This is our team's first presentation on Diabetes of the Public Health course conducted by our faculty Dr. Sanjana Zaman

1. Presented by
Kamrul Hasan Rakib
Khaja Asif
Abu Kayes Ahmed
Mohsin Islam Sajol
Nafiz Islam Arko
Directed by
Dr. Sanjana Zaman
MBBS, PhD
Assistant Professor (Adjunct)
Dept. of Public Health
North South University (NSU)
DATE : 20-FEB-18
Course Info
Public Health
Code 101
Section 28

2. OVERVIEW
 Introduction to Diabetes
 Signs and symptom’s of Diabetes
 Diagnosis and complications of Diabetes
 Scenario ( World and Bangladesh ) of Diabetes
 Prevention of Diabetes
 Management of Diabetes

3. INTRODUCTION TO DIABETES
• Diabetes is a disease in which your blood glucose or blood sugar levels
are too high. Glucose comes from the foods you eat. Insulin is a
hormone that helps the glucose get into your cells to give them
energy
Main types ofdiabetes
TYPE 1DIABETES
Body does not produce
enough insulin
TYPE 2DIABETES
Body produces insulin
but can’t use it well

4. What is Type 1 diabetes ?
• Type 1 diabetes is a chronic disease that occurs when the pancreas
does not produce enough insulin to properly control blood sugar
levels.
What causes Type 1 diabetes ?
The body’s own immune system attacks and destroys beta cells in the pancreas
that are responsible for creating the hormone insulin

5. What is Type 2 diabetes ?
• Type 2 diabetes formally called non-insulin dependent diabetes is a
disorder that is characterized by high blood glucose in the context of
insulin resistance and relative insulin deficiency
What causes Type 2 diabetes ?
Type 2 diabetes occurs when the pancrease doesn’t make enough insulin on the
cells of the body become resistant to insulin

6. COMPLICATIONS OF DIABETES
Chronic kidney disease
Cardiovascular disease
Damaging blood vessels
Diabetic Amyotrophic
Diabetic retinopathy

7. End-stage renal disease (ESRD) are caused by diabetes, hypertension
or a combination of the two. The prevalence of ESRD is heavily
dependent on access to dialysis and renal replacement
Adults with diabetes historically have a two or three times higher
rate of cardiovascular disease. The risk of cardiovascular disease
increases continuously with rising fasting plasma glucose levels, even
before reaching levels sufficient for a diabetes diagnosis
Diabetes appears to dramatically increase the risk of lower extremity
amputation because of infected, non-healing foot ulcers.

8. DIAGNOSIS OF DIABETES
A fasting plasma glucose test measures your blood glucose after you
have gone at least eight hours without eating or drinking anything but
plain water.
An oral glucose tolerance test measures your blood sugar after you
have gone at least eight hours without eating and drinking and two
hours after you drink a glucose-containing beverage.
In a random plasma glucose test, your doctor checks your blood
glucose without regard to when you ate your last meal.

9. SIGNS & SYMPTOMS OF DIABETES
Increased thirst
Increased hunger (especially after eating)
Dry mouth
Frequent urination or urine infections
Unexplained weight loss (even though you
are eating and feel hungry)
Fatigue (weak, tired feeling)
Blurred vision
Headaches
Diabetic coma (loss of consciousness)

10. Type 1 Diabetes Symptoms
• Unplanned weight loss- If your body can't get energy from your food,
it will start burning muscle and fat for energy instead. You may lose
weight even though you haven't changed how you eat.
• Nausea and vomiting- When your body resorts to burning fat, it
makes “ketones.” These can build up in your blood to dangerous
levels, a possibly life-threatening condition called diabetic
ketoacidosis. Ketones can make you feel sick to your stomach

11. Type 2 Diabetes Symptoms
• Frequent yeast infections- Both men and women with diabetes can
get these. Yeast feeds on glucose, so having plenty around makes it
thrive.
• Slow-healing sores or cuts- Over time, high blood sugar can affect
your blood flow and cause nerve damage that makes it hard for your
body to heal wounds.

12. DIABETES IN WORLD
• 422 Millions adults have diabetes
• 1.6 million deaths are directly
attributed to diabetes each year
• 3.7 million deaths due to diabetes
and high blood glucose
is overweight1in3
1in10 is obese

13. DIABETES PREVALENCE IN COUNTRIES
0%
2%
4%
6%
8%
10%
1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014
Prevalence
Low-income Lower middle-income Upper middle-income High-income WHO– Diabetes country profiles, 2016

14. DIABETES IN BANGLADESH
54%
46%
NUMBER OF DIABETES
DEATHS
MALE
FEMALE
62%
38%
DEATHS ATTRIBUTABLE TO HIGH
BLOOD GLUCOSE
MALE
FEMALE
12150
14280
24800
39800
WHO– Diabetes country profiles, 2016

15. Proportional mortality (% of total deaths, all ages)* of Bangladesh
9%
17%
10%
11%
3%
18%
32%
Injuries
Cardiovascular Disease
Cancers
Respiratory Diseases
Diabetes
Other NCD's
Communicable, maternal, perinatal and
nutritional conditions
WHO– Diabetes country profiles, 2016

16. PREVENTION OF DIABETES
Population based
Legislation & Policy based
Environment based

17. Population based prevention
• Reduction in calorie intake
• Increasing physical activity
• Reducing Population exposure to
tobacco

18. Legislation and policy based prevention
• Fiscal measures and policy action
• Trade and agricultural policies
that promote healthy diets
• Regulations of Marketing

19. Environment based prevention
• Supportive environment for
physical activity
• Setting based intervention
• Social marketing and
mobilization

20. Organization in public health sector involved in Diabetes prevention
Diabetes care complication study
Public health aspects of diabetes
Prevention of type 2 DM through lifestyle
Epidemiology of diabetes mellitus (DM)
Socioeconomic consequences of NDC’s
 Major focal areas of research

21. Running projects by BADAS
Diabetes Prevention Program (2008)
 Goal of the project :
To create to promote and to raise the awareness for reduce, to hault,
to Prevent or to delay the onset or development of Type-2 Diabetes
and other NCDs like CVD, Hypertension etc. through different
approaches and in different strategies

22. WHAT GOVT CAN DO
Healthy Environments
Better Diagnosis &
Treatment
BetterData
ENSURE

23. MANAGEMENT OF DIABETES
3 ways to manage diabetes :
Food Exercise Medication

24. FOOD
• We know that healthy eating is base of healthy living with or without
diabetes but if you have diabetes you need to know how foods affect
your blood sugar levels
What to do :
Learn about Carbohydrate
counting and portion sizes
Make every meal well balanced
Avoid sugar and sweetened foods

25. EXERCISE
• Physical activity is another important part of your diabetes management
plan. When you exercise, your muscle use sugar ( Glucose ) for energy.
Regular physical activity also help your body use insulin more efficiently.
These factors work together to make your blood sugar level lower.
What to do :
Talk to your doctor about an exercise plan
Check your blood sugar level regularly
Be prepared
Know your numbers

26. MEDICATION
• Insulin an other diabetes medications are designed to lower your
blood sugar levels when diet and exercise alone are not enough for
managing diabetes but medications can.
What to do :
Store insulin properly
Report problems to your doctors

27. Eat healthily
Be physically active
Avoid excessive weight gain
Check blood glucose if in doubt
Follow medical advice