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ROLE OF PHCc IN DIABETIC CARE  By DR/Mohamed Tahir Takana MBBS,DPH
DIABETIC CARE IN PHC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Q.A IN DIABETIC CARE ,[object Object],[object Object]
1-STANDARDS OF RESOURCES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PROCESS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SCREENING OF DIABETES Yearly Previously identified IGT Yearly H/o polycystic ovary syndrome Yearly H/o vascular disease Yearly Hypertension>140/90 m.m of Hg Yearly HDL<35mg or TG>250mg/dl Yearly H/o G. diabetes (Babies>4kg) Yearly Habitually physically inactive>35 Yearly Family H/o diabetes Yearly Age>35 years & BMI>25 Every 3 years All Individuals>45 years FREQUENCY AT RISK POPULATION
TESTS USED FOR SCREENING ,[object Object],[object Object],Do OGTT with 75g anhydrous G dissolved in H2O 100-125mg/dl 5.6-6.9mmol/L Impaired G tolerance >200mg/dl >11.1mmol/L >126mg/dl >7.0mmol/L Diabetes <140mg/dl <7.8mmol/L <100mg/dl <5.6mmol/L Normal 2 hours post prandial Fasting blood Glucose Category
PRPVISIONAL DIAGNOSIS   ,[object Object],[object Object],[object Object],[object Object]
MANAGEMENT ,[object Object],[object Object],[object Object],[object Object]
TREATMENT  GUIDE Should B managed at hospital Screening only Gestational diabetes Re-assessment every 6 months or when Needed Should be seen in maintenance phase Type-1 diabetes  Re-assessment Untill controlled Should be seen in maintenance phase Type-2 diabetes  (Poorly controlled) “ YEARLY REFERRAL Mainly at PHCC.Follow-up according to control Simple Type-2 diabetes  Diet+Exercise Diet+Exercise+Oral Role of Hospital Role of PHCC Category of diabetes
A-PROCESS FOR A NEWLY DIAGNOSED CASE   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],ROLE OF NURSE ROLE OF DOCTOR
FOLLOW-UP APPOINTMENT AT PHCC After one week >250 mg/dl After 2 weeks 201-249 mg/dl After 3 weeks 180-200 mg/dl After 1 months 140-179 mg/dl After 2 months 126-139 mg/dl After 3 months <126 mg/dl APPOINTMENT FBS
B-PROCESS FOR A CASE DURING FOLLOW-UP VISIT   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],ROLE OF NURSE ROLE OF DOCTOR
C-PROCEDURES FOR DEFAULTERS ,[object Object],[object Object],[object Object],[object Object]
INDICATIONS FOR REFERRAL ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
D-PROCEDURES DURING ACUTE EMERGENCIES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],ROLE OF NURSE ROLE OF DOCTOR
4-EVALUATION  (OUTCOME) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
THANK YOU

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Role Of PHC In Dibetic Care

  • 1. ROLE OF PHCc IN DIABETIC CARE By DR/Mohamed Tahir Takana MBBS,DPH
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  • 6. SCREENING OF DIABETES Yearly Previously identified IGT Yearly H/o polycystic ovary syndrome Yearly H/o vascular disease Yearly Hypertension>140/90 m.m of Hg Yearly HDL<35mg or TG>250mg/dl Yearly H/o G. diabetes (Babies>4kg) Yearly Habitually physically inactive>35 Yearly Family H/o diabetes Yearly Age>35 years & BMI>25 Every 3 years All Individuals>45 years FREQUENCY AT RISK POPULATION
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  • 10. TREATMENT GUIDE Should B managed at hospital Screening only Gestational diabetes Re-assessment every 6 months or when Needed Should be seen in maintenance phase Type-1 diabetes Re-assessment Untill controlled Should be seen in maintenance phase Type-2 diabetes (Poorly controlled) “ YEARLY REFERRAL Mainly at PHCC.Follow-up according to control Simple Type-2 diabetes Diet+Exercise Diet+Exercise+Oral Role of Hospital Role of PHCC Category of diabetes
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  • 12. FOLLOW-UP APPOINTMENT AT PHCC After one week >250 mg/dl After 2 weeks 201-249 mg/dl After 3 weeks 180-200 mg/dl After 1 months 140-179 mg/dl After 2 months 126-139 mg/dl After 3 months <126 mg/dl APPOINTMENT FBS
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