Overview of few important diseases
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Deals with two very basic health problems viz. Diabetes Mellitus ansd Hypertension
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Overview of few important diseases
- 1. Overview of two important health burdens D . A shek R r bhi oy Email: mail@abhishek.ro Junior Resident, Dept. of Biochemistry, Grant Govt. Medical College & Sir J.J. Group of Hospitals, Mumbai.
- 3. Diabetes Mellitus Burden in India(Epidemiology): • 63 million Indians are affected with Diabetes as of 2012. • In 2007, the figure was 40 million. • In just 5yrs, more than 50% increase in prevalence of the disease. • The total number is said to rise to about 101 million by 2030 and India, USA and China will be the DIABETIC CAPITALS of the world.
- 4. Source: International Diabetes Federation
- 6. Source: International Diabetic Federation
- 10. Who is at Risk? •Obesity •Hypertension •Family History of Diabetes •Lack of Exercise and Lifestyle •Age 45 years or more •Pre-Diabetes
- 11. Plasma Glucose levels.. After overnight fasting: Normal: <100 mg/dL Pre-Diabetic: 100-125 mg/dL Diabetic: >=126 mg/dL 2hrs After Meals/Post Prandial: Normal: <140 mg/dL Pre-Diabetic: 140-199 mg/dL Diabetic: >=200 mg/dL
- 12. Insulin • Hormone from Pancreas that regulates glucose metabolism • Secreted throughout the day • More quantity is released after the meals • Insulin deficiency or improper functioning causes Diabetes
- 14. Physiologic Serum Insulin secretion profile
- 25. What should be done? • Self-monitoring of blood glucose (individualized frequency) • HbA1c testing (2-4 times/year) • Patient education in Diabetes management (annual) • Eye Examination (annual) • Foot-examination (1-2 times/year by physician; daily by patient) • Screening for Diabetic Nephropathy • Blood Pressure Measurement (quarterly)
- 26. Drugs..
- 27. Hypertension Hypertension has been seen as a global burden. India alone has more than 140 million affected as of 2012 The number is predicted to increase to 214 million by 2030 Has caused more than 2.4 million deaths Estimated to cause 4 million deaths by 2030
- 28. Blood pressure Classification Blood of Classification • • • • Normal Pre-Hypertension Stage I Hypertension Stage II hypertension Systolic, mm of Hg <120 mm of Hg 120-139 mm of Hg 140-159 mm of Hg >= 160 mm of Hg Diastolic, mm of Hg and <80 mm of Hg or 80-89 mm of Hg or 90-99 mm of Hg or>= 100 mm of Hg
- 29. WHEN & WHY? • When the normal regulatory mechanisms fail, it is only then that hypertension develops • Hypertension is so dangerous because it is silent and does not give any warnings.
- 30. Factors influencing development of Hypertension High Normal Blood pressure Family History of Hypertension
- 31. Factors influencing development of Hypertension Excess consumption of common salt (NaCl) Some segments of the populations are “Salt Sensitive” because their blood pressure is affected by consumption of salt.
- 32. Factors influencing development of Hypertension Alcohol Consumption
- 33. Factors influencing development of Hypertension • Smoking
- 36. Factors influencing development of Hypertension Obesity and Lack of Exercise Less active individuals are 30-50% more likely to develop hypertension.
- 39. Factors influencing development of Hypertension Other Factors: Potassium Calcium Magnesium
- 40. Complications of Hypertension Stroke Congestive HEART failure Hypertension Renal Disease Retinopathy
- 41. •Hypertensive Retinopathy (Eyes) •Congestive Cardiac Failure and Myocardial Infarctions (Heart) •Hypertensive Nephropathy (Kidney) •Arteriosclerosis (Peripheral Arteries) •Cerebral Stroke (Brain)
- 51. Prevention is better than cure • Maintain a healthy weight. • REDUCE WEIGHT if you are obese. • DO EXERCISE. • ABSTAIN from SMOKING & HEAVY DRINKING. • SAY NO to FAST FOODS. • Reduce the intake of Salt and Sodium in our diet. (< 2000 mg/day)
- 52. The DASH Diet • The Dietary Approaches to Stop Hypertension Clinical trials (DASH) • Diets rich in fruits, vegetable and low fat dairy products can help reduce blood pressure in Hypertensive individuals
- 53. The DASH Diet includes • The DASH Diet includes: • 7-8 servings of grains and grain products • 4-5 servings of vegetables • 4-5 servings of fruits • 2-3 servings of low fat dairy products • 2 or less servings of meat, poultry and fish • 2-3 servings of fats and oils • Nuts, seeds and dry beans 4-5 times /week • Limited ‘sweets’ low in fat.
- 54. Reducing Sodium in diet • Use fresh foods rather than canned food. • Even if you canned food, read if the label says “no salt added”. • Decrease the use of Table Salt. • Avoid too much sea food
- 56. SAY NO to? • 1. SAY NO to SMOKING • SMOKING KILLS..
- 57. 3. SAY NO to ALCOHOL
- 58. 2. SAY NO to FAST FOODS
- 59. 4. SAY NO to EXCESS SALT
- 60. SAY YES to? • 1. SAY YES to EXERCISE
- 61. 2. SAY YES to HEALTHY FOOD
- 62. 3. SAY YES to ROUTINE HEALTH CHECK-UPS
- 63. 4. SAY YES to PRESCRIBED MEDICINES
Notas del editor
- Now I narrowed it down to these two clinical conditions. There is a reason for doing so.. Because of its importance and relevance in day to day life, its relevance in our society. You pick any one from the streets and ask are you or any of your family members are suffering from DM or HTN.. There is a very high probability that the answer will be YES… I referred to DM and HTN as Health burden and not disease or disorder because they are burden to the society, to the families and to the govt.. Infact they are a burden to the nation as a whole. Why? Coz they drain you out. Financially, economically, emotionally, mentally. Billions and Billions of dollars and crores and crores of rupees ar being invested to make drugs for HTN and DM available to the general population at the govt hospitals etc… Hence they are aptly justified as health burdens..
- In a nation of above 1.2 billion population, this seems to be a small figure isn’t it, but ill tell you that this is not the case. Why we will just realize this in subsequent slides to come…
- Pictorial representation of the facts that I said above, pay notice that, India, chinaand usa are already the top three countries with highest diabetic population. And by the year of 2030, they are going to be almost exclusive countries with the highest percentage of diabetics among all taken together.
- What is remarkable in this slide is that more than…50% of the population who died were below 60 yrs of age. Isn’t this say something? It is relatively viable age of the population, the age group of the population that is non- dependant of others.. This is hence a grave concern for the whole society.
- How many of you have seen the movie TITANIC? Ofcourse it was a good movie but what I wanted to draw your attention is the ice berg to which the titanic dashed against. The problem with ice berg is tat only a small portion of it is visible to eyes, most of it is inside the water. Now why I gave this diagram here is that, same is the case with these diseases also. The diagnosed cases just form the tip of ice berg. That means that actually whatever data I spoke of was just of this tip of the ice bergs. So most of the population is not diagnosed. They are like the bottom of the ice berg.So, how can we rectify this? When we know what are the risk factors.. Whom should we screen to diagnose? We can only come to know this when we know what are the risk factors for DM.
- Obese people have increase susceptibility to insulin resistance.Hypertensives in long run tend to develop diabetes too. You’ll see that if you come to meet a hypertensive and ask him/her than does she have diabetes, there is a good chance that the answer might be yes.Family history of diabetes,, mother father.. Diabeteic , there is good chance that you too can develop that.Lack of exercise cause obesity and hence DM….After age of 45, the life style starts to change, our body mechanism slow down,, we are less active as day passes by and our hormone levels also tend to change. The race of individuals also is responsible to some extent.Pre diabetic.. We will come to know about it in next slides
- Do you know why I showed a spike of insulin highest during the breakfast..? Because ideally the breakfast should be most heavy.. What we don’t realize is that we have a gap of almost 10-12hrs between our dinner and breakfast, but there is only 4-5hrs gap between breakfast and the lunch.. So which one should be heavier? Of course breakfast.
- Prescribed drugs should be taken regularly once you are stamped Diabetic…
- We are going to get obese just because of the fact that people are resorting to junk food, fast food. Coke, chowmins, egg roles burgers are all that is happening in today’s world. What is the question of the hour is that why are we following the WEST? This is a matter of great concern.
- This is a picture that I got hold of when I was browsing the web. It showed the evolution of man from the ages of Apes. This is not the modern man, this is the modern man.. FAT and OBESE..
- Potassium: In population studies, dietary potassium and blood pressure are inversely related. High potassium intakes are associated with lower BP.Calcium:In the Nurse’s Health Study, consuming the RDA for calcium resulted in lower risk of developing hypertension than consuming lower levels (400 mg/day). Magnesium is a potent inhibitor of vascular smooth muscle contraction and may play a role in blood pressure regulation as a vasodilator
- Stroke and Cerebral hemorrhages. Congestive Heart failure and Myocardial Infarctions. Hypertensive Retinopathy, Hypertensive Nephropathy…. Almost all systems are affected to some extent with these two clinical conditions. We are just witnessing a few important ones….
- T2 enhanced MR imaging of brain.. hematoma in left temporal lobe . With midline shift…
- The idea is not to tell you about DASH per se.. The idea is to tell you about the ingredients that were given in the DASH diet…
- And finally we talked of taking common salt less than 2g/day… so what are the steps that can ensure it being done…
- Move, workout,hit the gym, run, jog, walk,, whatever you want to do as a part of exercise you can do that.. Don’t just sit around and warm your chairs.. I know this can certainly become difficult for us sometimes.. We don’t get time to eat.. So what do we do about exercise… but as they say “Where there is a will, there is always a way” Isn’t it.. So do it…
- Lots of salads, fruits, green leafy vegetables, potassium, calcium, magnesium rich diets, almost all fruits have these… pomegranate, banana and all.. Have those. Along with your staple food…less of fats.
- Lets be aware about how these diseases are affecting our society. There is only one way to rectify and treat them, by early and correct diagnosis. And how will that happen? By routine visits to the doctor or to any health practisioner but ensure that any problem if present is identified as early as possible. Because we all ultimately do the same thing, ofcourse by different methods… it is to make the patient free from his disease..
- When you are stamped as Diabetic or Hypertensive, make sure you take your medications judiciously. Just because you pressure and sugar is under control, doesn’t mean that you can stop your medications all together… so please continue taking your medications as prescribed.. With this we come to an end to this presentation.. It was a pleasure speaking in front of you all..