The major non communicable diseases at current are Cancers, Hypertension, Diabetes, Cardiovascular diseases. As per Global Burden of Disease study deaths from non-communicable diseases (NCD's) rose by just under 8 million between 1990 and 2010, accounting for two of every three deaths (34.5 million) worldwide by 2010.
8 million people died from cancer in 2010, 38% more than two decades ago, of these, 1•5 million (19%) were from trachea, bronchus, and lung cancer. Ischaemic heart disease and Stroke collectively killed 12•9 million people in 2010, or one in four deaths worldwide, compared with one in five in 1990; 1.3 million deaths were due to diabetes, twice as many as in 1990.
It is estimated that the overall prevalence of Hypertension, Ischemic Heart Diseases and Stroke is 159.46, 37.00 and 1.54 respectively per 1000 population of India.
Diabetes affects 350 million worldwide. Over 90 million adults have diabetes in the South-east Asian region. Prevalence of diabetes in India is about 62.47 per 1000 population. Half of those with diabetes remain undiagnosed.
What is Diabetes?
Diabetes is a condition in which the level of sugar (glucose) in the blood is high. The body produces insulin, a hormone secreted by the pancreas, which breaks down the sugar consumed in food. A reduction in the production and/or utilization of insulin causes diabetes. If left untreated or uncontrolled, diabetes can lead to serious problems, such as heart disease, stroke, blindness, kidney failure, among others. Some of these may be life-threatening.
Forms of diabetes
There are two major forms of diabetes type 1 and type 2.Type 1 is characterized by a lack of insulin and type 2 results when body uses ineffectively insulin. Type 2 accounts for around 90% of all diabetes worldwide.
What tests can be done to check for diabetes? What are the normal values?
Several tests can be done to estimate the blood sugar level. All these tests estimate the amount of sugar in a certain quantity of blood.
FPG (fasting plasma glucose): this tests the amount of sugar in the blood stream after one has not eaten for 8–10 hours (overnight fasting). This is usually done first thing in the morning before breakfast. A FPG value ≥126 mg/dL (≥7.0 mmol/L) indicates that the person has diabetes.
OGTT (oral glucose tolerance test): this is another type of test for diabetes. The blood sugar level is checked in the fasting state and then 2 hours after drinking a certain amount of glucose. It shows how the body processes glucose. If the 2-hour value is ≥200 mg/dL (11.1 mmol/L), it indicates the presence of diabetes.
Glycated haemoglobin (HbA1C): this test measures how well the blood sugar has been controlled over the past 3 months. If the HbA1C is ≥6.5% (47.0 mmol/ mol), it indicates the presence of diabetes. OGTT (oral glucose tolerance test): this is another type of test for diabetes.
Who is at risk of developing type 2 diabetes?
We do not know why some people develop type 2 diabetes and others do not. However, certain factors increase the risk, some of which are given below: Family history: if one has a parent or sibling with type 2 diabetes, the risk of getting diabetes increases.
Age: the risk of type 2 diabetes increases with age, especially after the age of 40 years. This may be associated with decreased exercise, loss of muscle mass and weight gain as age increases. Despite the known association of type 2 diabetes with age, in recent years, the incidence of type 2 diabetes has been increasing dramatically among children, adolescents and young adults.
Race: people from certain racial backgrounds are found to have a higher risk of developing diabetes, although the reason is not known.
Overweight/obesity: being overweight is a primary risk factor for type 2 diabetes. The more fatty tissue one has, the more resistant the cells become to insulin. However, one does not have to be overweight to develop type 2 diabetes.
Inadequate physical activity: the less active one is, the more likely one is to develop type 2 diabetes. Physical activity helps one control weight, use glucose as energy and increase the sensitivity of the cells to insulin.
Unhealthy diet: a diet rich in calories, saturated fats and sugar, and low in fibre can lead to an increase in body weight and thereby increase the risk for developing diabetes. Having high blood pressure or a high lipid level also puts a person at risk of developing diabetes.
Gestational diabetes: women who developed diabetes during pregnancy have a higher risk of developing type 2 diabetes. If the baby born to such a woman weighed more than 9 pounds (>4 kg), one is also at risk of developing type 2 diabetes in future.
So a large proportion of diabetes which is mainly type 2 is preventable with the simple low cost primary preventive actions like maintaining a normal body weight, engaging in regular physical activity, eating a healthy diet and avoiding tobacco.
WHO being a non political health agency of United Nations Organization whose main objective is attainment by all humans in the world of the highest level of health. WHO experts produce health guidelines and standards, and help countries to address public health issues.
WHO Constitution was drafted in 1946 and enforced on 7th April 1948.Each year it is celebrated on this very day that is 7th April across all the member countries of WHO as the World Health Day. As the theme selected for this year was 'Beat diabetes'. It highlighted the priority area that was Diabetes. The goal is to scale up diabetes prevention, strengthen care, and enhance surveillance.
NCDs have common risk factors such as tobacco use, unhealthy diet, physical inactivity and excess adiposity. Policies and programmes focusing on reducing the burden of these common risk factors are likely to make a substantial impact on mitigating the mortality and morbidity due to NCDs.
Keeping in view the heavy burden of non communicable diseases or life style diseases in general and diabetes in particular, our department being a specialisation of preventive medicine is going to establish preventive health clinic in Government medical college in the near future. The main goal for that will be to screen individuals with high risk of getting life style diseases, and those found with high risk will get best possible care in terms of preventive and curative actions so as to prolong in them the onset of these life threatening diseases and to control and limit the complications in those who already have these life style diseases.