Type - 1 Diabetes Mellitus:Indian and Global Scene - PowerPoint PPT Presentation

Loading...

PPT – Type - 1 Diabetes Mellitus:Indian and Global Scene PowerPoint presentation | free to view - id: 95249-NTczZ



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Type - 1 Diabetes Mellitus:Indian and Global Scene

Description:

Mody ( With its Various - Genetic Subtypes ) 3 - 5 ... Public Education programme (Shri Prakash Endowment Public Lectures). VHS DIABETES DEPARTMENT ... – PowerPoint PPT presentation

Number of Views:467
Avg rating:3.0/5.0
Slides: 44
Provided by: DIA1154
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Type - 1 Diabetes Mellitus:Indian and Global Scene


1
Type - 1 Diabetes MellitusIndian and Global
Scene Burden Challenges.
C.V.Krishnaswami FRCP(E) DTMH(EDIN) FAMS.
Head of Diabetes Department,Voluntary Health
Services,Chennai, Tamil Nadu, India.
2
WHO HAS SEEN A BLOOD SUGAR?
Reflections on Medical education Frank Davidoff,
M.D.
Who has seen the wind ?
Neither you nor I
But when the trees bows down their heads the
wind is passing by.
CHRISTINA ROSSETTI In who has seen the wind
3
Incidence of IDDM in children aged under 15
WHO 94387
4
Diabetes Voice. Vol. 44. March. No 1/99. P.33
5
Types of Diabetes Mellitus Seen in Young People (
lt 40 years of age )
  • Type - 1 Diabetes Mellitus (IDDM / JIDDM ( lt 15
    Years ) 80
  • Mody ( With its Various - Genetic Subtypes )
    3 - 5
  • FCPD ( Peculiar to Para equatorial regions (15
    30 Yrs ) Now classified by WHO as sec Diabetes
    Mellitus ) 2
  • E.O.D/NIDDY 25 lt40 Yrs( Early Onset Type
    - 2 Diabetes Mellitus )
    10
  • LADA (IDDM Onset gt 25 Years )
    1- 2
  • Genetic Syndromes Assoc with Diabetes Mellitus
    sec toPit Tumor etc.

    0.5
  • 7. Type - 2 Diabetes Mellitus in Childhood
    0.5

6
Types of Diabetes Mellitus Seen in Young People
( lt 40 years of age )
  • Diabetes in Young People.
  • - MODY (5 Genetic Sub Types described).
  • - EOD (Type 2).
  • - Type - 2 Diabetes Mellitus in Children.
  • - /- LADA (Type 1).
  • - FCPD (Fibro Calculus
    Pancreatic Diabetes Now
    classified by the WHO as a secondary form of
    Diabetes)

7
Types of Diabetes Mellitus Seen in Young People (
lt 40 years of age )
  • Type - 2 Diabetes Mellitus in very young
    children is being increasingly reported from
    Japan, Singapore, Hong Kong
  • In Japan Type - 2 Diabetes Mellitus in 6-12
    Years age Groups. in 1976 0.2/100,000/Yrs
    1999 2.0/100,000/ Yrs
  • In 12 15 Years age Group
  • 1976 L 7.3/100,000/Yrs 1995
    13.5/100,000/Yrs
  • This in crease is correlated with affluence and
    increased reported intake of animal protein
    Fat (Fall, CHD, Barker DJP(1997) Indian
    Pediatr)

8
EVIDENCE FOR INCREASING PREVELANCE OF DIABETES
MELLITUS IN CHILDHOOD
Prevalence of diabetes mellitus among the cohort
of children in the child health and education
study.. At age 10 years was 1.3/1000(1970),
previous British birth cohort Studies
0.6/1000(1946)

Sarah Steward-Brown et
al.
B.M.J.,19832861855-1857
9
Increasing incidence of J.I.D.D.M. in the west
  • 5 of Diabetic clinic population
  • P.Forsham - (1970)
  • 10 of Diabetics - Drury -
    (1976)
  • 20 of Diabetes - Rayfield Seto - (1978)

10
INCIDENCE OF INSULIN DEPENDENT DIABETES IN
ENGLAND A STUDY IN THE OXFORD REGION , 1985-86
The overall yearly Incidence of newly diagnosed
Insulin-dependent diabetes mellitus in people
under 21 was 15.6 cases/100,000.case ascertain
was greater than 95
Conclusion The incidence of insulin dependent
diabetes in England is
considerably higher than reported from
large Scale studies
P.J.Bingley and Gale(B.M.J., 1989
298,558-60)
11
CLINICAL REVIEWS
Rise in Incidence Of Type 1 Diabetes In Infants
Epidemiology of type 1 diabetes mellitus in
Switzerland steep rise in incidence in under 5
years old children in the past decade. Schoenle
EJ, Lang-Muritano M,Gschwend S,Laimbacher
J,Mullis PE,Torresani T,Biason-Lauber A,Molinari
L, Diabetologia 200144286-9
International Diabetes Monitor Volume 14,Number
1,2002
12
Age-Specific incidence of type 1 diabetes
mellitus in children aged 0-14 years and 0-4
years in Switzerland between 1991 and 1999.
The solid line shows the average rate of change,
which was significant in both age groups 0-14
years, slope 0.33 or 0.13 (p 0.03) 0-4
years, slope 0.88 or- 0.13 (p 0.0002)
International Diabetes Monitor Volume 14,Number
1,2002
13
Between 1991 and 1999 only the youngest age group
contributed to the overall increase in incidence
of type 1 diabetes in children.
In this prospective study (1991 1999) the
authors found that the annual incidence of
childhood diabetes had increased from 7.8/100,000
in 1991 to 10.6/100,000 in 1999, corresponding to
an annual average increase of 5.1. The most
striking finding was the increased incidence in
the 0-4 year age group, which had risen from 2.4
to 10.5 per 100,000, corresponding to an average
yearly increase of 23.8 (Fig 1)
14
There was no variation in 5-9 year or 10-14 year
age groups, meaning that the 0-4 year age group
alone was responsible for the rise in the
childhood type 1 diabetes inathea10ayearsaofafollo
w-up.The present paper refers to an incident of
10.6 / 100,000 in 1999, representing an average
annual increase of 5.1, higher than the
EURODIAB average increase of 3.5 (2.5-4.4). But
what is more important is that only the youngest
age group (0-4 years) contributed to
thisaincrease.
International Diabetes Monitor Volume 14,Number
1,2002
15
Whatever the speculative explanation for the
rise in incidence in the youngest Swiss children,
the phenomenon represents a challenging burden to
the health care system.
International Diabetes Monitor Volume 14,Number
1,2002
16
Tahoku J.exp. Mod., 1983 141 Suppl., 161-170
The Significance of Certain Epidemiological
Variants in the genesis of Juvenal
Insulin-Dependent Diabetes Mellitus the need for
A Global program of Co-operation.
C.V.KRISHNASWAMI and P.CHANDRAVoluntary Health
Services Hospital and Government Stanley
Hospital, Department of pediatrics,Government
Stanley Hospital, Chennai Tamilnadu
17
(No Transcript)
18
MAGNITUDE OF YOUNG DIABETES IN INDIA URBAN
POPULATION
ABSTRACT
As there is paucity of reports in India on the
prevalence of diabetes in the young, aged lt20
years, a population based survey was undertaken
to assess the same. Urban population was selected
for the survey. The prevalence of diabetes among
these aged 0-20 years was assumed as 0.2. The
sample size of the total population required to
estimate it with 95 CI and 25 precision was
calculated y random cluster sampling method.
Key words Diabetes mellitus, Type-1 diabetes,
Prevalence, Type 2 diabetes, Young population
19
MAGNITUDE OF YOUNG DIABETES IN INDIA URBAN
POPULATION
The required sample size of all the ages was
155000 which was obtained from 30 randomly
selected corporation divisions of the city. Ten
trained social workers recorded required
information of the selected families on the
prescribed forms by daily house visits. This
study was conducted during 1998 1999. Among
156258 individuals of all ages surveyed, there
were 60310 persons aged 0-20 years. The age
standardized prevalence of known diabetes was
0.02 in those aged lt 20 years. This survey
indicates that diabetes of any category is not a
public health problem in those aged lt20 years in
Chennai city, India.
Key words Diabetes mellitus, Type-1 diabetes,
Prevalence, Type 2 diabetes, Young population
20
Chapter 1
HUMANISTIC QUALITIES IN MEDICENE
JOHN A BENSON Jr
"The essence of the practice of medicine is that
it is an intensely personal matter...the
treatment of a disease may be entirely impersonal
the care of a patient must be entirely personal
.The significance of the intimate personal
relationship between physician and patient cannot
be too strongly emphasized for in an
extraordinary large number of cases both
diagnosis and treatment are directly dependent on
it...One of the essential qualities of the
clinician is interest in humanity , for the
secret of the care of the patient is in caring
for the patient".
--Francis W.Peabody,1927
21
(No Transcript)
22
By learning you will teach
By teaching you will learn.
Latin
Proverb
The High Risk Foot in diabetes Mellitus. Robert
G.Frykberg. Churchill Living stone
1991.
23
SERVICES OFFERED BY THEVHS DIABETES DEPARTMENT
  • In the NGO sector catering to the public of
    Chennai, TamilNadu (India) for over 35 years

The Services Include
Regular Out-Patient services for all persons with
Diabetes SPECIAL COMPREHENSIVE FREE MEDICARE FOR
ALL PERSONS with JIDDM(Type 1 DM with onset below
15 years) includes supply of Insulin HMBG
monitoring / training with equipment and regular
follow up with all investigations like
FLOURESCEINE ANGIOGRAPHY for eyes, renal package,
foot care etc., treatment of co-morbid
conditions, educational and social support, job
placements and rehabilitation, plus pregnancy
care and delivery.
24
Simple guidelines for accurate results
  • Keep the hand clean by washing with soap and
    water.
  • Do not wipe the hand with spirit or iodine
    solutions use only cotton soaked in clean
    water.
  • New needle is used to prick the finger.
  • Check calibration of the meter, code number on
    the meter and on the strip, expiry date of
    the reagent strip and batteries in the meter.
  • After finger prick, try not to squeeze finger
    but to milk from the base of the finger for
    a drop of blood.
  • Interest and involvement in doing the procedure
    and proper training is essential for
    accurate results.
  • The timing of food intake and type of insulin or
    oral tablets taken by the patient need
    correlation with blood test.

25
Differences between Venous Plasma abd Capillary
Blood Glucose
26
VHS DIABETES DEPARTMENT
  • Diabetes pregnancy for all with GDM screening
  • Diabetes Foot care service
  • Diabetes Renal care service
  • Diabetes Retinopathy surveillance and prevention
    of blindness program for Type 1 IDDM
  • Diabetes nutrition department clinical
    services, diploma training and research
    programmes
  • Diabetes specialists nurse educators service and
    training certificate programme

27
REHABLITATION SERVICES
  • Diabetes Research and academics activities (Shri
    Prakash CME Programme for doctor).
  • Public Education programme (Shri Prakash
    Endowment Public Lectures).

28
VHS DIABETES DEPARTMENTRESEARCH ACTIVITIES
2001-2002
  • Prevalence of diabetes-survey in chennai
    city-collaborative work,along-with the national
    institute of epidemiology,chennai.
  • Natural History of diabetic Nephropathy in type 2
    diabetes
  • Magnitude of young onset diabetes in south
    India-Are we doing enough?
  • Preliminary Experience in alternate Modalities of
    wound healing in Diabetes.
  • Incidence of gestational diabetes in pregnant
    women,chennai.

29
VHS DIABETES DEPARTMENTRESEARCH ACTIVITIES
2001-2002
  • Study of children of people with Type 1 Diabetes
  • Psychological impact of Type 1 Diabetes on
    children of different age group?
  • Mortality in Type 1 Diabetes
  • Study of Type 1 Diabetes and autonomic neuropathy
  • Study of progressive of nephropathy in Type 1
    DiabetesRetrospective/Prospective

30
The following projects are the basic research
projects in progress during the year
  • DNA Repair Mechanism in peripheral lymphocyte in
    Diabetes
  • Telemere dynamic in health disease
  • Molecular markers in Type 1 diabetes
    classification of IDDM patients
  • Gene mapping of children of Type 1 Diabetes a
    collaborative study
  • Long term follow up of the complication profile
    in Type 1 Diabetes

31
(No Transcript)
32
(No Transcript)
33
(No Transcript)
34
(No Transcript)
35
(No Transcript)
36
(No Transcript)
37
(No Transcript)
38
(No Transcript)
39
(No Transcript)
40
(No Transcript)
41

I thank the following team mates for their
co-operation and selfless service
42
Peter H. Forsham
43
Thank You
Cvk_at_diabetopaedia.com
About PowerShow.com