EPC of DM Flashcards

1
Q

Drivers of Diabetes Epidemic?

A
  1. Demographic Change - Falling Birth Rates and Low Death Rates
  2. Disease Burden Change - Infection change to chronic diseases
  3. Urbanisation (rural to urban)
  4. Nutritional Transition (high income now eating more meat, low/middle income eating more carbs
  5. Occupational Transition (sedentary)
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2
Q

Risk factors for diabetes?

A
  1. Family History
  2. Lack of Exercise
  3. Unhealthy Eating
  4. Overweight, Metabolic Syndrome
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3
Q

Ethnicity Trend in DM?

A

Higher in Asian (Middle East + Pacific Islands) + Indigenous Communities in West

In Singapore, Indians > Malays > Chinese

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4
Q

5 methods to reduce DM?

A
  1. Prevent (primary)
  2. Control (tertiary)
  3. Screen (Secondary)
  4. Understand (primary)
  5. Do your part (primary) (stakeholder engagement)

‘Please Stop Un-Curing Diabetics’

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5
Q

Discuss Primary Prevention of DM.

A

High Risk Strategy vs Population Based Strategy
- HRS: Helps those at high risk but does not change overall population risk profile
- PBS: Shifts entire population risk lesser but is difficult to mount and sustain

E.g. of PBS:
1. Exercise (150min/week; 20min of vigorous activity 3x/week)
2. My Healthy Plate
3. Public Health Framework ‘4 Es’
- Engineer = healthier foods; walking instead of driving (cycling paths)
- Enforce = ban on smoking; ‘fat’ tax
- Encourage = healthier food in supermarket rows at eye level; make it less convenient to drive; incentives; disincentives
- Educate

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6
Q

Discuss Secondary PRevention of DM.

A

Screening for all 40 and above + any age for those with risk factors
- overweight
- family history
- high risk ethnicity
- gestational DM
- HTN
- HyperL

Do HbA1c, OGTT, Fasting Glucose

Subsidize screening

Repeat screening every 3 years for normal results, annually for those with IFG/IGT

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7
Q

5 qns for diabetes risk assessment.

A
  1. DOB
  2. Gender
  3. BMI
  4. Family History of DM
  5. History of HTN
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