Diabetes: Beyond Sugar

CHAOS C - Coronary artery disease H - Hyper-tension, -glycaemia, -insulinaemia A - Atherosclerosis O - Obesity S - Stroke

Top 5 co-existing conditions Diabetes in Europe, 2000 Type , Type

Top 5 co-existing conditions Diab Care Asia, 2000 Type

T 2 DM Management of T 2 DM Extends Beyond Glucose Control T 2 DM Management of T 2 DM Extends Beyond Glucose Control need to be addressed Issues like Obesity High Cholesterol Hypertension Smoking

Therapeutic Lifestyle change Healthy Eating, Time management, Regular exercise – 30 min daily brisk walking.

Lipid control DIFFICULT! – Target is changing – What level is safe? – Multifactorial (Hyperglycaemia leads to hyperlipidaemia )

HT Peripheral vascular disease Coronary Heart Disease 43% End Stage Renal Failure Stroke 18% Congestive Heart Failure Hypertension Complications

Hypertension- Hypertension- Interesting Facts  5-6 mm reduction in DBP lowers stroke risk by 33% and CHD risk by 15%  Hypertension Optimal Study (HOT) Study- DBP  85 mm Hg associated with lower risk of CVS events than reduction to  90 mm Hg

Hypertension in India CODI Study – BP was measured in 54.5% of patients with DM, – In 40% BP was found to be high, – 10% were on treatment BUD Study – 24% of people with high BP were currently checking.

Clinical and Experimental Studies Treatment -Target Organ Protection Antiatherosclerosis CNS protection Cardioprotection Renoprotection

Recommended Treatment Goals for Hypertension With DiabetesWithout Diabetes <130/80 mm Hg<140/80 mm Hg

SMOKING

How to manage all? PATIENT Dietitian Pr. Nurse Govt. Sp. Doctor Pharms. Fm. Doctor Sp. NursePodiatrist