The document discusses diabetes, its history, types, symptoms, complications, and considerations for insurance underwriting. It notes that diabetes is a chronic metabolic disorder caused by insufficient insulin production or resistance. It has been known for over 2500 years and was first named "diabetes" by Greek physician Aretaeus in the 2nd century BC. Major developments discussed include the discoveries of insulin by Banting and Best in 1921 and the identification of islets of Langerhans in the pancreas by Paul Langerhans in 1869. The document outlines the differences between type 1 and type 2 diabetes and their prevalence. It also discusses diabetes risks, symptoms, potential complications affecting eyes, heart, kidneys, nerves and feet,
Scratching Your Head Psychiatry: Practicing OUTSIDE of the Allopathic Box
Diabetes Mellitus-Killer Disease
1. The Silent Killer
Dr. Bakht Jamal Shaikh
Munich Re. Seminar at Hotel Sheraton Karachi
December 20, 2012.
2. Diabetes is Chronic Metabolic Syndrome
caused due to absence or resistance to Insulin
hormone, resulting more Glucose in blood.
Dr. BJS
Pancreas
35-50% people do not
know that they are
Diabetic.
3. •2500 year old disease
•400 BC: Sushruta Sweet odor/taste
Statue of Sushruta in India
Dr. BJS
4. •250 BC: Word “Diabetes” was used first time
by Greek Physician Aretaeus, means “Siphon”
or “Drain”.
•Flushing out the muscle
and water from the body.
Aretaeus of Cappadocia
Dr. BJS
5. •1674 AD: Dr Thomas Willis, Physician of King
Charles-I first used the word “Diabetes
Mellitus”
Mellitus (Latin)
honey sweet
Dr. Thomas Willis
Dr. BJS
6. •1869 AD: Berlin Medical student Paul
Langerhans discovered that beta cells of
Pancreas secret Insulin, now known as “Islets of
Langerhans”
Insulin Island
Paul Langerhans
Dr. BJS
7. •1889 AD: German Dr. Joseph Von Mering
removed pancreas of dog and it became
Diabetic.
Dr. Joseph Von Mering
Dr. BJS
8. •1921 AD: Sir Fredrick Banting and his friend
Best of Canada discovered Insulin.
Sir Fredrick Banting
Dr. BJS
It took almost 23 centuries
for effective treatment of
Diabetes Mellitus.
13. •Life Long Disease
•Life Style Disease
•Preventable
•Irreversible
•No Cure
•Controllable
•Full of Complications
•Decrease 5-10 years of Life
•40 million DALYs (Disability Adjusted Life Years) wasted annually
•Pakistan average age at onset lower i.e. 33 years
•Hepatitis C virus enhance the chances of early onset
•50% cases lead to Heart Attack
•10-20% to Kidney Failure
•2% to Blindness
•More prevalence in men but more death in women due to lack of attention
Dr. BJS
14. •Causes more deaths than AIDS + Breast Cancer
•13,000 people die daily
•1 die every 7 seconds (500 die during this session)
•Pre-Diabetes: 281 m or 4% of population
•DM : 558 m or 8% of total population (187 m unknown)
•Top 1 country is Micronesia: 37 %
•Bottom country is Mali: 1.7%
•World Annual Cost US$ 471 B (26 annual Pak Budget)
Source: IDF
Dr. BJS
World
15. •Death 84,336 p.a. 50% Death below 60.
•8th. Cause of Death
•10.25 m suffer from DM (3.65 m unaware)
• TOP 10th in World in number (#)
• TOP 7th. in World in percentage (%)
i.e. 10.5% of Adult (20-79) Population
•IGT: 7.42 Million
Source: IDF
Dr. BJS
Pakistan
24. • Weight loss
• Infection &
Delayed healing
• Fatigue
Dr. BJS
25. A1C (90 Days)Result Random Blood Sugar
(RBS)
101-126 mg% Impaired 141-200 mg% 5.7 to 6.4 %
Up to 100 mg% Normal Up to 140 mg% Up to 5.6 %
Above 126 mg% Diabetic Above 200 mg% Above 6.4%
Fasting Blood Sugar
(FBS)
Source: ADA
Dr. BJS
34. Underwriting Approach
Case of DM Presented as:
1. Family History (see Age, Obesity & Rate)
2. Glycosuria (Postpone till Diagnosis & Rx)
3. I.G.T (see Profile & rate or further invest.)
4. Unaware but suffering Diabetes M.
5. Known Diabetic under control. (Accept +EM)
6. Known Diabetic out of control/comp. (Dec)
Dr BJS
35. 1. Age at onset: Earlier the age more the mortality risk
At age 35: 300%
At age 65: 150%
2. Type: (I or II) I riskier than II.
3. Duration since onset: More duration, more riskier.
Dr. BJS
