世界衛(wèi)生組織全球糖尿病報(bào)告.ppt

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世界衛(wèi)生組織全球糖尿病報(bào)告.ppt

Scopeofthereport BurdenofdiabetesPreventingdiabetesManagingdiabetesNationalresponseRecommendations BurdenofDiabetes Diabetes isaserious chronicdiseasecharacterizedbyelevatedbloodglucoseoccurseitherwhenthepancreasdoesnotproduceenoughinsulin type1 orthebodycannoteffectivelyusetheinsulinitproduces type2 DiabetesisoneofthefourmajorNCDs Riskfactors Type1Exactcausesareunknown Type2RiskisdeterminedbygeneticandmetabolicfactorsOverweight obesityandphysicalinactivityarethestrongestriskfactorsFetal earlychildhoodnutritionaffectfuturerisk Complicationsofdiabetes 108million 422million Riseindiabetes 1980 2014 Riseisfasterinlow andmiddle incomecountries IncreaseindiabetesismostmarkedintheWHOEasternMediterraneanRegion Mortalityfromdiabetes 43 ofdeathsoccurredundertheageof70years Economicimpactofdiabetes Catastrophicmedicalexpendituresignificantlyhigherinpeoplewithdiabetes Directannualcostofdiabetesglobally US 827billion LossesinGDPworldwideestimatedtobeUS 1 7trillionfrom2010to2030 DiabetesandtheglobalNCDagenda PREVENTINGDIABETES Overweightandobesityincreasing 20141in3overweight1in10obese Preventingtype2diabetesatthepopulationlevel MultisectoralapproachestoreducetheprevalenceofmodifiablediabetesriskfactorsAcombinationoffiscalpolicies legislation changestotheenvironmentandraisingawarenessofhealthriskscanpromotehealthierdietsandphysicalactivity Healthyworkplaces School basedapproach Preventingtype2diabetesinpeopleathighrisk Diabetescanbedelayedorpreventedinpeoplewhoareoverweightandhaveimpairedglucosetolerance IGT Dietandphysicalactivityaremoreeffectivethanmedication Thehigh riskapproachneedstobeimplementedinaccordancewithavailableresources MANAGINGDIABETES Diagnosingdiabetes DiabetesisdiagnosedbymeasuringglucoseinbloodFasting2hoursaftera75goralloadofglucosemeasuringglycatedhaemoglobin HbA1c Highproportionoftype2diabetesisundiagnosed Managementofdiabetes Goodmanagementcanpreventcomplicationsandprematuredeathusing standardguidelinesandprotocols WHOPackageofEssentialNCDinterventions smallsetofgenericmedicinesdietandphysicalactivitypatienteducationaboutself careregularscreeningforearlydetectionandtreatmentofcomplications Accesstoaffordableinsulin Peoplewithtype1diabetesrequireinsulinforsurvival Peoplewithtype2diabetesoftenneedinsulinLow incomecountriesgenerallypaymostforinsulinwhilehigh andmiddle incomecountriespayleast Only23 oflow incomecountriesreportthatinsulinisgenerallyavailable Earlydetectionandtreatmentofcomplications End stagerenaldiseaseMeasurementofurineproteinprogressiontokidneyfailurecanbeslowedbyessentialdrugsCardiovasculardiseasesMeasureandcontrolcardiovascularriskfactorsBlindnessPeriodiceyeexaminationsandtimelylaserphotocoagulationLowerlimbamputationProperfootwearandregularexaminationoffeetProviderehabilitation Integratedmanagementofdiabetesandotherchronichealthconditions DiabetesmanagementshouldbeintegratedwithmanagementofotherNCDs andinsomesettingswithtuberculosisandHIV AIDS NATIONALRESPONSE Nationalcapacityforpreventionandcontrolofdiabetes NCDCCS2015 177countries 156countrieshaveanationaldiabetespolicy planorstrategy only127arefundedandoperational 68 ofcountrieshaveoperationalpoliciesfordietandphysicalactivity 50 ofcountrieshaveconductedanational population basedsurveywithmeasurementofbloodglucosestatuswithinthepast5years Only47 ofcountriesreportfullimplementationofguidelinesformanagementofdiabetes Only1 3oflow andlower middleincomecountrieshaveallthreebasictechnologiesinPHCbloodglucoseurinestripforglucose ketoneandheightandweightmeasurementBloodglucosemeasurementisgenerallyavailableinprimarycarein50 oflow incomecountries Nationalcapacityforpreventionandcontrolofdiabetes NCDCCS2015 177countries RECOMMENDATIONS Recommendations WHOresponse

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