Epidemiology of Diabetes Flashcards
What is diabetes?
Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces
• This leads to high blood sugar levels
How do you diagnose diabetes?
Fasting blood sugar >7mmol/l
Random blood sugar >11mmol/l
Describe type 1 diabetes?
- AKA-insulin-dependent, juvenile or childhood-onset
- characterized by deficient insulin production and requires daily administration of insulin
- Autoimmune ( β-cell destruction)
- idiopathic
- Common in children
Describe type 2 diabetes?
- Formerly called non-insulin-dependent or adult-onset
- Results from the body’s ineffective use of insulin
- comprises the majority of people with diabetes around the world
- Largely the result of excess body weight and physical inactivity.
- 95% of diabetes is type 2 (WHO)
What is gestational diabetes?
- Diabetes occurring during pregnancy
- Associated with pregnancy complications
- Babies at risk of diabetes later in life
What is the clinical presentation of diabetes?
- Polyuria (excretion of a lot of urine )
- Polydipsia (Thirst)
- Weight loss and fatigue.
- These symptoms may occur suddenly especially type 1
- Often less marked symptom in type 2- As a result, the disease may be diagnosed several years after onset, once complications have already arisen
Describe the complications of diabetes?
1 Raised blood sugar over time leads to serious damage to many of the body’s systems, especially the nerves and blood vessels
- Coronary heart disease
- Adults with diabetes have a 2-3-fold increased risk of heart attacks and strokes - Neuropathy (nerve damage)
- Neuropathy increases the chance of foot ulcers, infection
- Major cause of limb amputation. - Retinopathy (damage eyes)
- Diabetic retinopathy is an important cause of blindness, and occurs as a result of long-term accumulated damage to the small blood vessels in the retina.
- 2.6% of global blindness can be attributed to diabetes - Nephropathy (kidney damage)
- Diabetes is among the leading causes of kidney failure
Describe the diagnosis and treatment of diabetes?
- Early diagnosis can be accomplished through relatively inexpensive testing of blood sugar.
- Treatment involves diet and physical activity
- Lowering blood glucose with ant diabetic drugs
- Lowering levels of other known risk
Describe the global burden of diabetes mellitus?
- The leading Non Communicable Disease world wide
- One of the leading causes of death
- Estimated 422 million people with diabetes worldwide
- In 2019,DM was the 9th leading cause of death
- 1.5 million deaths worldwide from diabetes in 2019 (Global burden of disease study)
- Representing a 31% increase from 2006.
- WHO projects that diabetes will be the 7th leading cause of death in 2030
- Burden is increasing at an alarming rate in low income countries
- fuelled by the global rise in the prevalence of obesity and unhealthy lifestyles.
- 161% increase by 2030
Describe the epidemiology of diabetes in low income countries?
• Four out of five people in the world with diabetes now live in low- and
middle-income countries
• The incidence of diabetes is accelerating in poorer communities
• There are now 336 million people with diabetes living in low- and middle income countries (international diabetes federation 2017).
• In Africa, up to 15% of adults aged 25 to 64 have diabetes
• Diabetes in the Region is a serious, chronic and costly disease that is
estimated to rise to 23.9 million cases by 2030.
• Diabetes is often a silent condition and is likely to be undiagnosed or poorly treated in LMIC
What is epidemiological transition?
Change in the pattern of health and disease due to changes in the demographic, economic and social determinants in a population
Describe the epidemiological transition of diabetes?
- Traditionally DM has been viewed as a ‘disease of developed countries + disease of the elderly (especially type 2)
- Alarming rise in low income countries
- Age transition of type 2 to younger age
- High rates of rural to urban migration-Most of Africa’s population now live in towns or cities,
- Taxis and buses reduce the need for exercise,
- Fast-food outlets are overtaking the traditional African diet
- Increased food quantity
- Dual burden with Infectious diseases (HIV, TB)
- ARTs known to cause hyperglycaemia
- COVID-19 has also shown to precipitate the development of DM
Describe why the age for type 2 diabetes has transitioned to a younger age?
- obesity
- exposure to diabetes in utero
- endocrine disrupting chemicals in common household products
How has COVID-19 precipitated the development of diabtes?
people afraid to go the the hospital for check ups
Describe the dual burden of diabetes and infectious diseases?
Low income countries have high burden of Infectious diseases
and now an Increased burden of Non Communicable Diseases (NCDs)
1. Diabetes increases the risk of infection and worse outcomes
- The Global Burden of Disease group-Diabetes accounts for 10.6% of the TB mortality in HIV-negative people
- In 2017, 790 000 cases of TB were attributable to diabetes. (WHO Global Tuberculosis Report 2018)
2. Increased rates of insulin resistance in People with HIV
3. ART - a risk factor of diabetes and hyperglycaemia
