Diabetes A Major Public Health Issue Health Essay

Diabetes A Major Public Health Issue Health EssayAccording to current estimates many 366 million bulk sire diabetes in 2011 all everyplace world. It has been projected that by 2030 this go out have risen to 552 million. The number of people with type 2 diabetes is change magnitude throughout the globe. Among them somewhat 80% of people with diabetes live in low- and middle-income countries. The majority of people with diabetes lie in the age group of 40 to 59 years of age. Almost half of this creation, 183 million people (50%) is undiagnosed.Diabetes bring ond 4.6 million destructions in 2011. 78,000 children develop type 1 diabetes every year.India has become the global capital for both the kinds of indisposition- Communicable as well as NCD or life-style diseases. thither is this manifold burden of disease. The major diseases in the NCDs are Diabetes, CHD and Hypertension. These three diseases alone cause more than 400 deaths per million population in a year. Among th em Diabetes demands the major concern because it is intricately related to the development of the two other factors (increases the risk of) CHD and Hypertension. in that respect is also an increasing trend of fleshiness world-wide which also adds to the development of Diabetes as a risk factor.It is the fourth or fifth leading cause of death in the most high-income countries and it is taking the form of an epidemic in some developing as well. Diabetes has become one of the most challenging health problems of this century. in that respect have been many studies since the last two decades which confirm that the low and middle income countries are going to face the greatest burden of this disease. The governments and public health planners of many developing countries including India still remain ignorant of this upcoming health evil. The magnitude of this disease has serious implications in terms of its frugal burden in its word and loss in terms of wage and deteriorated quality of work by people affected by Diabetes. This can drastically influence the growth of a country in particular developing countries like India.Global Prevalence of Diabetes and projection till 2030global-diabetes.pngNumbers of people with diabetes (in millions) for 2000 and 2010 (top and middle values, respectively), and the percentage increasewed.pngSource- Nature Vol. 414 13 December 2001 www.nature.comThere have been reports of increasing cases of Myocardial Infarction even in very young patients among the Juvenile diabetes cases. It is a far more disenable than generally considered, it drastically decreases ones stamina and working capacity. As it is a multisystem disorder it influences other sensory functions as well much(prenominal) as diabetic retinopathy (hampering vision), Diabetic nephropathy (causing renal disease and failure), Diabetic neuropathy (including diabetic foot) and many other complications.The presentation of classical symptoms of polydypsia, polyphagia, polyuria is not always the picture of diabetes. It is only seen in a few(prenominal) classical cases. So, it is often diagnosed during routine test or examination done when patient had presented for some other disease or illness. The lack of awareness among people about this disease is of major concern. Due to this many cases go undetected.India has imitated the air jacketern ways of lifestyle and thereof illnesses such as obesity and diabetes are increasing day by day. In 2011, India had 62.4 million people with type 2 diabetes, compared with 50.8 million cases in 2010, according to the International Diabetes Federation (IDF) and the Madras Diabetes Research Foundation. The nationwide prevalence of diabetes in India now tops 9%, and is as high as 20% in the relatively prosperous southern cities. By 2030, the IDF predicts, India will have 100 million people with diabetes.Another matter of great concern is the fact that the onset of type 2 diabetes tends to affect people in the West in their 40s and 50s, whereas the disease strikes Indians at a much younger age. Even young people of 25 years of age are being diagnosed with the disease, a trend that threatens to seriously hamper the countrys economic development.The rise of type 2 diabetes in India was in fact foreseen by some scientists and health experts. Till1980s, the urban prevalence of diabetes was at least double the rural prevalence. But this picture of diabetes has changed pregnantly over time and has spread out of urban cities into the countryside and majority of rural areas. lawsuit 2 Diabetes constitutes more than 90 % of the whole diabetes cases in any country including India. It has a wide variety of determinants and risk factors associated with it, which need to be known and centre during policy formulation to address Diabetes.Aetiological determinants and risk factors of type 2 diabetesGenetic factorsGenetic markers, family history, thrifty gene(s)Demographic characteristicsSex, age, ethni cityBehavioural- and lifestyle-related risk factorsObesity (including distribution of obesity and duration)Physical inactivityDietStressWesternization, urbanization, modernizationMetabolic determinants and intermediate risk categories of type 2 diabetesImpaired glucose toleranceInsulin resistancePregnancy-related determinants (parity, gestational diabetes, diabetes in offspringof women with diabetes during pregnancy, intra-uterine mal or over nutrition)Source- Nature Vol. 414 13 December 2001 Www.Nature.ComVillages in wealthier southern states like Tamil Nadu and Kerala are seeing prevalence hit double digits, which is enormous. If it was confined to affluent India, you could still put a lid on it, but now its rising quickly all over the country. as per Nikhil Tandon, an endocrinologist at the All India Institute of Medical Sciences in New Delhi.There is also a considerable genetic propensity towards Diabetes in the Asian population curiously in India.india diabtes.pngAIMS OBJ ECTIVESDiabetes has yet not been recognized in our country as a major public health issue, although the morbidity and mortality and hence economic burden and loss due to it is much higher than that caused by many other communicable or other diseases such as AIDS or STDs, for which there are well formulated programs. But there are no such programs or targeted approach to tackle this very prominent verification of health in our country, Diabetes. There is almost no health care accessibility and availability dedicated in this regard in public get over. They are primarily excluded from government policies and decision making process. Not much work or studies have been conducted on the prevalence of Diabetes in India, especially rural India. There is a need to assess the real magnitude of this urgent problem which demands special concern in form of targeted policies and programs and screening. The aim of my vignette is to highlight the conterminous need of recognition of Diabetes as a major public-health concern and formulation of strategies,Policies and programs concerning Diabetes in India.RECOMMENDATIONS(1) Studies need to be conducted to determine the level of awareness and knowledge about diabetes at the community level in different parts of India. As we know IEC is very important for any community or mass scale program to be successful. It is also important in view of the Sickness behavior and the sick role played by the individuals. Creating awareness among the people will make them come up for the screening and a better turn up for treatment in early stage which will probatively descend the loss due to the disease to the person and state as a whole.(2) More studies and research required to identify the risk factors for diabetes, the relationship between anthropometric measures and diabetes risk and estimate the burden of diabetes in this rural Indian population with an objective to identify target areas for next healthcare planning.(3) Screening pro grams need to be formulated in the mass scale and many rounds of such screening will be required to assess the real magnitude of the problem in Indian population, so that, resources are used accordingly for planning of policies and programs. These data will be extremely important for planning the public health policies especially the envisaged National Diabetic go steady Program.(4) Tracing the comminuted pattern of the disease in the population and its demographic pattern is essential. Some of the recent studies have determine increasing cases of juvenile diabetes and there is detection of more and more cases in the lower marginalized and poorer section of population (Diabetes was once believed to be disease of elites, those of the rich sections of population associated with over eating, obesity etc). Now the picture of disease is changing which needs to be traced and addressed in the following policies for diabetes control and foreseeion. Research should also be directed in th e direction to identify the most appropriate test for screening purpose, as the results depend on the test employed to a significant degree, especially when employed for mass screening.(5) Clear cut policy outlines to tackle with the complications of Diabetes- The complications due to Diabetes can be even more disabling and in some cases even fatal. So it is very important to make clear cut policy outlines to tackle with the complications of Diabetes and its prevention. Measures should aim at intensive control of blood glucose to prevent the retinal, renaland neuropathic complications of diabetes. There is a concealed burden of Impaired Glucose Tolerance. The possibility of preventing type 2 diabetes by interventions that affect the lifestyles of subjects at high risk for the disease have focused on people with impaired glucose tolerance (IGT). It affects at least 200 million people worldwide. Approximately 40% of subjects progress to diabetes over 5-10 years, but some revert to nor mal or remain IGT. So, it is very essential to take this group of individuals into consideration.(6) Formation of a separate body at a lower place Ministry of Health and Family Welfare as Diabetes Control Organization or so to tackle with Diabetes in an integrated and comprehensive way throughout the country. Formulation of Control and Prevention Programs to be implemented in each state.Prior to this there should be formation of an Expert group to assess the actual prevalence and exact demographic characteristics of Diabetes in different regions of India.(7) Reinforcing legislative changes such as increased taxation of certain unhealthy foods to promote healthy diet. Although it is difficult but such steps may help to a great extent.CONCLUSIONA much more integrated approach is needed to have a significant impact on the diabetes epidemic in India. Type 2 diabetes is not merely a disease but reflection of a much large problem, that is, the effect of environmental and lifestyle chang es on human health. We need well integrated policies for education of the mass through IEC. The major proportion of Diabetes cases in India is Type-2 which is preventable. It is a huge threat to public health and in absence of interventions there would be great loss.Thus prevention of diabetes and its micro- and macro-vascular complications should be an essential component of future public health strategies for all nations. An essential and immediate need is the formation of multidisciplinary national encompassing all parties that can help address and control the central socioeconomic causes that have led to the diabetes epidemic.ANNEXURERecent studies have highlighted the potential for intervention in IGT subjects to reduce progression to type 2 diabetes. One such study is the recently completed Diabetes Prevention Program in the United States.Diabetes education is necessary to control Diabetes. It includes diabetes self-management education (DSME) and diabetes self-management tra ining (DSMT). It helps people to modify their behavior and hence mange the disease. Healthy People 2010 objective regarding diabetes education- At least 60 percent of persons with diabetes should receive formal diabetes education in order to attain considerable level of awareness in the community as per the American Association of Diabetes Educators.List of Stake holders-Govt. of India, Ministry of health and Family Welfare.State Governments.NGOs and other organizationsMedia for awareness.Family of Diabetic patients.