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EPIDEMIOLOGY OF DIABETES MELLITUS - Treasa Joseph. Definition. Diabetes is a heterogeneous group of diseases, characterized by a state of chronic hyperglycemia, resulting from a diversity of etiologies, environmental and genetic, acting jointly. Clinical Classification.
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EPIDEMIOLOGY OF DIABETES MELLITUS - Treasa Joseph
Definition • Diabetes is a heterogeneous group of diseases, characterized by a state of chronic hyperglycemia, resulting from a diversity of etiologies, environmental and genetic, acting jointly.
Clinical Classification • Diabetes Mellitus (DM) Insulin-dependent DM (IDDM, Type 1) Non Insulin dependent DM (NIDDM, Type 2) Malnutrition related DM (MRDM) Other types • Impaired Glucose Tolerance (IGT) • Gestational DM (GDM)
Prevalence of Diabetes Mellitus 2000 – 171 million 2030 – 366 million • By 2025 – India with most number of diabetic cases - 79 million
Problem Statement • Iceberg Disease • Increased prevalence in newly industrialized and developing countries. • Disease acquired in the most productive period of their life. • 20% of current global diabetic population resides in the SEAR. • Indian population has increased susceptibility to DM.
Undiagnosed or inadequately treated patients develop multiple chronic complications. • Lack of awareness about interventions for prevention and management of complications.
Prevalence of type 2 diabetes: rural-urban combined- Kerala Age standardised prevalence Men - 14.9 % Women -13.2 % Age standardised for Kerala population 2001
Prevalence of type 2 diabetes in different geographic strata Coastal Highland Midland Urban
Epidemiological Determinants • AGENT FACTORS Pancreatic disorders Defects in formn of insulin Destruction of beta cells Decreased insulin sensitivity Genetic defects Autoimmunity
HOST FACTORS Age Sex Genetic factors Genetic markers – HLA-B8, B15, HLA DR3 & DR4 Immune mechanisms Obesity Maternal diabetes
ENVIRONMENTAL FACTORS Sedentary lifestyle Diet Dietary fibre Malnutrition Alcohol Viral infections Chemical agents Stress Others
Screening for DM • Urine Examination 2 hrs after meal Lack of sensitivity • Blood Sugar Testing fasting, PPBS, RBS TARGET POPULATION
Prevention And Care • PRIMARY PREVENTION • Population Strategy • High Risk Strategy • SECONDARY PREVENTION • TERTIARY PREVENTION
Why Study the Epidemiology • Long term disease • Global epidemic • Modifiable risk factors • Multiple complications • Contributes to 5.2% of total deaths