PRESENTED BY RTN PP PHF RANJAN ALLES DIABETES AWARENESS PROGRAMME ROTARY DISTRICT 3220 / DASL PRESENTED BY RTN PP PHF RANJAN ALLES

THE PISS MANNEQUIN IN BRUSSELS

HISTORY OF DIABETES DIABETES WAS DISCOVERED IN ANCIENT EGYPT IN THE 16TH CENTURY BC. IT IS DERIVED FROM THE GREEK WORD “DIABEINEIN” WHICH MEANS TO PASS THROUGH OR SIPHON. MELLITUS MEANS SWEET AS HONEY IN LATIN. ANCIENT HINDUS USED TO REFER TO IT AS “MADHU MEHA” WHICH MEANS SWEET WATER.

WHAT IS IS A CONDITION WHERE YOUR BLOOD SUGAR LEVEL IS TOO HIGH AND IS CAUSED BY THE LACK OF OR INSUFFICENT PRODUCTION OF INSULIN. THIS CONDITION IS DETRIMENTAL TO HEALTH AND IF LEFT UNTREATED CAN LEAD TO MANY COMPLICATIONS INVOLVING THE KIDNEYS, LIVER, EYES, HEART, NERVES, GUMS ETC AND EVEN DEATH. (A fasting blood sugar level of 75 - 100 mg/dl is considered normal)

Diagnosis

Main Types of Diabetes Type 1 Diabetes (T1DM) Type 2 Diabetes (T2DM) Gestational Diabetes (GDM)

HOW WOULD YOU GET HIGH BLOOD SUGAR? The food you eat provides the cells with the sugar necessary to Generate the energy required by you. The body converts most of the food you eat into sugar and the blood carries this sugar to the cells. Sugar needs the insulin( a hormone) produced by the “Islets of Langerhann” which is in the pancreas to be absorbed by the cells. If your body does not produce any or enough insulin or if the Insulin you produce does not work right the sugar cannot get absorbed into the cells. At this point the sugar remains in the blood and causes an elevation of the sugar level causing DIABETES.

Complications Heart disease & stroke 50% diabetics die of heart disease Kidney failure 20% diabetics die of kidney failure Blindness 2.5 million diabetics go blind annually Amputation 1 million amputations annually Amputation picture

Global Prevalence - >20yrs 2011 2030 Population 7.0 b 8.3 b DM 366 m (8.3%) 552 m (9.9%) IGT(IMPAIRED GLUCOSE) 280 m (6.4%) 398 m (7.1%) 50% undiagnosed Diabetes Atlas – 5th Edition – Nov 2011

Prevalence - Sri Lankan >20yrs Urban Rural 1990 5% 2% 2000 12% 7% 2010 16.4% 8.7% Diabetes - 10.3% - 2 million Pre-diabetes - 11.5% - 2.3 million Katulanda et.al.

Prevalence of Risk Factors in 22,507 – Diabrisk-SL Put the key yellow red

WHAT ARE THE SYMPTOMS OF DIABETES? HIGH THIRST FREQUENT URINATION WEIGHT LOSS FOR NO APPARENT REASON FEELING VERY HUNGRY/ TIRED OFTEN SLOW HEALING WOUNDS BLURRY VISION LOSS OF SENSATION OR TINGLING IN THE FEET

Causes of T2 Diabetes Genetics Foetal Origins Lifestyles-Obesity Interaction of Genetics Foetal Origins Lifestyles-Obesity Stress

Obesity Trends* Among U.S. Adults BRFSS, 1989 Body mass index Weight in KGS- - Height in metre squared 18.5 - 24.9 Normal 25 - 29.9 Overweight 30 - 34.9 Obese 35 - 39.9 Severely Obese 40 - < Morbidly Obese Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. Adults BRFSS, 1990 Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. Adults BRFSS, 1991 Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. Adults BRFSS, 1992 Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. Adults BRFSS, 1993 Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. Adults BRFSS, 1994 Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. Adults BRFSS, 1995 Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. Adults BRFSS, 1996 Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. Adults BRFSS, 1997 Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. Adults BRFSS, 1998 Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. Adults BRFSS, 1999 Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. Adults BRFSS, 2000 Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. Adults BRFSS, 2001 Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. Adults BRFSS, 2002 Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. Adults BRFSS, 2003 Montana Colorado Arizona Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. Adults BRFSS, 2004 Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. Adults BRFSS, 2005 Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity Trends* Among U.S. Adults BRFSS, 2006 colorado Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.

Obesity* Trends Among U.S. Adults BRFSS, 2007 (*BMI 30, or about 30 lbs overweight for 5’4” person) No Data <10% 10%–14% 15%–19% 20%-24% 25% Source: Behavioral Risk Factor Surveillance System, CDC

Obesity* Trends Among U.S. Adults BRFSS, 2008 (*BMI 30, or about 30 lbs overweight for 5’4” person) Montana Kansas Texas No Data <10% 10%–14% 15%–19% 20%-24% 25% Source: Behavioral Risk Factor Surveillance System, CDC

Sri Lanka –Obesity in Urban School Children 7 schools in Colombo 8-12 years old 50 students in each Yr 4 -7 (1224) Obesity 4.3% boys, 3.1% girls 66% obese from high income Wickramasinghe VP, Lamabadusuriya SP, Atapattu N, Sathyadas G, Kurunarathne P. Nutritional status of schoolchildren in an urban area of Sri Lanka. Ceylon Med J. 2004 Dec;49(4):114-8.

How do you Prevent Diabetes 1.Identification of risk factors a. Physical - early Increased BMI Increased waist Low physical activity Family history b. Biochemical - late FBC/ IGT/DM

How do you prevent Diabetes 2. Lifestyle Modification Correct Nutrition Adequate exercise Stress Control

Correct Nutrition What is good for a diabetic is good for all Golden rule: Quality, Quantity & Timing Quality - Healthy, balanced diet - high fiber natural foods - low in calorie Quantity – To ensure ideal body weight Timing - Do not delay or skip meals – 4 small meals recommended for school kids

What is Adequate Exercise Exercise is essential for all persons of all ages on a regular basis Golden rule: It should be continuous and regular and of your choice Try to exercise with family and friends to minimizes boredom Sedentary activities (e.g. sleeping, reading, playing computer games, watching TV) should be minimized

Exercise Regimes 30 min x 5 times a week or more – Good 30 min x 3 times a week – minimum required <30 min and/or <3 times a week – Inadequate Children should play daily at least for 1 hour To burn fat - continuous exercise 45-60 min 3-5 times a week essential

How do you reduce stress? Stress is common in modern lifestyle Be calm and positive – avoid negative thoughts Avoid extreme responses – middle path Meditation – Yoga Set realistic goals / expectations Adapt to changing situations Do not fear to fail – Success is always round the corner

ROTARY CLUB OF MEMPHIS CENTRAL TYPE ONE DIABETES INITIATIVE Dream Factory-wish for Skylar Bolton- 9 years with diabetes sniffing Black labrador Denali - Rotarian magazine aug 2009

Lets save our children

CHECK LIST Seeni Meanie Campaign Check list for Rotarians Appoint a Seeni Meanie (SM) co-ordinator and inform the contact details i.e name, address and mobile number to secretariat by email: seenimeanie@sltnet.lk or 0777703707 (contact persons: Laksha / Dhanya) Immediately   Read the details in the file given on the day of the briefing or the file sent to you. The big SM sticker in the President’s file is for you to fix same on your Rotary flag! Confirm acceptance of the 2 Action Kits to the SM secretariat – Immediately Identify 2 (two) foster schools – Inform the secretariat of the names and addresses of the school – Immediately

CHECK LIST CONTINUED Once the Secretariat has registered the schools, you are advised to contact the Medical Officer of Health as well as the Zonal Educational Director of the respective area (Please take a copy of the Education Ministry letter from the Director Nutrition) and inform them of the Diabetes Awareness and Prevention Campaign you hope to conduct in the respective schools- Before 31st July 2012. Meet with the Principal to obtain his or her support. Hand over the letter in the chosen language along with the Education Ministry letter and request the Principal to appoint the SM team (up to 12) including the team leader – Before 3rd August 2012  

CHECK LIST CONTINUED   If your foster school has an Interact club, they can spearhead the campaign. If your club is supervising an Interact club, they may assist you in the implementation of the project.  Rotary club to get the SM team to conduct pre evaluation by photocopying 50 questionnaires (in the preferred language) and return the completed forms to the Secretariat – Before 14th August 2012 Rotary club to get the SM team to formulate Campaign Ideas and submit the proposal to the Secretariat in the preferred language. This should be done as per the prescribed format in action kits. - Before 14th August 2012 Rotary club will receive the screened proposal with the approval and recommendations from the Secretariat – 15th to 31st August 2012

CHECK LIST CONTINUED    Implementation of Seeni Meanie Campaign – 1st September 2012 – 28th February 2013  Rotary club to get the SM team to conduct post evaluation questionnaire and return same to the Secretariat – 14th -28th February 2013  Assistant Governor’s to evaluate and judge regional cluster campaigns and choose regional winners – 1st March 2013 – 14th March 2013  Final evaluation and judging of the Regional winners to choose the National winner and the 1st and the 2nd runner up – 15th March 2012 – 31st March 2013. Awards Nights – Date, Time and Venue to be informed.

THANK YOU FOR YOUR ATTENTION