Diabetes And Sugar

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Diabetes And Sugar

  1. 1. Diabetes: Beyond Sugar
  2. 2. CHAOS <ul><li>C - Coronary artery disease </li></ul><ul><li>H - Hyper-tension, -glycaemia, -insulinaemia </li></ul><ul><li>A - Atherosclerosis </li></ul><ul><li>O - Obesity </li></ul><ul><li>S - Stroke </li></ul>
  3. 3. Top 5 co-existing conditions Diabetes in Europe, 2000 Type 1 - 1531, Type 2 - 7911
  4. 4. Top 5 co-existing conditions Diab Care Asia, 2000 Type 2 - 2238
  5. 5. Management of T 2 DM Extends Beyond Glucose Control need to be addressed Issues like Obesity High Cholesterol Hypertension Smoking
  6. 6. Therapeutic Lifestyle change <ul><li>Healthy Eating, </li></ul><ul><li>Time management, </li></ul><ul><li>Regular exercise </li></ul><ul><ul><li>30 min daily brisk walking. </li></ul></ul>
  7. 7. Lipid control <ul><li>DIFFICULT! </li></ul><ul><ul><li>Target is changing </li></ul></ul><ul><ul><li>What level is safe? </li></ul></ul><ul><ul><li>Multifactorial </li></ul></ul><ul><ul><li>(Hyperglycaemia leads to hyperlipidaemia ) </li></ul></ul>
  8. 8. Hypertension Complications HT Peripheral vascular disease Coronary Heart Disease 43% End Stage Renal Failure Stroke 18% Congestive Heart Failure
  9. 9. Hypertension- Interesting Facts <ul><li>5-6 mm reduction in DBP lowers stroke risk by 33% and CHD risk by 15% </li></ul><ul><li>Hypertension Optimal Study (HOT) Study- DBP  85 mm Hg associated with lower risk of CVS events than reduction to  90 mm Hg </li></ul>
  10. 10. Hypertension in India <ul><li>CODI Study </li></ul><ul><ul><li>BP was measured in 54.5% of patients with DM, </li></ul></ul><ul><ul><li>In 40% BP was found to be high, </li></ul></ul><ul><ul><li>10% were on treatment </li></ul></ul><ul><li>BUD Study </li></ul><ul><ul><li>24% of people with high BP were currently checking. </li></ul></ul>
  11. 11. Clinical and Experimental Studies Treatment -Target Organ Protection Antiatherosclerosis CNS protection Cardioprotection Renoprotection
  12. 12. Recommended Treatment Goals for Hypertension <140/80 mm Hg <130/80 mm Hg Without Diabetes With Diabetes
  13. 13. SMOKING
  14. 14. How to manage all? PATIENT Dietitian Pr. Nurse Govt. Sp. Doctor Pharms. Fm. Doctor Sp. Nurse Podiatrist

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