Diabetes is a chronic metabolic disease characterized by high blood sugar levels. It occurs either due to lack of insulin (type 1) or when cells fail to respond to insulin (type 2). Diabetes prevalence is increasing worldwide and is a major cause of premature death. India is experiencing a rise in non-communicable diseases like diabetes accounting for over 42% of deaths. The National Diabetes Control Programme was launched in 1987 to screen for and manage diabetes through prevention, early diagnosis, treatment and rehabilitation efforts. However, limited funding has constrained expanding this program nationwide.

1. DR.MAHESWARI JAIKUMAR

2. DIABETES
DR.MAHESWARI JAIKUMAR

3. DIABETES - A CHRONIC DISEASE
• Diabetes is one of the major causes
of premature illness and death
worldwide
• Diabetes prevalence is increasing in
every country in the world, and the
toll is climbing in terms of human
lives as well as the costs to society.

4. • Diabetes is a metabolic disease
which is characterized by high blood
sugar levels.
• It can be caused either due to the
lack of insulin (type 1 diabetes) or
because the body’s cells fail to
respond to the insulin produced
(type 2 diabetes).

5. • Some of the common symptoms of
diabetes are hunger, frequent urination
and increased thirst. While type 1
diabetes is usually genetic, type 2
diabetes is caused more by lifestyle
factors.
• It is one of the common ‘lifestyle
diseases’ which is plaguing people in
the developed countries and often has
a causal link to heart diseases,
hypertension and obesity.

6. DIABETES MORTALITY
• 4.8 million people died due to diabetes in
2012 and half of all people who die of
diabetes are under the age of 60.
• Worldwide, only half of all people with
diabetes are diagnosed,1 so a significant
number already have serious medical
complications associated with
hyperglycaemia by the time they see a
doctor.

8. GLOBAL SCENARIO
• Prevalence is 4% (1995) which will
be 5.4% in 2025, 2% -5% in Western
communities and developing
countries as 10% or even 20%.

9. INDIAN SCENARIO
Prevalence of range from 2.1% in
1972 to 12.4% in 2001 .
In Southern India studies showed a
40% increased in prevalence over a
period of 6 years

10. MAGNITUDE OF THE PROBLEM
• Is a chronic disease and need life
long treatment
• Heart disease in diabetes is 21.4%
• Neuropathy 17.5%

11. • Peripheral Vascular Disease (6.3%
- 30%)
• Retinopathy 19.0%
• Microalbuminia 26.3%

12. • India is experiencing a rapid health
transition with a rising burden of Non
Communicable Diseases (NCDs).
• Overall, NCDs are emerging as the leading
causes of death in the country accounting
for over 42% of all deaths (Registrar General
of India).
• NCDs cause significant morbidity and
mortality both in urban and rural
population, with considerable loss in
potentially productive years (aged 35–64
years) of life.

13. CAUSES
1.HOST FACTORS
2.ENVIRONMENTAL FACTORS

14. HOST FACTORS
1.Age (Middle age)
2.Gender (Male)
3.Genetic factors (Family history)
4.Obesity
5.Pregnancy

15. OBESITY -ASSESSMENT
1.BODY MASS INDEX.
2.PONDERAL INDEX.
3.BROCCA INDEX.
4.LORENT’Z FORMULA.
5.CORPULENCE INDEX.

16. 1.BODY MASS INDEX
(Quetelet’s index)
BMI = Weight (Kg)
Height2 (m)

17. 2.PONDERAL INDEX.
Height (Cm)
Cube root of body weight (Kg)

18. 3.BROCCA INDEX.
(HEIGHT – 100) = Expected weight

19. 4.LORENT’Z FORMULA
• Ht (cm) -100 - Ht (cm)-150
2 (women) or 4 (men)

20. 5.CORPULENCE INDEX
ACTUAL WEIGHT
DESIRABLE WEIGHT
(This should not exceed 1.2)

21. NATIONAL DIABETES
CONTROL PROGRAMME
• Based on these alarming figures
Government of India started
National Diabetes Control
Programme on pilot basis during 7th
Five year plan in 1987 in some
districts of Tamil Nadu, J & K and
Karnataka

22. • In 1995-96 12 lakhs was allocated
• In 1997-98 one crore was allocated

23. PROGRAMME
• GOI started National Diabetes Control
Programme on pilot basis during 7th
Five year plan in 1987 in some districts
of Tamil Nadu, J & K and Karnataka.
Due to paucity of funds in subsequent
years this programme could not be
expanded further in remaining years.

24. OBJECTIVES
• 1.Prevention of diabetes through
identification of high risk subjects and
early intervention in the form of health
education
•
2. Early diagnosis of disease and
appropriate treatment morbidity and
mortality with reference to high risk
group

25. 3.Prevention of acute and chronic
metabolic, cardiovascular, renal and
ocular complication of the disease
4. Provision of equal opportunity for
physical attainment and scholastic
achievement for the diabetic patients
5. Rehabilitation of those partially or
totally handicapped diabetes people.

26. • The ultimate aim is to integrate
control of diabetes into that of
hypertension and heart diseases.
• Risk factors for diabetes are
included in the integrated disease
surveillance project 2004

27. SCREENING FOR DIABETES
1. URINE EXAMINATION.
2.BLOOD SUGAR TESTING.

28. PREVENTION (Primary)
1.PRIMARY PREVENTION (population
Strategy)
A. Nutritional habits.
B. Maintenance of body weight.
C. Physical exercise.
D. Avoidance of sweet food

29. • HIGH RISK STRATEGY
A. Avoidance of over nutrition &
obesity.
B. Subjects at risk should avoid
diabetogenetic drugs.
C. Reduce factors promoting
atherosclerosis.

30. SECONDARY PREVENTION
A. Proper management of diabetes.
B. Self care.
C. Home blood glucose monitoring.

31. TERTIARY PREVENTION
A. Prevention of complications –
Cardiomyopathy, Retinopathy,
Neuropathy, Nephropathy etc.
B. Epidemiological researches- Registers
for diabetes.