prevent diabetes
TRANSCRIPT
Prevention of Diabetes, Can we?
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…...”
Onset of Diabetes
Type 1 DM
Type 2 DM
Normal
Normal
Diabetes
Diabetes
Borderline
Borderline
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
Primary Prevention in Type 2 DM
• POPULATION STRATEGY– Lifestyle change– Environmental factors
• HIGH RISK STRATEGY– Targeting the high risk
group
Prevention of Type 2 DM
• BASIC PROBLEM - Insulin resistance– Answers
• Exercise• Maintain body weight• Healthy eating
REGULAR FOLLOW UP with GTT, every 2 - 5y
Prevention of chronic complications-common determinants-1
• EDUCATION• Regular exercise• Healthy eating - avoid
COCOCOLANISATION• Life style modification
Prevention of chronic complications-common determinants-2
• Near normal glycaemia• Blood pressure control• Lipid control• Specific treatment
Specific treatment - RETINA
• Aspirin• ACE inhibitor• LASER
Photocoagulation
Specific treatment - KIDNEY
• ACE inhibitor• Protein restriction in
diet
FOOT CARE - whom to provide?
• Everybody?– Previous or present ulcer– Poor circulation– Abnormal sensation– Impaired vision– Poor Diabetes control– Deformity– Prosthesis
How to manage all?
PATIENT
Dietitian
Pr. Nurse
Govt.
Sp. Doctor
OrthotistFm. Doctor
Sp. Nurse Podiatrist