By: NSABIMANA P. OLIVIER, B. Pharm. NON COMMUNICABLE DISEASES(NCDs) DIABETES

DIABETES Diabetes is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. The effects of diabetes include long–term damage, dysfunction and failure of various organs

What’s Occuring in the body? Our body uses a hormone called insulin to handle glucose, which is a simple sugar that’s a main source of energy. In diabetes, something goes wrong in the body so that you can not produce insulin or are not sensitive to it. That means that your body produces high levels of blood glucose, which acts on organs to produce the symptoms of the disease.

To maintain a constant blood glucose level, the body relies on two hormones produced in the pancreas that have opposite actions: insulin and glucagon.

Pathophysiology of Diabetes As blood glucose rises, the body sends a signal to the pancreas, which releases insulin.

MECANISM of ACTION Glucose gets absorbed from the intestines and distributed by the bloodstream to all cells. The body tries to maintain a constant glucose concentration in the blood. So, when you over supply on glucose, your body stores the excess in the liver and muscles by making glycogen When glucose is in short supply, the body makes glucose from stored glycogen or from the food that’s been eaten.

 International Diabetes Federation (IDF) data indicate that by the year 2025, the number of people affected will reach 333 million –90% of these people will have Type 2 diabetes.  Today, not only are adults being diagnosed with this disease, but its also affecting today’s youth.  The annual health costs caused by diabetes and its complications account for around 6-12% of all health-care expenditure. Burden of Diabetes

MAIN TYPES OF DIABETES Types 1 Diabetes Types 2 Diabetes Gestational diabetes

 Was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes.  Type 1 diabetes develops when the body’s immune system destroys pancreatic(IMPINDURA) beta cells, the only cells in the body that make the hormone insulin that regulates blood glucose.  This form of diabetes usually strikes children and young adults, although disease onset can occur at any age.  Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes.  Risk factors for type 1 diabetes may include autoimmune, genetic, and environmental factors. Type 1 diabetes

10 Type 1 Diabetes  auto immune disorder  insulin-producing cells destroyed  age of onset: usually childhood, young adulthood  daily insulin replacement necessary  most prevalent type of diabetes in children and adolescents

11 SYMPTOMS: Type 1 Diabetes increased urination tiredness weight loss CAUSE: uncertain, likely both genetic and environmental factors increased thirst hunger blurred vision ONSET: relatively quick

 Was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes.  Type 2 diabetes may account for about 90% to 95% of all diagnosed cases of diabetes.  It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce insulin.  Type 2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity.  Type 2 diabetes is increasingly being diagnosed in children and adolescents.(!!!!??????) Type 2 diabetes

Risk factors for type 2 diabetes  Are overweight.  Are 45 or older.  Are physically inactive.  Have a parent or sibling with type 2 diabetes.  Are African American, Native American, Hispanic American, or Pacific Islander.  Have abnormal cholesterol levels.  Have had gestational diabetes, or given birth to a baby greater than 9 lbs.  Have high blood pressure. Type 2 is more common in people who: 14

SYMPTOMS: Type 2 Diabetes tired, thirsty, hunger, increased urination

 A form of glucose intolerance(Extreme sensitivity) that is diagnosed in some women during pregnancy.  During pregnancy, gestational diabetes requires treatment to normalize maternal blood glucose levels to avoid complications in the infant.  After pregnancy, 5% to 10% of women with gestational diabetes are found to have type 2 diabetes.  Women who have had gestational diabetes have a 20% to 50% chance of developing diabetes in the next 5-10 years. Gestational diabetes

Symptoms of Diabetes Type 2 diabetes is often without symptoms in its early stages. That’s the reason there are 40% of people with Type 2 diabetes are unaware of their disease. When there are symptoms, they may occur gradually. If present, they usually are: feeling tired and weak passing large volumes of urine, especially during the night having frequent infections having blurred eyesight Excessive hunger and thirst

COMPLICATION OF DIABETES

Why is the prevalence of Type 2 diabetes increasing? Aging of the population. Increased incidence due to urbanization especially in the developing countries. – More sedentary lifestyle. – Food consumption patterns, – more foods with high fat content – more refined carbohydrates. – Physical inactivity

Prevention of diabetes Recommendations to reduce risk of type 2 diabetes – Regular physical activity – Interventions to reduce obesity ( Control your BMI ) – Individuals at risk should have dietary intake assessed and receive individualised dietary advice and continued dietetic support Evidence Based Guideline for the Prevention of Type 2 Diabetes. Australian Government NHMRC

The major components of the treatment of diabetes are: Management of DIABETES Diet and Exercise A Oral hypoglycaemic therapy B Insulin Therapy C

ADVICES

Eat more fruit and vegetables Fresh Frozen Tinned Dried Juice

Eat starchy foods regularly Bread Potatoes Rice Pasta Cereals Plantain Chapatis

Reduce animal or saturated fat intake Use low fat milk Use low fat spread instead of butter Use oil high in unsaturated fat, eg olive oil, rapeseed oil

Cut down on sugary foods Not a sugar free diet Cut out sweets Cut out sugary drinks

Be Active…Often Exercise for 30 minutes or more at least 4 days a week.

PREVENTION IS BETTER THAN CURE !!!!!!! BUT IF ANY COMPLAINTS OCCUR TO YOU, CONSULT YOUR PHYSICIAN ASSP !!!!