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Diabetes Basics 14 Nov 22.ppt
- 1. Military Hospital Lecture on 17 Nov 2022 Talk by Col Bharat Malhotra Senior Advisor Medicine EDUCATION TO PROTECT TOMORROW Take Charge of Your Diabetes Care Do You Have The Knowledge to Make Informed Decisions?
- 2. IDF Global report – Factsheet updated as on 2021 DIABETES GLOBAL FACTSHEET
- 3. IDF Global report – Factsheet updated as on 2021 Prevalence of Diabetes (20-80 years) in 2021 Country Patients with Diabetes 1. CHINA 140.9 Million cases 2. INDIA 74.2 Million cases 3. PAKISTAN 33 Million cases 4. USA 32.2 Million cases 5. INDONESIA 19.5 Million cases
- 4. • 30.3 Million 2000 • 50.8 Million 2011 • 74.2 Million 2021 INDIA • 8.5 – 15% Statistics from the International Diabetes Federation (IDF) - 2017
- 5. DIABETES - CLASSIFICATION Type 1 Diabetes Type 2 Diabetes 1 2 Gestational 3 Specific Causes 4
- 6. DIAGNOSIS FOR DIABETES • > 126 mg/dL Fasting • > 6.5% HBA1C • > 200 mg/dL • Plus Symptoms 2 h after food • > 200 mg/dL GTT < 100 mg/dL NORMAL DIABETES < 140 mg/dL < 140 mg/dL < 5.7 mg/dL Check Plasma Glucose 8h fasting HBA1C – NGSP certified
- 7. NONMODIFIABLE AGE RACE ETHNICITY FAMILY HISTORY MODIFIABLE OBESITY HIGH CHOLESTEROL HYPERTENSION SMOKING PHYSICAL INACTIVITY DIABETES – RISK FACTORS
- 8. Asymptomatic – detected by lab tests Symptoms Complications SYMPTOMS
- 9. COMPLICATIONS OF DIABETES WHO/IDF data (2021) 6.7 million death by Diabetes
- 10. REFERALS DIETICIAN PHYSICIAN EYE SPL DENTIST PSY SPL– If Indicated TREATMENT Lifestyle modification Diabetic diet Medications Insulin – if required MONITOR FOLLOW UP TREATMENT PLANS
- 12. Avoid Excess Sweets – Chocolates, cakes, candies and Indian sweets (High calorie content) 2/5
- 13. Avoid Fried Food Stuff – These include pakoras, samosas, parathas, cheese balls etc Avoid Excess Ghee, Butter, Saturated fats 3/5
- 14. Red Meat with oil Deep Fried Chicken Egg yolk Gravy chicken like butter chicken to be avoided 4/5
- 15. Specifically avoid food items which are fried, gravied, creamed or sugared 5/5
- 16. Diet for average normal adult (2300- 2500 kcal per day) Cereals i.e. Chapatti, rice 500-550 g Fruits 200–250 g Non veg 50-100 g Fats & Oils 30–35 g; refined sugars 50-60 g Vegeta- bles 200-250 g Milk, Pulses 50-100 g
- 17. DIABETIC DIET PLAN CARBOHYDRATE – LOW GLYCEMIC INDEX – HIGH FIBER PROTEINS FAT
- 18. 2 small wheat chapati or 2 small bread 1 cup cooked mix veg, cheese 15g or butter 5gm 1 cup tea/coffee with skim milk with no sugar Small banana 2 wheat chapati and 1 cup cooked rice 1 cup vegetable + 1 cup dal (1 tsp oil or ghee for cooking) ½ cup Dhai and Salads 2 Mário biscuits / 1 cup tea or coffee with no sugar or 1 small cup fruit 2 wheat chapati 1 cup vegetable + 1 cup N/Veg (1 tsp oil or ghee for cooking) 1 cup thin watery dal ½ cup Dhai and Salads Whole milk cup SAMPLE DIABETES CHART 1600 kcal
- 19. Flour with higher level of bran Brown rice/ Rice as small portion Pulses Beans Dalia Fruits Vegetables Salads Consume food rich in Fiber Use Toned Milk Toned Milk
- 20. Dressed Chicken Fish Go slow on red meat Go slow on yolk of egg Prefer marinated/baked/grilled Avoid heavy gravy / oily gravy Nonveg be portion of meal and not as whole meal Nonvegetarian Food Avoid Yolk
- 21. Avoid excess of salt in cooked food/ Salads Avoid pickles, sauces Avoid tinned, preserved food 5-6 grams of salts/day is ideal Beneficial – in high BP too Salt….
- 22. Oil Use…. Coconut oil Ground nut oil Sunflower oil Mustard oil Sunflower oil Ground nut oil Sunflower oil Desi Ghee The RICH Safflower oil Olive oil Soyabean oil Canola oil RESTAURANTS Palm oil Vanaspati Dalda
- 23. Type of Oil – what to choose OIL SMOKE POINT Refined safflower oil 510 Mustard oil 480 Ghee 480 Refined sunflower oil 450 Sesame oil 450 Coconut oil 450 Virgin olive oil 410 Butter 302 DEEP FRY High smoke point PUFA MUFA SOYABEAN OIL OLIVE OIL SUNFLOWER OIL WALNUTS CASHEWNUTS NUTRITIONAL BENEFIT Harmful – Deep Fry CHOLESTEROL All Animal fat oils SATURATED FAT BUTTER GHEE COCONUT OIL, PALM OIL
- 24. Type of Oil – what to choose OIL SMOKE POINT Refined safflower oil 510 Mustard oil 480 Ghee 480 Refined sunflower oil 450 Sesame oil 450 Coconut oil 450 Virgin olive oil 410 Butter 302 DEEP FRY High smoke point PUFA MUFA SOYABEAN OIL OLIVE OIL SUNFLOWER OIL WALNUTS CASHEWNUTS NUTRITIONAL BENEFIT Harmful – when Deep Fry CHOLESTEROL All Animal fat oils SATURATED FAT BUTTER GHEE COCONUT OIL, PALM OIL
- 25. TRANS FAT VANASPATI GHEE REUSED OIL ROAD SIDE DHABA LOCAL BAKERY
- 26. Why are SOFT DRINK bad? Not toilet cleaner Has Citric acid, Phosphoric acid Why is it Bad? Blank calories – Sugars overdose 13.8 x 6 = 82.8 gms of sugar in 600 ml Caramel (pepsi), Sunset yellow E110 (Fanta) Preservative – Sodium benzoate Stabilizer – E1450 Sodium citrate, Phosphoric acid Carbonated soda
- 27. Can we take Preservative Fruit juices? Why is it not so good? Sugar in plenty Concentrated FRESH CITRUS FRUIT Is allowed
- 29. Physical Activity Aerobic exercise (Endurance) Anaerobic exercise (Strength of muscle) Avoid Sedentary Habits EXERCISE 30 Min /60 Mins 5 times / week
- 30. – Jogging 6-7 Km/hr – Cycling 15 Km/hr – Swimming 20-25 meters in a minute – Competitive tennis, squash, badminton (singles) Examples: Go Out Of Home To Exercise 30 mins /day 5 times a week
- 31. SMOKING ALCOHOL We neither prescribe nor encourage STOP TODAY SAY NO TO SMOKING
- 32. . Treat Obesity Obesity is a problem In ladies & kids too Time Bomb that kills
- 33. Happy meal atmosphere Do not use foods as rewards Children mirror eating habits of parents Increase variety in food, low energy snacks Balanced meal plan Low fat intake after 10 yrs. of age Encourage playing outside home WHAT SHOULD BE DONE TO TACKLE CHILDHOOD OBESITY?
- 34. MEDICINE & LATEST INSULINS PEN BASED DEVICES CONVENTIONAL INJ MEDICINES FOR DIABETES DIABETIC DIET 1500/1800 kcal/d
- 35. Taking Insulin Injections WHEN HOW MUCH METHOD OF TAKING SUGAR (F) > 250 MG/dL HBa1C > 10% OHA FAILURE ADMITTED IN HOSPITAL COMPLICATIONS PREGNANCY
- 36. HYPOGLYCEMIA ANXIETY SWEATING SLEEPINESS LACK OF COORDINA TION IRRITABLE HUNGER ALERT VALUE < 70 MG/DL
- 37. Why foot care is important in diabetics ?
- 38. GESTATIONAL DIABETES Treat With Insulin PROBLEMS TO CHILD MACROSOMIA MISCARRIAGE STILLBIRTH CONGENITAL DEFECTS IUGR (GROWTH RETARDATION) PLACENTAL INSUFFICIENCY 1 VISIT & AT 24-28 WKS
- 39. YOU, YOUR DOCTOR AND THE MEDICAL EXAMINATIONS Believe that your – Doctor is your best guide Medical exams Healthy lifestyle among children right from adolescence
- 40. IF YOU AGREE WITH US, PLEASE DO US A FAVOUR Lets pledge to keep our families safe from complications of Diabetes