350 likes | 454 Views
Prospects of Diabetes in Sudan Mohamed Ali Eltom. Summarize the past Rescale the present Predict the future. Sudan after 9 July. Diabetes prevalence. National Diabetes Survey 1993 0.1 % Type 1 Diabetes 3.4 % Crude prevalence
E N D
Summarize the past • Rescale the present • Predict the future
Diabetes prevalence National Diabetes Survey 1993 0.1% Type 1 Diabetes 3.4% Crude prevalence 2.1% Unknown Diabetics 5.5% in the Northern State 8.3% in Dongla 14 % in Argo 6.0 % in Khartoum State 4.0 % in Gezeira State 1.0 % in NorthKurdofan State
Natural History of Diabetes • Poor glycaemic control, adequate control only in12% • Low quality of life • Acute and long-termcomplications are common (67%) • High mortality rates amongchildren
Micro vascular complications • Retinopathy 43% • Nephropathy 22% • Neuropathy 37% Macrovascular complications • Cardiovascular disease 28% • Peripheral vascular disease 10% • Cerebrovascular accidents 5.5%
Factors Related to Poor Metabolic Control • Deficient patients awareness and compliance • Unaffordability and unavailability of drugs and monitoring equipment • Reduced level of well organized diabetes care • Poor health service organization
Challenges to diabetes care in Sudan • Inadequate Financial Resources • Insufficient Health care system • Professionals • Patients
Difficulties experienced in diabetes care • Patients • Limited access to care : less than 20% of patients have access to minimum standards of care + urban/rural differences • Insulin, other medications and supplies for testing metabolic control • Involvement of patients and families
Difficulties experienced in Diabetes Care Patients, cont. • Lack of awareness and the challenge of • self- management • Reluctance to become empowered and • self- managing • Standards and materials for education
Diabetes Education Facilities • Education is offered by doctors in a busy clinic atmosphere • Diabetes educator has not been integrated in diabetes management • No national diabetes patienteducation programs • to definepatient goals, monitor progress and • evaluate achievement • Lack of educational materials and equipment
Ketone bodies in urine: 45.6% Hypoglycemia that needed special attention: 37% Acute Complications of Diabetes
56.6 % admitted at least once to the hospital within a year Hospital Admission
Diabetic ketosis: 71.8% Hypoglycemia: 5.9% Malaria: 10.6% Other medical disorders or surgical intervention: 9.4% Main causes
Families pay a considerable part of their income and receive insignificant support other than that from relatives and friends The direct cost of diabetes care requires 23% of the available economic resources of the parents The low costs reflect the minimal care given to the diabetic patients The present organization of diabetes care does not provide the patient with empowerment, knowledge and self-care ability Well-trained diabetic teams and education programs may improve this situation
Prevalence 2025 • Estimate 16% (more than 3 Million Diabetic)
Action • Primary prevention programs • Organized educational programs and proper medical services
National Diabetes Policy Federal and state governments have identified priorities and agreed on anapproach to: • Diabetes prevention, early detection, management and treatment • In partnership with key organizations and service providers www.diabetesinsudan.org
Areas of Development • Primary prevention strategies • Approved guidelines • Optimum practice models for service delivery • Partnerships between the different stakeholders in the diabetes sector • Alternative methods of funding for diabetes prevention and management
Integrated Approach to Prevention and Care • Promotion of Healthy Life-Styles • Raising Community Awareness • Primary Prevention at onset • Screening for Type II DM • Development of National Strategy
Optimum Practice Modelsfor Service Delivery Quality Care Diabetes Facilities (QCDF) • MDC in 25% of Primary Health Care Centers (1 MDC for a catchment area of 4000 diabetic) • 1 Diabetes Referral Unit for every 4 MDC
Distribution of QCDF in the Country According to Prevalence Levels
International Relations • Health Diplomacy • IDF • WDF • World Summit
Regional Relations • Arab • African
Arab World High income Middle income Low income • Research • Training • Education Material • Human Resources • Philanthropies • Civil Societies
Cardiovascular risk factors (%) among adults in four Arab countries 2005
Cardiovascular risk factors (%) among adults in four Arab countries
Bilateral Relations • Egypt • Jordan • Saudi Arabia • Sweden