 1 diabetes
|
http://www.thehindubusinessline.com/news/international/australian-researchers-claim-to-find-cure-for-type-1-diabetes/article4094616.ece
|
The Australian researchers have claimed to have made a breakthrough which could lead to treating the Type 1 diabetes patients.
According to ABC report, scientists at the Walter and Eliza Hall Institute said they have identified stem cells in the adult pancreas and converted them into insulin-producing cells. They discovered the cells continued to function when they were transplanted into mice.
Professor Len Harrison of the institute said that the finding has the potential to cure the disease.
"This means that the potential to regenerate insulin-producing cells in someone with Type 1 diabetes is there. It's a question of working out how to make that happen in order to reverse or cure it," he said.
Harrison said suppressing the immune system's response to the new cells is pivotal.
"There can really be no cure for Type 1 diabetes, even with stem cells, even under the most ideal conditions unless the immune system is prevented from seeing them as foreign and attacking them," he said.
Prevention of Type 1 diabetes is very fundamental to its cure, the researcher added.
|
|
|
|
|
