he Rotarian Action Group for Diabetes is working to stop the global epidemic of the disease. Come learn how Rotarians can lead communities to better health and prevent children dying from lack of insulin. Learn about model programs of prevention and service that your club can institute to improve health in your own community.
Co-moderators:
C. Wayne Edwards, Past District Governor
Rotary Club of Tallahassee, Florida, USA
Larry C. Deeb, Member, The Rotary Foundation Cadre of Technical Advisers
Rotary Club of Tallahassee, Florida, USA
2. 2014 ROTARY INTERNATIONAL CONVENTION
Diabetes Overview
Prof Martin Silink
Rotary Club of Lane Cove
University of Sydney
3. Diabetes Atlas 2013
Type 1 children 500,000
Type 2 adults 382,000,000
>7 million more each year
4,000,000 Deaths per year
1,000,000 Amputations per year
Leading cause of adult blindness
Leading cause of adult kidney failure
80% in developing world
Prevalence estimates for 2013
The Size of the Problem
5. A touch of sugar can’t be too serious ?
???????
Does Mild Diabetes exist?
6. Burden of disease in Australia
DALY’s
(Disability
Adjusted
Life Years)
Number of
years lost
due to
ill-health,
or early
death
7. Not all cells are equally damaged by high glucose levels
Most cells are able to maintain a relatively normal
internal glucose level despite elevated blood
glucose
Four organs are not effective in doing this:
Retina Nerves Kidney Large arteries
Retinopathy Neuropathy Nephropathy
Key Concepts in Chronic Complications
Atherosclerosis
8. FinnDiane Study of Mortality and Nephropathy
Groop PH et al Diabetes 2009;58:1651-1658
4201 people with T1D
Finland major clinics
Mean Ages 36-42
Diabetes 20-32 years
SMR 2.8
SMR 0.8
SMR 9.2
13. Modern-Day Clinical Course of Type 1 Diabetes Mellitus After 30 Years’
Duration
The Diabetes Control and Complications Trial/Epidemiology of Diabetes
Interventions and Complications and Pittsburgh Epidemiology of Diabetes
Complications Experience (1983-2005) D Nathan et al, and Diabetes Control and
Complications Trial/Epidemiology of Diabetes Interventions and Complications
(DCCT/EDIC) Research Group* Arch Intern Med. 2009 July 27; 169(14): 1307–
1316. doi: 10.1001/archinternmed .2009.193
Retinopathy
Nephropathy
Cardiovascular
Disease
Cumulative incidences after 30 years
of diabetes:
CT IT
Retinopathy 50% 21%
Nephropathy 25% 9%
Cardiovascular disease 14% 9%
<1% became blind, required kidney
replacement, or had an amputation
DCCT/EDIC Study after 30 Years
16. Life
Expectancy
in T1D and T2D
Glucose monitoring
Lifestyle
No smoking
Physical activity
BP control
Lipid Control
Improving
social determinants
of health
Access to care
Self empowerment
Intensive therapy
Diabetes education
Strategies to Improve Life Expectancy in Diabetes
Complications screening
Aspirin
Early
diagnosis
17. What can Rotary do?
SUPPORT:
Insulin
Glucose monitoring
Diabetes education
Training of health professionals
Complication screening
Foot care
Eye care
BP control
ADVOCATE:
Healthy cities
Healthy schools
Healthy work
Healthy foods
PROMOTE:
Healthy weight
Healthy eating
Healthy activity
What can Rotary do?
LFAC
Be the voice of the community for healthy living
