Diabetes e saúde pública
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Estudo epidemiológico apresentado pela chefe do Ambulatório de Diabetes de Gestação da Universidade Federal do Rio de Janeiro (UFRJ), Lenita Zajdenverg, nesta segunda-feira (07/11), durante audiência pública da Comissão de Saúde da Assembleia Legislativa do Rio (Alerj), presidida pelo deputado Bruno Correia (PDT). O evento marcou o Dia Mundial do Combate à Diabetes, lembrado no dia 14 de novembro.
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Diabetes e saúde pública
- 1. Diabetes Mellitus Um problema de sáude pública Lenita Zajdenverg Sociedade Brasileira de Diabetes/RJ Universidade Federal do Rio de Janeiro
- 5. Custo Direto Anual EUA, 1992 Rubin R, et al. J Clin Endocrinol Metab 1994 $ 2604 $ 9493
- 8. Controle Glicêmico no Brasil Estudo Epidemiológico de Diabetes Controle ideal (A1c <7) Controle Inadequado (A1c > 7) Tipo 2 (n= 5.692) 73,2% 26,8% Tipo 1 (n= 979) 89,6% 10,4%
- 11. Redução de risco Retinopatia (76%) Melhora do controle glicêmico reduz o risco de complicações do diabetes Nefropatia (34%) Neuropatia (69%) Diabetes Control and Complications Trial Research Group.(DCCT) N Engl J Med ; 329:977-986 , 1993. Redução de 1,8% na A1c
- 13. Abordagem Integrada MACRO : política, financiamento, planejamento MESO : comunidade; organizações sociais e profissionais MICRO : pessoa com diabetes; família
- 16. Carta Aberta à SES do Rio de Janeiro e ás SMS dos municípios do estado do Rio de Janeiro
- 19. Obrigada!!!
Notas del editor
- IDF Regions and global projections for the number of people with diabetes (20-79 years), 2010-2030
- Number of people with diabetes (20-79 years), 2010 and 2030
- One area of focus is prevention. We now have robust evidence that type 2 diabetes can be prevented in people who are at high risk of diabetes. Two of the prevention trials that showed this were conducted in the two countries that have the largest numbers of people with diabetes: India and China. The study in China began over 20 years ago and a follow-up study has shown that the beneficial effects of the 6-year intervention have continued after the study period. Indeed, 20 years after the study started, fewer people in the intervention group developed diabetes than in the control group. [Q&A: Need to know details, e.g. number of participants, type of intervention] The interventions in these studies were based on increased physical activity and improved diet. One of the challenges that now remains is to determine the most efficient and effective way to screen for those at high risk. Improving diet and increasing physical activity is also likely to reduce the incidence of diabetes in the general population and a second approach targeted at the general population is also needed. While we have good trial evidence that type 2 diabetes can be delayed or prevented, we currently have limited evidence about how to do this in the general population.
- The second area of focus is to improve the coverage of good quality basic care. Care for people with diabetes is often seen as expensive and certainly the data in the IDF Diabetes Atlas underlines the high economic costs of diabetes. Many countries, however, could improve the care provided for people with diabetes cost-effectively by focussing on good quality basic care. In work carried out for the World Bank and World Health Organization interventions were divided into three groups based on their feasibility and cost-effectiveness. The IDF global guideline for type 2 diabetes is also divided in a similar way allowing for the availability of resources. Just improving the coverage of the first group of World Bank/WHO interventions—moderate blood glucose control; moderate blood pressure control and foot care—will make a huge difference in many low- and middle-income countries shown in the IDF Diabetes Atlas to have large numbers of people with diabetes.
- Providing good quality diabetes care requires an integrated approach. At the micro level, and at the centre of all care, are the people with diabetes, their families and their immediate carers. At the meso level is the community and healthcare organizations within which care is delivered. At the macro level are the supporting policy and financing frameworks. The World Health Organization’s Innovative Care for Chronic Conditions Framework provides guidance on the relationships between, and the contents of, these three levels. This framework can be used to help repair the fragmentation of health services across the range of needs that people with diabetes have, and to provide links to broader population interventions, such as those for the prevention of diabetes.