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2014 ROTARY INTERNATIONAL CONVENTION
Rotarian Action Group on
Diabetes
2014 ROTARY INTERNATIONAL CONVENTION
Diabetes Overview
Prof Martin Silink
Rotary Club of Lane Cove
University of Sydney
Diabetes Atlas 2013
Type 1 children 500,000
Type 2 adults 382,000,000
>7 million more each year
4,000,000 Deaths per year
...
Diabetes in Australia – the epidemic grows
A touch of sugar can’t be too serious ?
???????
Does Mild Diabetes exist?
Burden of disease in Australia
DALY’s
(Disability
Adjusted
Life Years)
Number of
years lost
due to
ill-health,
or early
de...
Not all cells are equally damaged by high glucose levels
Most cells are able to maintain a relatively normal
internal gluc...
FinnDiane Study of Mortality and Nephropathy
Groop PH et al Diabetes 2009;58:1651-1658
4201 people with T1D
Finland major ...
GLUCOSE + SUPEROXIDE
Reactive oxygen species
Damage is caused by:
Prevention of Chronic Complications
Major Trials proving Glucose control matters
Type 1 diabetes
• DCCT 1983-1993
• Post DCCT/EDIC 1993+
Type 2 diabetes
• UKP...
Key Results of DCCT:
1441 patients with T1D, aged 13-39 years
Half treated intensively to maintain HbA1c 7.2%
Half treated...
Trials proved
Glucose Control Matters
Key Concepts in Chronic Complications
Modern-Day Clinical Course of Type 1 Diabetes Mellitus After 30 Years’
Duration
The Diabetes Control and Complications Tri...
Trials proved
Metabolic Memory
Period of good control has long
term benefits
Key Concepts in Chronic Complications
Preventing the Diabetes Burden
Primary
Prevention
Secondary
Prevention
Tertiary
Prevention
Life
Expectancy
in T1D and T2D
Glucose monitoring
Lifestyle
No smoking
Physical activity
BP control
Lipid Control
Improvin...
What can Rotary do?
SUPPORT:
Insulin
Glucose monitoring
Diabetes education
Training of health professionals
Complication s...
Please join the Rotarian Action Group on Diabetes
RAGD
Thank you
RAGD
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Rotarians and Diabetes Prevention Developing Healthy Communities: Part 1 rag on diabetes

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Rotarians and Diabetes Prevention Developing Healthy Communities: Part 1 rag on diabetes

  1. 1. 2014 ROTARY INTERNATIONAL CONVENTION Rotarian Action Group on Diabetes
  2. 2. 2014 ROTARY INTERNATIONAL CONVENTION Diabetes Overview Prof Martin Silink Rotary Club of Lane Cove University of Sydney
  3. 3. Diabetes Atlas 2013 Type 1 children 500,000 Type 2 adults 382,000,000 >7 million more each year 4,000,000 Deaths per year 1,000,000 Amputations per year Leading cause of adult blindness Leading cause of adult kidney failure 80% in developing world Prevalence estimates for 2013 The Size of the Problem
  4. 4. Diabetes in Australia – the epidemic grows
  5. 5. A touch of sugar can’t be too serious ? ??????? Does Mild Diabetes exist?
  6. 6. Burden of disease in Australia DALY’s (Disability Adjusted Life Years) Number of years lost due to ill-health, or early death
  7. 7. Not all cells are equally damaged by high glucose levels Most cells are able to maintain a relatively normal internal glucose level despite elevated blood glucose Four organs are not effective in doing this: Retina Nerves Kidney Large arteries Retinopathy Neuropathy Nephropathy Key Concepts in Chronic Complications Atherosclerosis
  8. 8. FinnDiane Study of Mortality and Nephropathy Groop PH et al Diabetes 2009;58:1651-1658 4201 people with T1D Finland major clinics Mean Ages 36-42 Diabetes 20-32 years SMR 2.8 SMR 0.8 SMR 9.2
  9. 9. GLUCOSE + SUPEROXIDE Reactive oxygen species Damage is caused by: Prevention of Chronic Complications
  10. 10. Major Trials proving Glucose control matters Type 1 diabetes • DCCT 1983-1993 • Post DCCT/EDIC 1993+ Type 2 diabetes • UKPDS 1978-1998 • Kumamoto 1992-2000 Key Concepts in Chronic Complications
  11. 11. Key Results of DCCT: 1441 patients with T1D, aged 13-39 years Half treated intensively to maintain HbA1c 7.2% Half treated conventionally maintained HbA1c 9.2% Intensive treatment reduced: • eye disease by 76% • kidney disease by 50% • nerve disease by 60% Diabetes Control and Complications Trial Results
  12. 12. Trials proved Glucose Control Matters Key Concepts in Chronic Complications
  13. 13. Modern-Day Clinical Course of Type 1 Diabetes Mellitus After 30 Years’ Duration The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications and Pittsburgh Epidemiology of Diabetes Complications Experience (1983-2005) D Nathan et al, and Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Research Group* Arch Intern Med. 2009 July 27; 169(14): 1307– 1316. doi: 10.1001/archinternmed .2009.193 Retinopathy Nephropathy Cardiovascular Disease Cumulative incidences after 30 years of diabetes: CT IT Retinopathy 50% 21% Nephropathy 25% 9% Cardiovascular disease 14% 9% <1% became blind, required kidney replacement, or had an amputation DCCT/EDIC Study after 30 Years
  14. 14. Trials proved Metabolic Memory Period of good control has long term benefits Key Concepts in Chronic Complications
  15. 15. Preventing the Diabetes Burden Primary Prevention Secondary Prevention Tertiary Prevention
  16. 16. Life Expectancy in T1D and T2D Glucose monitoring Lifestyle No smoking Physical activity BP control Lipid Control Improving social determinants of health Access to care Self empowerment Intensive therapy Diabetes education Strategies to Improve Life Expectancy in Diabetes Complications screening Aspirin Early diagnosis
  17. 17. What can Rotary do? SUPPORT: Insulin Glucose monitoring Diabetes education Training of health professionals Complication screening Foot care Eye care BP control ADVOCATE: Healthy cities Healthy schools Healthy work Healthy foods PROMOTE: Healthy weight Healthy eating Healthy activity What can Rotary do? LFAC Be the voice of the community for healthy living
  18. 18. Please join the Rotarian Action Group on Diabetes RAGD
  19. 19. Thank you RAGD

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