In recent decades, India has witnessed a rapidly exploding epidemic of diabetes.
Indeed, India today has the second largest number of people with diabetes in the
world. The International
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Diabetes Federation (IDF) estimates that there are 72.9 million people with diabetes in India in 2017, which is projected to rise to 134.3 million by the year 2045. The prevalence of diabetes in urban India, especially in large metropolitan cities has increased from 2% in the 1970s to over 20% at present and the rural areas are also fast catching up.
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Guía Clínica – Diabetes Mellitus tipo 1
The document "Management of Type 2 Diabetes Mellitus" provides comprehensive guidelines for the diagnosis, prevention, and treatment of type 2 diabetes in adults. It emphasizes the importance of ind
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ividualized glycemic targets, lifestyle interventions like diet and exercise, and the use of medications such as metformin, SGLT2 inhibitors, and GLP1 receptor agonists to manage blood sugar levels and reduce long-term complications. The document also discusses the screening and management of comorbidities such as hypertension, hyperlipidemia, and diabetic complications like retinopathy, neuropathy, and nephropathy. It highlights the role of diabetes self-management education and support in improving adherence to treatment and patient outcomes. The guidelines are evidence-based and aim to reduce morbidity and mortality associated with type 2 diabetes.
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Guidelines and Consensus for the Diagnosis, Management and Prevention of Type 2 Diabetes Mellitus in Indonesia
The ICMR type 1 diabetes guidelines come at a time when the SARS-CoV-2 pandemic
has disproportionately affected people with diabetes population, exposing them to a
high risk for severe illness and
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mortality. Globally, diabetes was responsible for over fourmillion deaths in the year 2019. It was the leading cause of end-stage kidney disease, adult-onset blindness and cardiovascular diseases. Further, there was a considerable heterogeneity in the prevalence of complications and deaths associated with diabetes across the countries.
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The new guidelines provide public health guidance on pharmacological agents for managing hyperglycaemia in type 1 and type 2 diabetes for use in primary health-care in low-resource settings. These guidelines update the recommendations for managing h
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yperglycaemia in the WHO Package of Essential NCD Interventions (WHO PEN) for primary care in low-resources settings, reviewing several newer oral agents as second- and third-line treatment: dipeptidyl peptidase-4 inhibitors, sodium-glucose co-transporter 2 inhibitors and thiazolidinediones. The guidelines also present recommendations on the selection of type of insulin (analogue versus human insulin) for adults with type 1 and type 2 diabetes.
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In 2014, the World Heart Federation (WHF) launched
an initiative to develop a series of Roadmaps [1e6]. Their
aim is to identify potential roadblocks on the pathway to
effective prevention, detection, and management of cardiovascular disease (CVD), along with evidence-based
solutions to overcome
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them. The resulting documents
provide a framework to translate strategic intent into action
on integrating epidemiology, population, and cardiovascular outcome trial data into national plans for optimal
CVD management.
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Lancet Glob Health 2018, Published Online September 12, 2018 http://dx.doi.org/10.1016/S2214-109X(18)30387-5
Care for persons with noncommunicable diseases (NCDs), such as cardiovascular disease, diabetes, cancer, and chronic obstructive pulmonary disease, is a major health priority for most countries worldwide, particularly for low-middle income countries
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where the problem seems to be worsening. Globally, research demonstrates that the vast majority of people with NCDs receive suboptimal care. Many people living with chronic conditions remain undiagnosed and unaware of their condition, while many others remain untreated or with inadequate control. Meanwhile the premature mortality caused by NCDs remains high in many countries. In response to the global epidemic of NCDs, the World Health Organization (WHO) launched the Global Strategy for the Prevention and Control of Noncommunicable Diseases in 2012, which establishes 9 voluntary global targets and indicators to be considered by Member States when formu- lating national plans to combat NCDs.
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Recommendations on the management of diabetes mellitis during the COVID-19 pandemic
Diabetes mellitus, also called diabetes, is a chronic metabolic condition in which the hormone insulin is not produced by the
pancreas in sufficient quantities or is not utilized effectively by the
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body to control blood glucose levels. As a result, blood
glucose levels are abnormally high (hyperglycaemia). Chronic uncontrolled hyperglycemia leads to long-term target organ damage, such as: retinopathy, nephropathy and neuropathy (microvascular complications); stroke, coronary heart disease
and peripheral arterial disease (macrovascular complications).
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The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes
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is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients with DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
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Health systems in Latin America face many challenges in controlling the increasing burden of diabetes. Digital health interventions are a promise for the provision of care, especially in developing countries where mobile technology has a high penetr
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ation. This study evaluated the effectiveness of the implementation of a Diabetes Program (DP) that included digital health interventions to improve the quality of care of persons with type 2 Diabetes (T2DM) in a vulnerable population attending the public primary care network.
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Abbreviated Report of a WHO Consultation
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 co
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lonization, loss of traditional practices, and systemic inequities. The report includes prevalence data 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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This publication was developed in response to the need for a reference list of priority medical devices required for management of noncommunicable diseases (NCDs), focusing on cardiovascular diseases and diabetes, especially for low- and middle-inco
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me countries to support universal health coverage actions.
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The "Prediabetes Risk Test" is a tool designed to help individuals assess their risk for prediabetes and type 2 diabetes. The test uses a point-based system with questions about age, gender, family history of
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diabetes, history of high blood pressure, physical activity level, and weight category. Based on the total score, individuals with a score of 5 or higher are at an increased risk of prediabetes, meaning their blood sugar levels may be elevated but not yet high enough to be classified as type 2 diabetes. The test encourages individuals with a high score to consult a doctor for further testing and suggests lifestyle changes as a preventive measure. Special risk considerations are provided for certain ethnic groups, such as African American, Hispanic/Latino, American Indian, Alaska Native, Asian American, and Pacific Islander populations.
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Chronic Non Communicable Diseases. Case Management Desk Guide