2. FACTS At least 194 m people worldwide suffer from diabetes; this figure is likely to be more than double by 2030 At least 194 m people worldwide suffer from diabetes; this figure is likely to be more than double by 2030 Around 4 m deaths every year are related to complications of diabetes Around 4 m deaths every year are related to complications of diabetes

3. FACTS WHO figures 19851995200020032030 30 m 135 m 177 m 194m 370 m

4. COUNTRIES WITH THE LARGEST NUMBER OF PERSONS WITH DIABETES 1995 2000 2003 1995 2000 2003 Country DM % million DM % million million INDIA 3.8 19.4 5.5 31.5 35.5 CHINA 2.0 16.0 2.4 20.7 23.8 USA 7.8 13.8 7.8 17.5 16 INDONESIA 4.1 4.5 6.5 8.5

5. COUNTRIES WITH THE HIGHEST PREVALENCE IN ADULT POPULATION 2003 Country DM % UAE 20.1 Qatar 16 Bahrain 14.9 Kuwait 12.8

6. Oman Oman DM 11.6% Impaired G T 6.1% New cases per year 3548 = 0.18% Highest Incidence North Batna 25% of total PDO 2% (Potential Diabetes 4%) 75% High Lipid

7. What is Diabetes mellitus? DM or Sugar problem is a chronic disease characterised by very high blood sugar. Caused by inherited and/or acquired deficiency in production of insulin by the pancreas, or by the ineffectiveness of the insulin receptors. DM or Sugar problem is a chronic disease characterised by very high blood sugar. Caused by inherited and/or acquired deficiency in production of insulin by the pancreas, or by the ineffectiveness of the insulin receptors. Type I –lack of production of Insulin; children and adolescents Type I –lack of production of Insulin; children and adolescents Type II – inability to respond properly to the action of Insulin; adults, 90% Type II – inability to respond properly to the action of Insulin; adults, 90%

8. The Pancreas: Anatomy and Functions

9. PANCREAS The pancreas is a small structure located near the stomach and attached to the wall of the small intestine. The pancreas is a small structure located near the stomach and attached to the wall of the small intestine. It produces hormones (insulin, glucagon & somatostatin) to aid in the maintenance of a proper blood sugar (glucose) level. The hormones are secreted into the bloodstream. It produces hormones (insulin, glucagon & somatostatin) to aid in the maintenance of a proper blood sugar (glucose) level. The hormones are secreted into the bloodstream. It also produces important enzymes to aid in the digestion of protein and fats (lipids). These enzymes travel from the pancreas to the small intestine through a small tube called the 'pancreatic duct.' It also produces important enzymes to aid in the digestion of protein and fats (lipids). These enzymes travel from the pancreas to the small intestine through a small tube called the 'pancreatic duct.'

11. CAUSAL FACTORS Genetic/ Family history Genetic/ Family history Race Race Stress Stress Over-eating&obesity Over-eating&obesity Physical Inactivity Physical Inactivity Gestational Diabetes Gestational Diabetes Drugs Drugs Infection Infection Other illnesses Other illnesses Surgery Surgery Autoimmune Autoimmune

12. Symptoms of Diabetes SOME or NONE of the following Frequent Urination Frequent Urination Excessive thirst Excessive thirst Unexplained weight loss Unexplained weight loss Extreme hunger Extreme hunger Sudden visual changes Sudden visual changes Tingling or numbness in hands or feet Tingling or numbness in hands or feet Feeling very tired most of the time Feeling very tired most of the time Wounds that are slow to heal Wounds that are slow to heal

13. DIAGNOSIS Urine strip test Urine strip test Blood sugar test Blood sugar test Glycosylated Haemoglobin: HbA1C Glycosylated Haemoglobin: HbA1C

14. What is the Treatment? Type I Strict carefully calculated diet Strict carefully calculated diet Planned physical activity Planned physical activity Insulin injections Insulin injections Home blood glucose testing Home blood glucose testing Type II Diet control Diet control Exercise Exercise Oral medication and or insulin Oral medication and or insulin Home blood glucose testing Home blood glucose testing

15. Hypoglycemia Hypoglycemia is low blood sugar. Hypoglycemia is low blood sugar. What causes hypoglycemia ? What causes hypoglycemia ? Taking too much insulin, Missing or delaying a meal, Exercising too much, Taking other medications. signs and symptoms signs and symptoms dizziness, confusion, dizziness, confusion, sweating, shaky tremors, headache or even fainting.

16. Management of Low Blood Sugar (Hypoglycaemia ) Tell your family, friends, colleagues at work about signs/symptoms and how to treat low blood sugar. Tell your family, friends, colleagues at work about signs/symptoms and how to treat low blood sugar. Carry medical card or tag Carry medical card or tag Eat or drink something that has sugar in it. Juice, sugar candy, milk etc. Eat or drink something that has sugar in it. Juice, sugar candy, milk etc. If unconscious don’t give anything by mouth-transfer to nearest clinic If unconscious don’t give anything by mouth-transfer to nearest clinic

17. Complications High blood pressure. High blood pressure. Heart disease; 50% Heart disease; 50% Strokes. Strokes. Nerve problems or Neuropathy; 50% Nerve problems or Neuropathy; 50% Blindness; 2% Blindness; 2% Kidney failure Kidney failure Impotence Impotence Diabetic foot disease-amputation/ulcers X40 Diabetic foot disease-amputation/ulcers X40 Consume 10% of Nation’s Health Budget Consume 10% of Nation’s Health Budget

18. How do we prevent? Healthy and Balanced diet Healthy and Balanced diet Regular physical activities/exercise Regular physical activities/exercise Maintain Normal body weight Maintain Normal body weight Early detection Early detection

19. Prognosis is good.