Showing posts with label diabetes. Show all posts
Showing posts with label diabetes. Show all posts

Monday, November 29, 2010

On Diabetes Worldwide

Diabetes mellitus affects more than 220 million globally, and is among the leading causes of death and disability worldwide. While nearly eight percent of the population of the United States is affected by diabetes - a figure which is expected to rise to 50 percent by 2020 - reports show that almost 80 percent of deaths due to the condition occur in developing nations. Experts indicate that in recent years more people with diabetes, particularly those in the developed world, are aware of their condition, but it is important to ensure that information is made available regarding not only how to manage the condition, but how to prevent it.



A chronic disease stemming from the body’s ineffective production or handling of insulin, diabetes may affect people at different stages of life, particularly childhood, adulthood, or pregnancy. Insulin is a hormone produced by the pancreas and secreted into the bloodstream to lower the amount of sugar in the blood. Excess sugar in the blood can lead to serious health problems, and individuals with diabetes must control their condition, often through monitoring their blood sugar levels and the administration of insulin either through frequent injections or an insulin pump. Type 1 diabetes; also known as insulin-dependent, juvenile, or childhood-onset diabetes; is characterized by deficient production of insulin. Though individuals with Type 2 diabetes, also known as non-insulin-dependent or adult-onset diabetes, often experience the same symptoms as those with Type 1 diabetes including excessive excretion of urine, thirst, vision changes, and fatigue, Type 2 diabetes results from the body’s ineffective use of the insulin it produces. Women may also experience gestational diabetes, which occurs in pregnant women as the placenta produces hormones to sustain the pregnancy which make the body’s cells more resistant to insulin. Reports indicate that in 90 percent of women affected by gestational diabetes, the condition resolves after delivery.

While Gestational diabetes occurs only in pregnant women, and Type 1 diabetes occurs primarily in individuals with a family history of the condition, anyone can develop Type 2 diabetes. Though some factors that contribute to Type 2 diabetes such as age and race cannot be controlled, others, including inactivity, weight, and body-fat distribution can be. According to the World Health Organization (WHO), 90 percent of individuals with diabetes have Type 2 diabetes, and a majority of these cases are the result of excess body weight and a lack of physical activity. Because these factors can also exacerbate the condition of individuals who have diabetes, experts recommend that precautions be taken, including maintaining a healthy diet, exercising, and carefully monitoring blood sugar and insulin levels.

Individuals with diabetes who allow their blood sugar and insulin levels to fluctuate too widely may experience disabling and potentially life-threatening complications. The risk of developing cardiovascular disease, nerve damage, and kidney damage are all greatly increased in individuals with diabetes, as are the potential for damage to the blood vessels of the eyes, nerve damage in the feet, and skin and bone problems. Reports indicate that diabetes increases the chance of foot ulcers and eventual amputation, is among the leading causes of kidney failure, and is responsible for nearly five percent of the 37 million cases of blindness worldwide.

In addition to these potentially disabling complications, if left unchecked, diabetes can lead to death. WHO projections indicate that by 2030, deaths due to diabetes and its complications may reach 2.2 million per year with the most rapid growth occurring in developing nations. Though treatment options are somewhat limited - with frequent blood sugar testing, diet, and an exercise regimen that includes weight training and aerobic activity being most effective - by understanding diabetes it may be possible to better control it and minimize the number of new cases.

Discuss this and other public health and chronic disease topics in the iCons in Medicine Forums

Monday, April 13, 2009

Using Telemedicine to Treat Chronic Disease

Chronic diseases pose a threat worldwide, particularly in the developing world. Heart disease, cancer, diabetes, and other chronic diseases account for over half of all deaths each year - double the number of deaths caused by infectious diseases, maternal and perinatal conditions, and nutritional deficiencies combined. Developing nations are facing an epidemic of non-communicable chronic diseases as risk factors such as obesity, lack of physical activity, and tobacco use continue to increase. Contrary to the popularly held belief that infectious diseases are the leading cause of death in the developing world, 80 percent of chronic disease deaths occur in low and middle income countries.

International attention and funding has primarily focused on communicable disease, and as a result the healthcare systems of developing nations are not well equipped to manage chronic conditions. For example, the World Health Organization spends only 50 cents per person on chronic disease (excluding mental health) per year, compared with $7.50 for the major infectious diseases. Regular doctor visits are necessary for proper treatment and management of chronic diseases, but most low- and middle-income countries have not developed the necessary infrastructure or network of specialty physicians to provide this type of care.

Telemedicine and teleconsultation programs offer a cost-effective solution to this problem. Through initiatives like iConsult, healthcare providers in remote or medically underserved areas can consult with specialty physicians over the Internet to gain access to their clinical expertise. By utilizing iConsult, an Endrocrinologist in New York City or Cardiologist in Portland would be able to offer assistance to a provider in a clinic in Chad, and ensure that a patient with diabetes or high blood pressure receives the highest quality of care.

Find out more about the iConsult program


Reports indicate a nutritious diet, physical activity, avoiding alcohol and tobacco use, and regular medical exams help decrease the risk of developing a chronic disease.


CDC Report on Chronic Disease - WHO Report on Chronic Disease - Report from SciDev Net

See also:
Nugent, R. (2008). Chronic diseases: a growing problem in developing countries. DiabetesVoice, 53, 17-20.