1 / 32

Osnove prevencije dijabetesa

Beograd 24.07.2013. Osnove prevencije dijabetesa. Profesor dr Neboj ša M. Lalić Medicinski fakultet Univerziteta u Beogradu , Klinika za endokrinologiju , dijabetes i bolesti metabolizma , KCS, Beograd. PREVALENCE ESTIMATES OF DIABETES, 2007. PREVALENCE ESTIMATES OF DIABETES, 2025.

fola
Download Presentation

Osnove prevencije dijabetesa

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Beograd 24.07.2013. Osnoveprevencijedijabetesa Profesor dr Nebojša M. Lalić Medicinski fakultet Univerziteta u Beogradu, Klinika za endokrinologiju, dijabetesibolestimetabolizma, KCS, Beograd

  2. PREVALENCE ESTIMATES OF DIABETES, 2007

  3. PREVALENCE ESTIMATES OF DIABETES, 2025

  4. Prevencija tipa 2 dijabetesa • nemedikamentna • medikamentna

  5. Nemedikamentna prevencija tipa 2 dijabetesa • dijeta • fizička aktivnost

  6. Finnish Diabetes Prevention Study 23% Risk of diabetes reduced by 58% after 4 years (17–29 CI) 11% (6–15 CI) Intervention Control % with Diabetes Tuomilehto J et al. N Engl J Med 2001;344:1343-1350.

  7. Finnish Diabetes Prevention Study Tuomilehto J, et al. N Engl J Med. 2001;344:1343-1350.

  8. Novembar 2006 god

  9. Nacionalni program zdravstvene zaštite od dijabetesa u Srbiji Standardi: • Standard 1: • Prevencija tipa 2 dijabetesa • Standard 2: • Detekcija osoba sa dijabetesom • Standard 3: • Osposobljavanje pacijenata sa dijabetesom • Standard 4: • Terapija i praćenje odraslih osoba sa dijabetesom • Standardi 5 i 6: • Terapija i praćenje dece i adolescenata sa dijabetesom • Standard 7: • Tretman akutnih komplikacija dijabetesa • Standard 8: • Tretman pacijenata sa dijabetesom u hospitalnim uslovima • Standard 9: • Tretman dijabetesa u trudnoći • Standardi 10, 11 i 12: • Detekcija i lečenje kasnih komplikacija dijabetesa

  10. Ministarstvo zdravlja Republike SrbijeProgramski okvirUNAPREĐENJE ZDRAVLJA STANOVNIŠTVA ZA BOLESTI OD POSEBNOG SOCIJALNO-MEDICINSKOG ZNAČAJA Program • RANA DETEKCIJA I PREVENCIJA TIPA 2 DIJABETESA NA PRIMARNOM NIVOU ZDRAVSTVENE ZAŠTITE U SRBIJI • Nosilac Programa: Republička stručna komisija za šećernu bolest Ministarstva zdravlja Republike Srbije • Rukovodilac Programa: Prof dr Nebojša M. Lalić Vlada Republike Srbije usvojila Nacionalni program u martu 2009. godine

  11. Detekcija rizika i prevencija tipa 2 dijabetesa Poseban pristup (gojaznost, IM, gestacijski dijabetes, hipertenzija, HLP, pretodno IFG / IGT) Upitnik procene rizika za tip 2 dijabetesa; zbir bodova: OGTT < 7 ≥ 15 7-14 Bez mera prevencije Savet o izmeni načina života Normoglikemija Dijabetes IFG IGT Terapija hiperglikemija i faktora rizika Intervencija Evaluacija Praćenje

  12. National Guidelines Prevention of type 2 diabetes, 2005

  13. Program prevencije tipa 2 dijabetesa u Republici Srbiji Plan intervencije Primarni nivo zdravstvene zaštite Prva poseta Prev. centru Individualna intervencija Identifikacija osoba sa visokim rizikom Primena dijete i fizičke aktivnosti 6 sedmica Druga poseta Prev. centru Intervencija u grupi • Pregled • • merenja: • telesne težine, visine, ITM, • obima struka, arterijskog pritiska, EKG • • anamneza prethodnih bolesti, • upitnici o navikama u ishrani i • fizičkoj aktivnosti • laboratorijske analize i OGTT • Globalna procena rizika za T2D i KVB Kontrolni pregled (6 meseci) Dalji redovni pregledi i evaluacija faktora rizika (6 meseci do 1 god)

  14. The IMAGE Curriculum for the Prevention Manager Training Course translated and adapted in the second half of 2010. The national course for prevention managers certified by the National CME Accreditation Board in May 2010 The national courses for prevention managers were held in Belgrade, 2011 - 2013 Prevention Manager Training (I)

  15. The national courses were attended by 102 participants (35 physicians, 48 nurses and 19 nutritionists) from 62 primary care centers in Serbia The faculty consisted of diabetologists, medical psycologists, public health specialists and diabetes nurse educators. We acknowledge the participation of Prof P. Kronsbein from Germany, Prof C. Graves and Dr A. Stathi from UK. The structure of the course consisted of 8 modules which comprised lectures and interactive workshops. The particants were provided with CDs with all the course materials. The evaluation showed high average mark of the course by the attendees Prevention Manager Training (II)

  16. Nacionalni program rane detekcije i prevencije tipa 2 dijabetesa u Srbiji Detekcija osoba sa povišenim rizikom za tip 2 dijabetesaPreliminarni rezultati Broj testiranih osoba: 3024 % Skor rizika<15 Skor rizika ≥ 15

  17. Nacionalni program rane detekcije i prevencije tipa 2 dijabetesa u Srbiji Detekcija osoba sa povišenim rizikom za tip 2 dijabetesaPreliminarni rezultati Da li je neko u vašoj porodici imao ili sada ima dijabetes ? % Skor rizika<15 Skor rizika≥ 15

  18. Nacionalni program rane detekcije i prevencije tipa 2 dijabetesa u Srbiji Detekcija osoba sa povišenim rizikom za tip 2 dijabetesaPreliminarni rezultati Da li uobičajeno tokom dana imate fizičku aktivnost najmanje 30 min ? % Skor rizika<15 Skor rizika≥ 15

  19. Nacionalni program rane detekcije i prevencije tipa 2 dijabetesa u Srbiji Detekcija osoba sa povišenim rizikom za tip 2 dijabetesaPreliminarni rezultati Koliko često jedete voće i povrće ? % Skor rizika <15 Skor rizika≥ 15

  20. Nacionalni program rane detekcije i prevencije tipa 2 dijabetesa u Srbiji Detekcija osoba sa povišenim rizikom za tip 2 dijabetesaPreliminarni rezultati Da li koristite lekove za povišen arterijski pritisak ? % Skor rizika <15 Skor rizika≥ 15

  21. Nacionalni program rane detekcije i prevencije tipa 2 dijabetesa u Srbiji Detekcija osoba sa povišenim rizikom za tip 2 dijabetesaPreliminarni rezultati * p < 0.01 Podaci su prikazani kao srednja vrednost +/-SEM

  22. Desetogodišnji rizik za razvoj tip 2 dijabetesa kod učesnika XXIX Konferencije opšte medicine Srbije Kopaonik, 26-30. 09. 2008. godine 12,7% Upitnik popunilo 620 učesnika Konferencije Svaki 7. lekar ima povišen rizik za razvoj tipa 2 dijabetesa!

  23. National Programme of Early Detection and Prevention of Type 2 Diabetes in Serbia Experiences (I)The main positive trends • satisfactory and progressively increasing response (20-30%) of the subjects invited for the screening • high compliance in responding to the questionnaires • satisfactory acceptance of the high-risk individuals to participate in the prevention part of the Program (40-50%)

  24. National Programme of Early Detection and Prevention of Type 2 Diabetes in Serbia Experiences (II)Challenges • inadequate or unsustainable logistics for the implementation of the screening in 7/25 primary centers • lack of the resources for practical education for prevention in high-risk individuals and • lack of the resources for the evaluation of the program especially for the electronic database and follow-up.

  25. National Programme of Early Detection and Prevention of Type 2 Diabetes in Serbia Experiences (III)Barriers • Lack of sustainable modalities for financing detection of increased risk and prevention of type 2 diabetes as a part of the national health care system • Problems with integration of preventive activities in the existing health care system on the planning as well as on the implementation level • Problems with integration of preventive activities in the organization of local communities, especially regarding the lack of the facilities for structured exercise • Problems with coordination between the workplace and the preventive interventions implemented in local community • Lack of adequately trained personnel, especially the prevention managers • Lack of the facilities within the health care centres for practical education of the participants in the Programme.

  26. National Programme of Early Detection and Prevention of Type 2 Diabetes in Serbia What are the plans for the future activities? • Development of national curriculum for education of educators for prevention of type 2 diabetes; • Development of the comprehensive system of education of educators for prevention of type 2 diabetes; • Development of the comprehensive system of education of health care professionals from primary health care for prevention of type 2 diabetes; • Development of the comprehensive system of implementation of the screening for the subjects with high risk for type 2 diabetes; • Development of the comprehensive system of detection of newly diagnosed patients with type 2 diabetes and their treatment through the health care system; • Development of algorithm for follow up implementation of preventive treatment for the subjects with high risk for type 2 diabetes; • Introduction of the regular evaluation system of the changes in the number of newly diagnosed patients with type 2 diabetes and subjects with high risk for type 2 diabetes; • Introduction of the regular evaluation system of the efficiency of the preventive treatment in the subjects with high risk for type 2 diabetes.

More Related