tertiary prevention of disease - diabetes

Prevention of Disease - Prevention of Disease - Tertiary PreventionTertiary Prevention

Tertiary Prevention of DiabetesTertiary Prevention of Diabetes

Prevention of Disease - Tertiary Prevention of Disease - Tertiary PreventionPrevention

aim to improve the quality of life for people aim to improve the quality of life for people with various diseases by limiting with various diseases by limiting complications and disabilities, reducing the complications and disabilities, reducing the severity and progression of disease, and severity and progression of disease, and providing rehabilitation (therapy to restore providing rehabilitation (therapy to restore functionality and self-sufficiency). functionality and self-sufficiency).

(cont.) Prevention of Disease - (cont.) Prevention of Disease - Tertiary PreventionTertiary Prevention

Unlike primary and secondary prevention, Unlike primary and secondary prevention, tertiary prevention involves actual tertiary prevention involves actual treatment for the disease and is conducted treatment for the disease and is conducted primarily by primarily by health care practitionershealth care practitioners, , rather than rather than public health agenciespublic health agencies. .

(cont.) Prevention of Disease - (cont.) Prevention of Disease - Tertiary PreventionTertiary Prevention

Tertiary prevention efforts have demonstrated Tertiary prevention efforts have demonstrated that it is possible to slow the natural course of that it is possible to slow the natural course of some progressive diseases and prevent or delay some progressive diseases and prevent or delay many of the complications associated with many of the complications associated with chronic diseases such as arthritis (inflammation chronic diseases such as arthritis (inflammation of the joints that causes pain, swelling, and of the joints that causes pain, swelling, and stiffness), asthma (inflammation and obstruction stiffness), asthma (inflammation and obstruction of the airways that makes breathing difficult), of the airways that makes breathing difficult), heart disease, and diabetes.heart disease, and diabetes.

Tertiary Prevention of DiabetesTertiary Prevention of Diabetes

Insulin is a hormone produced by the pancreas Insulin is a hormone produced by the pancreas to control the amount of glucose (sugar) in the to control the amount of glucose (sugar) in the blood. blood.

Diabetes mellitus is a disease in which high Diabetes mellitus is a disease in which high blood glucose levels result from insufficient blood glucose levels result from insufficient insulin production or action. insulin production or action.

When there is not enough insulin produced, the When there is not enough insulin produced, the body is unable to metabolize (use, regulate, and body is unable to metabolize (use, regulate, and store) glucose, and it remains in the blood.store) glucose, and it remains in the blood.

(cont.) Tertiary Prevention of (cont.) Tertiary Prevention of DiabetesDiabetes

Type 1 diabetes mellitus (also called insulin-Type 1 diabetes mellitus (also called insulin-dependent diabetes or juvenile-onset diabetes) dependent diabetes or juvenile-onset diabetes) occurs when pancreatic beta cells, the cells that occurs when pancreatic beta cells, the cells that make insulin, are destroyed by the body's own make insulin, are destroyed by the body's own immune system. It usually develops in children immune system. It usually develops in children and young adults. and young adults.

Because people with diabetes do not have Because people with diabetes do not have enough insulin, they must be injected or inject enough insulin, they must be injected or inject themselves with insulin several times a day or themselves with insulin several times a day or receive insulin via a pump. receive insulin via a pump.

About 5 to 10 percent of all diagnosed cases of About 5 to 10 percent of all diagnosed cases of diabetes are type 1.diabetes are type 1.


Approximately 90 to 95 percent of all diagnosed Approximately 90 to 95 percent of all diagnosed cases of diabetes are type 2 diabetes mellitus cases of diabetes are type 2 diabetes mellitus (also called non–insulin-dependent diabetes or (also called non–insulin-dependent diabetes or adult-onset diabetes). Type 2 diabetes occurs adult-onset diabetes). Type 2 diabetes occurs when the body becomes resistant to insulin. when the body becomes resistant to insulin.

As a result of the cells being unable to use As a result of the cells being unable to use insulin effectively, the amount of glucose they insulin effectively, the amount of glucose they can take up is sharply reduced and high levels can take up is sharply reduced and high levels of glucose accumulate in the blood.of glucose accumulate in the blood.


People who are older than age forty, People who are older than age forty, overweight, have a family history of overweight, have a family history of diabetes, and are physically inactive are at diabetes, and are physically inactive are at greater risk of developing type 2 diabetes. greater risk of developing type 2 diabetes. African-Americans, Hispanic/Latino African-Americans, Hispanic/Latino Americans, Native Americans, and some Americans, Native Americans, and some Asian Americans and Pacific Islanders are Asian Americans and Pacific Islanders are at greater risk for type 2 diabetes.at greater risk for type 2 diabetes.


Approximately 1.3 million new cases of Approximately 1.3 million new cases of diabetes were diagnosed among diabetes were diagnosed among Americans aged twenty years and older in Americans aged twenty years and older in 2002, and the incidence of type 2 diabetes 2002, and the incidence of type 2 diabetes is increasing among people of all ages, is increasing among people of all ages, including children.including children.

Prevalence of diabetes in Prevalence of diabetes in people aged 20 years or older, people aged 20 years or older, by age group, 2002by age group, 2002 2 diabetes are able to control their blood sugar 2 diabetes are able to control their blood sugar

by losing excess weight, maintaining proper by losing excess weight, maintaining proper nutrition, and exercising regularly. Others nutrition, and exercising regularly. Others require insulin injections or orally administered require insulin injections or orally administered (taken by mouth) drugs to lower their blood (taken by mouth) drugs to lower their blood sugar.sugar.

Other types of diabetes can occur as a result of Other types of diabetes can occur as a result of pregnancy (gestational diabetes) or physiologic pregnancy (gestational diabetes) or physiologic stress such as surgery, trauma, malnutrition, stress such as surgery, trauma, malnutrition, infections, and other illnesses. These types of infections, and other illnesses. These types of diabetes account for about 5 percent of all diabetes account for about 5 percent of all diagnosed cases of the disease.diagnosed cases of the disease.

COMPLICATIONS OF DIABETESCOMPLICATIONS OF DIABETES

People with diabetes are about twice more likely People with diabetes are about twice more likely to die at any given time than people without the to die at any given time than people without the disease, but the risk of death from diabetes is disease, but the risk of death from diabetes is even greater for young adults than older adults. even greater for young adults than older adults.

Persons with diabetes who are age twenty-five Persons with diabetes who are age twenty-five to forty-four are at 3.6 times greater risk than to forty-four are at 3.6 times greater risk than those age sixty-five to seventy-five (who are at those age sixty-five to seventy-five (who are at 1.5 times greater risk than people in the same 1.5 times greater risk than people in the same age group without diabetes). age group without diabetes).

In 2001 diabetes was the seventh leading cause In 2001 diabetes was the seventh leading cause of death among all age groups.of death among all age groups.

PREVENTING COMPLICATIONS PREVENTING COMPLICATIONS OF DIABETESOF DIABETES

Early detection and treatment of diabetic eye Early detection and treatment of diabetic eye disease can reduce the possibility of blindness disease can reduce the possibility of blindness or serious loss of vision by about 50 percent. or serious loss of vision by about 50 percent.

Early detection and treatment of kidney Early detection and treatment of kidney disease sharply reduces the risk of developing disease sharply reduces the risk of developing kidney failurekidney failure

Careful attention to foot care reduces the risk Careful attention to foot care reduces the risk of amputation by as much as 85 percent.of amputation by as much as 85 percent.

(cont.) PREVENTING (cont.) PREVENTING COMPLICATIONS OF DIABETESCOMPLICATIONS OF DIABETES

To help increase early detection of diabetes (secondary To help increase early detection of diabetes (secondary prevention) and reduce the morbidity (illnesses) and mortality prevention) and reduce the morbidity (illnesses) and mortality (deaths) associated with it (tertiary prevention), the CDC and (deaths) associated with it (tertiary prevention), the CDC and National Institute of Diabetes and Digestive and Kidney Diseases National Institute of Diabetes and Digestive and Kidney Diseases of the NIH launched the National Diabetes Education Program of the NIH launched the National Diabetes Education Program (NDEP) in 1998. (NDEP) in 1998.

Increase public awareness of diabetes, improve self-management Increase public awareness of diabetes, improve self-management of people with diabetes, enhance health care providers' of people with diabetes, enhance health care providers' knowledge and treatment of diabetes, and promote health policies knowledge and treatment of diabetes, and promote health policies that improve access, availability, and quality of diabetes care. that improve access, availability, and quality of diabetes care.

To meet these educational objectives, the NDEP, working with a To meet these educational objectives, the NDEP, working with a variety of other health organizations, develops and distributes variety of other health organizations, develops and distributes teaching tools and resources.teaching tools and resources.

(cont.)(cont.) PREVENTING PREVENTING COMPLICATIONS OF DIABETESCOMPLICATIONS OF DIABETES

Print advertising and patient education materials Print advertising and patient education materials developed by the NDEP focus on personal developed by the NDEP focus on personal responsibility for self-management of diabetes.responsibility for self-management of diabetes.

For example, one 1999 print advertisement was For example, one 1999 print advertisement was translated from Spanish into English after it proved translated from Spanish into English after it proved tremendously successful in Hispanic/Latino tremendously successful in Hispanic/Latino communities. communities.

Featured a photograph of a lightning bolt next to the Featured a photograph of a lightning bolt next to the heading: "There are many things in life that can't be heading: "There are many things in life that can't be controlled. Fortunately diabetes isn't one of them."controlled. Fortunately diabetes isn't one of them."

(cont.) PREVENTING (cont.) PREVENTING COMPLICATIONS OF DIABETESCOMPLICATIONS OF DIABETES

The 148-page NDEP patient information book also emphasizes The 148-page NDEP patient information book also emphasizes the importance of self-care in the prevention of complications of the importance of self-care in the prevention of complications of diabetes. diabetes.

E.g. the section on foot care explains, "There's a lot you can to do E.g. the section on foot care explains, "There's a lot you can to do prevent problems with your feet. Controlling your blood glucose prevent problems with your feet. Controlling your blood glucose and not smoking or using tobacco can help protect your feet. You and not smoking or using tobacco can help protect your feet. You can also take some simple safeguards each day to care for and can also take some simple safeguards each day to care for and protect your feet." protect your feet."

Goes on to explain the importance of self-care habits such as Goes on to explain the importance of self-care habits such as having one's feet checked, washing them carefully, trimming toe-having one's feet checked, washing them carefully, trimming toe-nails, taking care of corns and calluses, protecting feet from heat nails, taking care of corns and calluses, protecting feet from heat and cold, wearing shoes and socks, and remaining physically and cold, wearing shoes and socks, and remaining physically active.active.

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tertiary prevention of disease - diabetes

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