a history of diabetes mellitus
TRANSCRIPT
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A History of Diabetes Mellitus
Zobida Ragbirsingh SRN, SCN, DHV, CCDE, MSc.
Andrew S. Dhanoo BSc., RPT, PhD (candidate)
Chamber of Commerce
“Measuring the Impact of Diabetes on Business” Friday 17th April, 2015.
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What is Diabetes Mellitus ?
muscle
pancreas
liver
stomach
adiposities
blood vessels
‘A group of diseases which affect how the
body uses glucose (blood sugar)’
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Major types of diabetes mellitus
Type 1 DM Type 2 DM
- Juvenile onset /IDDM - Adult onset /NIDDM
- 5-10 % - 90-95 %
- Autoimmune destruction of β-cells - No insulin produced - Abrupt –Early in life - Symptomatic
- Impaired glucose tolerance (IGT) - Insulin insensitivity / resistance
-Risk Factors - Obesity - Poor diet - Sedentary - Smoking - Coloured
- Asymptomatic until complications
-Exogenous Insulin - Self management
-Lifestyle modification -Oral agents -Insulin -Self management
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Normal Regulation of Blood Glucose
High
Insulin Glucose
Low
High
Low
With diabetes
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The whole body is affected by diabetes !!!
Micro-vascular Macro-vascular
Eye: Retinopathy
Kidney: Nephropathy
Sexual Impotence
Brain: Stoke, Cancer, Dementia
Cardiovascular System: Coronary artery disease
Periphery: Peripheral Neuropathy, Slow healing, Amputations
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Risk factors of Type 2 DM
Diabetes
Overweight
Sedentary
Overeating Hereditary
Old-age
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Once upon a time, a long time ago…
With 3500 years of diabetes history, only the last 100 years saw an
explosion of diabetes knowledge and treatment
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1500 BC - Egypt
First written reference to
diabetes by ancient Egyptian physicians
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230 BC - Greece
Apollonius of Memphis - The name diabetes (from Greek “to
pass through”) given to the disease
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100 AD - Roman
Aulus Cornelius Celsus -First clinical description of diabetes
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500 AD - India
Susruta and Charaka - First distinction between type 1 and
type 2 diabetes mellitus - People with DM has sugary urine
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1000 AD - Portugal
Avicennsa- Arab doctor, describes sugar in urine.
- Notes gangrene and impotence complications
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1696 AD - England
Nicholas Culpeper - Recommends powered mouse (with Fleas) as treatment for
diabetes
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1776 AD - England
Matthew Dobson- -Discovered that Blood and urine of people with DM contains
sugar - Concludes that DM is not a disease of the Kidney but the
whole body.
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1788 AD - England
Thomas Cowley- -First link between DM and Pancreas
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1849 AD - France
Claude Bernard - -Glucose stored in the Liver
- Hypo (low sugar) affects the brain
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1869 AD - Germany
Paul Langerhans - Small clusters of cells in Pancreas, named islets of langerhans
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1889 AD - Germany
Oscar Minkowski - Removed dog’s pancreas – Show DM
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1907 AD - Germany
Georg Zuelzer- Pancreatic extract “acomatol,” produced by Zuelzer,
decreased glucosuria in dogs
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1921 AD - Germany
Frederick Banting- Discovery of Insulin
Commercial Extracts of Dog pancreas used on humans
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1921 AD - Germany
Synthalin- First oral blood sugar lowering medication , extract from
French lilac flower
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1934 AD - England
RD Lawrence and HG Wells - First Diabetes Association – British Diabetes Association
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1936 AD - Denmark
Hans Christian Hagedonrn- First Long Acting Insulin produced
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1950 AD
Formation of the International Diabetes Federation (IDF)
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1955 AD
Frederick Sanger- Sequences Insulin ( finds the structure) – Wins Nobel prize
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1970 AD
Urine testing strips introduced for easy monitoring
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1980 AD
Portable blood glucose meters become available
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1982 AD
Diabetes Specialist Nurses (DSN) more common – One of the biggest advancements in diabetes since insulin
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1993 AD
DCCT – Prove that intense blood sugar control can slow/prevent diabetes complications (type 1)
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1998 AD
UKPDS – (Type 2)Good control of blood sugar reduces DM complications
- Healthy BP reduce Heart attacks and stroke
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2003 AD
The Human Genome Project – Begin the search for genes linked to DM
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2007 AD
First Genome-Wide Association Studies for Diabetes – Find genes linking to Type 2 DM
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Diabetes in the world today
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Diabetes in the world today
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0
2
4
6
8
10
12
14
16
18
World prevalence % By Country (2012- IDF) 223 countries
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The state of diabetes in Trinidad & Tobago
-0.01
0.01
0.03
0.05
0.07
0.09
0.11
0.13
0.15
Poon-King et al 1968 -2% IGT, 2% T2DM
T&T National Health Survey, 1996 -11% self reported diabetics
MOH /PAHO – STEPS, 2012 -13% estimated prev. - 20% IGT - ↑ glucose in 16% 15-24
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18:100,000 Children 5-17 with DM and/or IGT (2009)
Batson et al. 2013
20.6 % of sample 15-24 years showed ↑ fasting glucose (2012) MOH-PAHO – STEPS 2012
Photo source: UWI Today – Jan 2011
2 Children <20 presented with T2DM (1962)
Poon-King et al. 1968
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REPORT: ONE IN FIVE CHILDREN IN SOUTH TRINIDAD OVERWEIGHT OR OBESE -Findings highlight need for national surveillance, urgent interventions
March 31st , 2014
3300 Students, 14 Primary Schools, 5-12 years
US
p5
p50
P95
CDC P95
0
10
20
30
40
50
60
70
1st (4-5yo) 2nd (4-5yo) std 1 (6-7) std 2 (7-8) std 3 (8-9) std 4 (9-10) std 5 (10-11)
Wei
ght,
kg
T&T
0
5
10
15
20
25
30
35
Boys Girls
Obese
Overweight
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Cure or Curse ?
Non-invasive Screening, Cure Disease, Stop Complications
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Best known for Carnival, Calypso, Steel
band, Reggae, Salsa, Chutney & Meringue
-and the most flamboyant and
spectacular celebrations in the
world
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DIABETES
EDUCATION
AWARENESS
IN
PRIMARY SCHOOLS
(DEAPS)
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DEAPS PROJECTS
• A DATT Project
• Target Group – Std 3 Students (Primary School)
• Objective - Education in a format specifically
for the needs of this age group
– Increase awareness on prevention mgt of diabetes
as it relates to obesity
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Skits
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Singing & Dancing
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BOOKS
TROPHIES
Other School Supplies
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Let’s Get Moving!
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I would like to thank you from the bottom of my pancreas, which is deeper than the bottom of my heart..