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Prevention of Diabetes, Can we?

Prevention of Diabetes, Can we?.

destiny-weber
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Prevention of Diabetes, Can we?

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  1. Prevention of Diabetes, Can we?

  2. EP Joslin, 1921“…… it is proper at the present time to devote time not alone to treatment, but still more, as in the case of typhoid fever, to prevention. The results may not be quite so striking or as immediate, but they are sure to come and important…...”

  3. Onset of Diabetes Type 1 DM Normal Borderline Diabetes Type 2 DM Borderline Normal Diabetes

  4. Primary Prevention in Type 1 DM • Time available is quite short • Limitation of Inflammation in Islet cells • Prevention of triggering factor/s • Gene therapy? Answer is not there for Clinical use today

  5. POPULATION STRATEGY Lifestyle change Environmental factors HIGH RISK STRATEGY Targeting the high risk group Primary Prevention in Type 2 DM

  6. Prevention of Type 2 DM • BASIC PROBLEM - Insulin resistance • Answers • Exercise • Maintain body weight • Healthy eating REGULAR FOLLOW UP with GTT, every 2 - 5y

  7. Prevention of chronic complications-common determinants-1 • EDUCATION • Regular exercise • Healthy eating - avoid COCOCOLANISATION • Life style modification

  8. Prevention of chronic complications-common determinants-2 • Near normal glycaemia • Blood pressure control • Lipid control • Specific treatment

  9. Specific treatment - RETINA • Aspirin • ACE inhibitor • LASER Photocoagulation

  10. Specific treatment - KIDNEY • ACE inhibitor • Protein restriction in diet

  11. FOOT CARE - whom to provide? • Everybody? • Previous or present ulcer • Poor circulation • Abnormal sensation • Impaired vision • Poor Diabetes control • Deformity • Prosthesis

  12. How to manage all? Sp. Doctor Dietitian Govt. PATIENT Sp. Nurse Podiatrist Pr. Nurse Orthotist Fm. Doctor

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