Non-Communicable Diseases: The Unheralded Global Epidemic_Block_5.12.11


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  • Health care needs to be reoriented toward chronic disease. The need for patient involvement in self-care requires more education, motivation and support services. Lifestyle diseases can not only be treated at the individual level, but require a community perspective to foster an enabling environment.
  • Obesity is the single greatest risk factor for diabetes. Childhood obesity rates must be confronted to stem the epidemic.
  • Endline data is currently being processed to gauge the effectiveness of our school based “healthy habits” program. Annecdotal evidence to date is very promising – both clinically and in terms of creating healthier school and home environments.
  • Non-Communicable Diseases: The Unheralded Global Epidemic_Block_5.12.11

    1. 1. Global Diabetes Project HOPE: Addressing Diabetes Around the World Charlotte Block, MS, RD Program Officer – Chronic Disease Project HOPE CORE Group Spring Meeting May 12 th , 2011 Baltimore, MD
    2. 2. Agenda – Global Diabetes <ul><li>The numbers </li></ul><ul><li>The causes </li></ul><ul><li>The impact </li></ul><ul><li>The challenges </li></ul><ul><li>The approaches </li></ul><ul><li>The future </li></ul>
    3. 3. Global Diabetes Burden: Large and growing Mexico 6.8 M (10.1%) Brazil 7.6 M (6%) China 43.2 M (4.5%) India 50.8 M (7.1%) Egypt 4.8 M (10.4%) Kenya 0.5 M (2.8%) South Africa 1.3M (4.5%) UAE 0.4 M (12.2%) Oman 0.2 M (11.1%) Indonesia 7 M (4.6%) USA 26.8 M (12.3%) UK 2.1 M (4.9%) Australia 1 M (7.2%) Japan 7 M (7.3%) Canada 2.9 M (11.6%) Russia 9.6 M (9%) Researched country Comparison country Source: IDF Diabetes Atlas 2010, MedMarket Diligence, LLC Diabetes and NCD Need
    4. 4. Global Diabetes Epidemic 2009
    5. 5. Top 10: Number of People with Diabetes 2010 and projected 2030 1 China 92.4 2. India 50.8
    6. 6. Major Causes? <ul><ul><li>Urbanization: </li></ul></ul><ul><ul><ul><li>Transportation changes </li></ul></ul></ul><ul><ul><ul><li>Culture shift: Western diet, processed foods, sedentary activities </li></ul></ul></ul><ul><ul><ul><li>Household income increases </li></ul></ul></ul><ul><ul><ul><li>Historic perceptions: more is better! </li></ul></ul></ul>
    7. 7. Public Health and Economic Impact: A Cause for Action Population incidence for diabetes grows 5.5% per year without behavior-change interventions Currently high-risk or undiagnosed populations develop late-stage complications before detection Diagnosed patients experience poor diabetes management due to lack of human and intellectual capital Specialty Care Burden Preventable conditions develop into high-cost and complex burdens on primary-tertiary health systems High-Cost Medical Treatment Growth in high-cost treatments for amputations, blindness, renal failure, and co-morbidities such as CVD Lack of Population Productivity Diabetes caused 6.8% of all deaths in 2010 and will increase 5.5-12% per year in some regions Prevalence 438 M People Global Spend $561 billion Source: IDF World Diabetes Atlas – Economic Impacts of Diabetes Health systems lack capacity and processes to treat chronic conditions (acute-focused) Governments lack effective programs and policies to prevent increased incidence and severity of diabetes Public Health Impact Economic Impact
    8. 8. Saving Lives: Understanding the Many Faces of Diabetes <ul><li>Type 1, 8 years old </li></ul><ul><li>Family bankruptcy due to health costs </li></ul><ul><li>No treatment access </li></ul><ul><li>Removed from school </li></ul><ul><li>Type 2, 45 years old </li></ul><ul><li>Limited exercise options </li></ul><ul><li>CVD/bp co-morbidities </li></ul><ul><li>Prominent cultural foods </li></ul><ul><li>Fate-driven beliefs </li></ul><ul><li>Type 2, 22 years old </li></ul><ul><li>Malnourished </li></ul><ul><li>TB dual burden </li></ul><ul><li>Limited access to funds for healthy foods </li></ul>“ Insulin is like air to me; I need it to live” “ Diabetes is my fate, so why should I change?” “ I’d rather have HIV than have diabetes”
    9. 9. Diabetes - Global Health Crisis <ul><li>Doubles risk of CVD and stroke </li></ul><ul><li>Leading cause of renal failure </li></ul><ul><li>10x lower limb amputations </li></ul><ul><li>Leading cause of blindness/impairment </li></ul><ul><li>2–3x the health-care resources or 15% of national health care budgets </li></ul><ul><li>TB risk 3x higher </li></ul>
    10. 10. What Works? <ul><li>Health professional development: </li></ul><ul><ul><li>Clinical </li></ul></ul><ul><ul><li>Education </li></ul></ul><ul><ul><li>Communication </li></ul></ul><ul><li>Patient–centered care </li></ul><ul><li>Lifestyle modifications </li></ul><ul><li>Peer/family support </li></ul><ul><li>Community awareness and mobilization </li></ul>
    11. 11. Diabetes Education <ul><li>Diabetes Educators help patients: </li></ul><ul><ul><li>Make informed health decisions </li></ul></ul><ul><ul><li>Adopt behavioural changes </li></ul></ul><ul><ul><li>Address psychosocial issues </li></ul></ul><ul><li>So patients can manage their diabetes-related health to the best of their ability </li></ul>
    12. 12. Project HOPE: Diabetes Programs Mexico 2001-present India 2007-present China 1996-present New Mexico, USA 2010- present S. Africa pending Nicaragua 2010 - present
    13. 13. Qingdao Chengdu Xi’an Beijing Guangzhou Hangzhou Shanghai Ruijin Shanghai Huashan Harbin Nanjin g China Diabetes Program (1996-Present) <ul><li>Rural and Urban Training Centers </li></ul><ul><li>Trained >40,000 health care providers </li></ul><ul><li>Reaching >170,000 patients and families </li></ul><ul><li>MoH partnership -> National Standards </li></ul>
    14. 14. <ul><li>“ Healthy Habits for a Healthy Weight” </li></ul><ul><li>Expanded to New Mexico & India </li></ul><ul><li>“ Diabesity” – targeting 3 rd graders </li></ul><ul><li>Holistic approach – school & home </li></ul><ul><li>Health vs illness focused </li></ul><ul><li>Promotes 3 healthy habits </li></ul>Mexico (2001 – Present) Layers of Obesity
    15. 15. <ul><li>Master Trainer/Centers of Excellence </li></ul><ul><ul><ul><li>Distance learning </li></ul></ul></ul><ul><ul><ul><li>Launching Diabetes Educator profession </li></ul></ul></ul><ul><ul><ul><li>Based on IDF diabetes ed. </li></ul></ul></ul><ul><ul><ul><li>10 Diabetes Centers country-wide </li></ul></ul></ul>India Diabetes Educator Project (IDEP)
    16. 16. New Mexico – HABITS for LIFE <ul><li>Targeting health disparities using Telehealth </li></ul><ul><li>US/Mexico rural border communities </li></ul><ul><li>Prevention, Screening & Access to Specialty Care </li></ul><ul><li>HW training to build clinical & educational capacity </li></ul>
    17. 17. Gestational Diabetes <ul><li>Pilot project in Nicaragua & Mexico </li></ul><ul><li>Training government health workers </li></ul><ul><li>Trainees screen and educate pregnant patient groups at health centers. </li></ul>
    18. 18. Plans for the Future… <ul><li>Integrated, community-based care - Johannesburg </li></ul><ul><li>Workplace health programs </li></ul><ul><li>Children with Type 1 diabetes </li></ul><ul><li>Expansion: </li></ul><ul><ul><li>Type 2 / Diabesity – Children </li></ul></ul><ul><ul><li>Gestational diabetes </li></ul></ul><ul><ul><li>Peer education/support </li></ul></ul>
    19. 19. For more information: Charlotte Block, MS, RD Program Officer - Chronic Disease/Nutrition [email_address] Thank You! Special thanks to consultant Emily Ewell