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Quality of the Indian clinical practice guidelines for the management of cardiovascular conditions
Dhurjati, R.; Sagar, V.; Kanukula, R. et al.
Journal of the Royal Society of Medicine Open
(2022)
CC
To assess the quality of Indian clinical practice guidelines (CPG)s for the management of cardiovascular conditions, MEDLINE, Embase, Google Scholar and websites of relevant medical associations and government organisations were searched, from inception until August 2020, to identify Indian CPGs for... the management of cardiovascular disease (CVD) conditions, produced in or between 2010 and 2019. Excluded were CPGs that were not specific to India, focused on alternative systems of medicine, of non-CVD conditions (even if they included a component of CVD), and those related to the electronic devices, cardiac biomarkers, or diagnostic procedures. Quality of the each included CPG was assessed using the AGREE II tool by four reviewers in duplicate, independently. Each AGREE II domain score and overall quality score was considered low (≤40%), moderate (40.1%-59.9%), and high (≥60%). Of the 23 CPGs included, six (26%) were reported to be adapted from other CPGs. Fourteen (61%) CPGs were produced by medical associations, six (26%) by individual authors and three (13%) by government agencies. Based on the AGREE II overall quality score, two (9%) CPGs were of high quality, four (17%) and seventeen (74%) CPGs were of moderate and low quality, respectively. Except for scope and purpose, and clarity of presentation all other domains were rated low. The quality of most Indian CPGs for managing CVD conditions assessed using the AGREE II tool was moderate-to-low. Combined efforts from different stakeholders are needed to develop, disseminate and implement high-quality CPGs while identifying and addressing barriers to their uptake to optimize patient care and improve outcomes.
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The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors ...(cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).
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The epidemiology of adult-onset type 1 diabetes (T1D) incidence is not well-characterized due to the historic focus on T1D as a childhood-onset disease.
96 million American adults - more than 1 - 3 - have prediabetes
If you’re interested in preventing type 2 diabetes, this guide can help you get started. Congratulations on taking the first step! By reading this, you’re already on your way. Prediabetes puts you on the road to possibly getting type 2 diabetes. Find out now, in less than 1 minute, if you may ha...ve prediabetes by taking the Prediabetes Risk Test. If your result shows you’re at high risk for type 2 diabetes, talk to your doctor about getting a simple blood sugar test to confirm it. Then, if you’re diagnosed with prediabetes, consider joining a lifestyle change program offered by the National Diabetes Prevention Program (National DPP). This program is proven to cut the risk for type 2 diabetes in half.
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If your result shows you’re at high risk for type 2 diabetes, talk to your doctor about getting a simple blood sugar test to confirm it. Then, if you’re diagnosed with prediabetes, consider joining a lifestyle change program offered by the National Diabetes Prevention Program (National DPP). Thi...s program is proven to cut the risk for type 2 diabetes in half.
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Diabetes - Printable Poster & Tools
recommended
Printable Posters & Tools: Below are posters and tools you can use in your workplace to support people living with diabetes.
Download diabetes posters for your workplace - Handy tools to support people with diabetes - diabetes resources.
The article "Best (and Worst) Oatmeal for Type 2 Diabetes" from Everyday Health discusses the benefits of incorporating oatmeal into a diabetes-friendly diet. It emphasizes that oatmeal, being rich in fiber and essential minerals like magnesium, potassium, and iron, can aid in blood sugar control, s...upport heart health, and assist with weight management.
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Physical activity plays an important role in the care
of people living type 2 diabetes. Regular physical
activity can help reduce some of the harmful
effects and slow or even reverse disease progression.
Being active can also reduce symptoms of depression
and anxiety, and enhance thinking, lear...ning, and
overall well-being. Conversely, too much sedentary
behaviour can be unhealthy.
more
The IDF Diabetes Atlas report highlights the disproportionate prevalence of type 2 diabetes (T2D) among Indigenous Peoples globally. It emphasizes the social and health disparities resulting from colonization, loss of traditional practices, and systemic inequities. The report includes prevalence dat...a across various Indigenous populations, identifying significant variability and often higher rates among Indigenous women compared to men. The report calls for culturally responsive and community-driven interventions to address diabetes prevention and management while advocating for better data collection and representation to support Indigenous communities worldwide.
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Factors to take into account when choosing, reviewing and changing medicines.
Rescue therapy:
For symptomatic hyperglycaemia, consider insulin or a sulfonylurea and review when blood glucose control has been achieved.
Diet and lifestyle advice:
At each point reinforce advice about diet and life...style.
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Type 2 diabetes in adults: management
National Institute for Communicable Disease (NICE)
National Institute for Communicable Disease (NICE)
(2022)
CC2
This guideline covers care and management for adults (aged 18 and over) with type 2 diabetes. It focuses on patient education, dietary advice, managing cardiovascular risk, managing blood glucose levels, and identifying and managing long-term complications.
The document provides detailed clinical guidelines for the therapy of Type 1 Diabetes as developed by the German Diabetes Association (DDG). It focuses on individualized insulin therapy, structured patient training, and monitoring of blood glucose levels. The guidelines emphasize preventing complica...tions like ketoacidosis and hypoglycemia while improving patients' quality of life through education and tailored medical care. Recommendations include the use of both basal and bolus insulin, continuous glucose monitoring, and integrating psychosocial support into treatment plans. The document serves as a comprehensive resource for healthcare professionals managing Type 1 Diabetes.
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Compendium of WHO and other UN guidance on health and environment - 2022 update
World Health Organization WHO
World Health Organization WHO; UN environment programme; UNDP; unicef
(2022)
C_WHO
The combined effects from ambient (outdoor) air pollution and indoor (household, in particular) air pollution cause approximately 7 million premature deaths every year, largely as a result of increased mortality from stroke, IHD, COPD, lung cancer and acute respiratory infections (1). Air pollution ...can occur in both the outdoor and indoor environments. Cook-stoves in homes, motor vehicles, industrial facilities and forest fires are common sources of air pollution. Air pollutants with the strongest evidence for adverse health outcomes include particulate matter (PM; both PM 2.5 (i.e. particles with an aerodynamic diameter
equal to or less than 2.5 μm) and PM10 (i.e. particles with an aerodynamic diameter equal to or less than 10 μm), ozone (O 3), nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ) and carbon monoxide (CO). Air pollution is however composed of many more pollutants (1).
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The World Health Organization (WHO) provides an overview of alcohol consumption and its global impact. Alcohol, containing ethanol, is a psychoactive and toxic substance that can lead to dependence. In 2019, alcohol consumption was responsible for approximately 2.6 million deaths worldwide, with 1.6... million resulting from noncommunicable diseases, 700,000 from injuries, and 300,000 from communicable diseases. Men accounted for the majority of these deaths, totaling 2 million, compared to 600,000 among women. Additionally, an estimated 400 million people aged 15 and older were living with alcohol use disorders in 2019.
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Background
The objective of this study was to investigate the effects of reduction, cessation, and resumption of smoking on cancer development.
Methods
The authors identified 893,582 participants who currently smoked, had undergone a health screening in 2009, and had a follow-up screening in 20...11. Among them, 682,996 participated in a third screening in 2013. Participants were categorized as quitters, reducers I (≥50% reduction), reducers II (<50% reduction), sustainers (referent), or increasers (≥20% increase). Outcome data were obtained through December 31, 2018.
Results
Reducers I exhibited a decreased risk of all cancers (adjusted hazard ratio [aHR], 0.96; 95% confidence interval [CI], 0.93-0.99), smoking-related cancers (aHR, 0.95; 95% CI, 0.92-0.99), and lung cancer (aHR, 0.83; 95% CI, 0.77-0.88). Quitters had the lowest risk of all cancers (aHR, 0.94; 95% CI, 0.92-0.96), smoking-related cancers (aHR, 0.91; 95% CI, 0.89-0.93), and lung cancer (aHR, 0.79; 95% CI, 0.76-0.83). In further analysis with 3 consecutive screenings, additional smoking reduction (from reducers II to reducers I) lowered the risk of lung cancer (aHR, 0.74; 95% CI, 0.58-0.94) in comparison with sustainers. Quitting among reducers I further decreased the risk of all cancers (aHR, 0.90; 95% CI, 0.80-1.00), smoking-related cancers (aHR, 0.81; 95% CI, 0.81-0.92), and lung cancer (aHR, 0.66; 95% CI, 0.52-0.84) in comparison with sustainers. Smoking resumption after quitting, even at a lower level, increased the risk of smoking-related cancers (aHR, 1.19; 95% CI, 1.06-1.33) and lung cancer (aHR, 1.48; 95% CI, 1.21-1.80) in comparison with sustained quitting.
Conclusions
Smoking cessation and, to a lesser extent, smoking reduction decreased the risks of cancer. Smoking resumption increased cancer risks in comparison with sustained quitting.
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The World Health Organization's fact sheet on physical activity emphasizes its critical role in maintaining health and well-being. It outlines the benefits of regular physical activity, such as reducing the risk of noncommunicable diseases like heart disease, stroke, diabetes, and certain cancers. T...he document provides specific recommendations for different age groups, detailing the amount and intensity of physical activity needed to achieve health benefits. It also addresses the global prevalence of physical inactivity, highlighting the need for policies and interventions to promote active lifestyles.
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Keeping active can help people stay at a healthy weight, avoid many chronic health problems, and reduce stress and boost mood.
Despite all its benefits, about one in three people globally gets too little, if any, physical activity.
In this systematic review, we aimed to examine the feasibility and acceptability of social media interventions targeting physical activity and/or diet for people with NCDs, the effectiveness of improving exercise and diet behaviours, specific design components used to promote user engagement and the... effectiveness on other health outcomes.
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The article examines the nutritional and lifestyle-related risk factors contributing to the prevalence of non-communicable diseases (NCDs) such as cardiovascular diseases, diabetes, and cancer in the Eastern Mediterranean Region (EMR). It highlights the transition in the disease burden from communic...able diseases to NCDs over the past 30 years. Key risk factors include obesity, unhealthy diets, physical inactivity, and high fasting plasma glucose. The article underscores the importance of promoting healthy dietary habits, physical activity, and policy interventions to curb NCDs in the region. It also discusses the economic and public health implications of these diseases and proposes strategies to mitigate their prevalence.
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