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UNDERSTAND DIABETES TAKE CONTROL

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									UNDERSTAND DIABETES


   TAKE CONTROL




            A campaign led by the
      International Diabetes Federation
                                                                                                                                                       What is diabetes?
    The premier awareness campaign
    The premier awareness campaign                                                                                                                     What is diabetes?

    of the diabetes world
       the diabetes world                                                                                                                              Diabetes is a chronic condition that arises either when the pancreas does not produce
                                                                                                                                                        Diabetes is a chronic disease that arises when the pancreas
                                                                                                                                                       enough insulin, or when the body cannot effectively use the insulin it produces. Insulin
                                                                                                                                                        does not produce enough insulin, or when the body cannot
                                                                                                                                                       is a hormone made by the pancreas that enables cells to take up glucose from the blood
                                                                                                                                                        effectively use the insulin it produces. Insulin is a hormone
    When does World Diabetes Day take place?
         does World Diabetes Day take place?                                              healthcare professionals, healthcare                         and use it for energy. Failure of insulin production, insulin action or both leads to increased
                                                                                                                                                        made by the pancreas that enables cells to take in glucose
                                                                                          decision-makers and the media. Numerous local and            sugar levels in the blood. This is a method used to determine whether a person has
    World Diabetes Day takes place on 14 November every                                                                                                 from the blood and use it for energy. Failure of insulin
    World Diabetes Day takes place on 14 November everymarks the was chosen of            national events are organized by the member associations      production, insulin action the blood associated raised glucose
                                                                                                                                                       diabetes or not. This high sugar level inor bothisleads to with long-term damage
    year. The date was chosen because it year. The date birthday                                                                                       and failurein the blood (hyperglycaemia). This is associated
    because it marks the birthday of Frederick Banting, Charles Best, is credited
    Frederick Banting, who, along with who, along with Charles Best, is
                                                                                          of the International Diabetes Federation and by other         levels of various organs and tissues.
    creditedthe discovery ofinsulin. While many events take place ontake place            diabetes representative organizations, healthcare
    with with the discovery of insulin. While many events or around the                   professionals, healthcare authorities, and individuals who
                                                                                                                                                       with long-term damage
                                                                                                                                                       Types of diabetes: to the body and the failure of
    day itself, a themedthe day runs throughout the year.
    on or around campaign itself, a themed campaign                                                                                                    various organs and tissues.
                                                                                          want to make a difference. World Diabetes Day unites the
    runs throughout the year, with actions planned to                                                                                                  Type 1 diabetes
                                                                                                                                                       Understand diabetes: Know the warning signs*
                                                                                          global diabetes community to produce a powerful voice for
    influence political opinion and support the goals of                                   diabetes awareness.
    How did it all begin?
    the campaign.                                                                                                                                             1 diabetes is an autoimmune
                                                                                                                                                       TypeFrequent urination disease characterized by the destruction of the insulin-
                                                                                                                                                       producing cells in the pancreas. Consequently, people with type 1 diabetes produce very
                                                                                                                                                             Excessive thirst
    World Diabetes Day was introduced by the International Diabetes Federation (IDF)                                                                          or no insulin hunger
                                                                                                                                                       littleIncreasedand must take insulin by injection or insulin pump to survive. There have
    How did it all begin?
    and the World Health Organization (WHO) in 1991, in response to concern over the                                                                          been recent advances in delivering insulin in other ways. Type 1 diabetes, which used
                                                                                                                                                       alsoWeight loss
    World incidence of Day was introduced by the
    escalatingDiabetes diabetes around the world. Since then, the event has grown in                                                                   to be called juvenile-onset diabetes, is most commonly diagnosed in children and young
                                                                                                                                                             Tiredness
    popularity every year.
    International Diabetes Federation (IDF) and the                                                                                                    adults. of interest and concentration
                                                                                                                                                             Lack
    World Health Organization (WHO) in 1991, in                                                                                                              Vomiting and stomach pain (often mistaken as the flu)
    response to concern over the escalating incidence                                                                                                        A tingling sensation or numbness in the hands or feet
    Why the Blue Circle? Since then, the event
    of diabetes around the world.                                                                                                                      Type 2 diabetes
                                                                                                                                                             Other signs include blurred vision, frequent infections
    has grown in popularity every year.                                                                                                                      and slow-healing wounds
    The blue circle signifies the UNITY of the global diabetes community in response to                                                                The development of type 2 diabetes is marked by insulin resistance. This resistance to
    the diabetes pandemic.                                                                                                                             insulin action is mostlymild or absentpeople with thiswith type overweight or
    Where does it take place?                                                                                                                           *These can be due to the fact that in people diabetes are 2
                                                                                                                                                       obese. In this state, the patient cannot use the insulin that they produce effectively. They
                                                                                                                                                        diabetes.
    World Diabetes Day is celebrated worldwide.                                                                                                        can often manage the condition through exercise and diet. However, in many cases oral
    It brings together millions of people in over                                                                                                      drugs are needed and often insulin is required. Type 2 diabetes accounts for over 90%
    160 countries to raise awareness of diabetes,                                                                                                      of the 250 million cases of diabetes worldwide. Of major concern is that type 2 diabetes
    including children and adults affected by diabetes,                                   The Table of Silence, Targa Jiu, Romania                     prevalence is increasing at an alarming rate in children.
1                                                                                                                                                                                                                                                        12
     Gestational Diabetes Mellitus (GDM)
     Type 1 diabetes                                                                                                                                                                    A global epidemic
                                                                                                                                                                                        Diabetes education is particularly lacking in developing
                                                                                                                                                                                         countries. Even in developed countries, many people
       Type 1 diabetes (GDM) is a type of diabetes in disease characterized
     Gestationaldiabetes is an autoimmune which women, without previously                                                                                                                cannot are more education because diabetes worldwide. The majority
                                                                                                                                                                                        Today, there access than 250 million people withthere are not enough
       by the destruction of the insulin-producing cells in the
     been diagnosed with diabetes, have high blood sugar levels during pregnancy. GDM                                                                                                    educators or centres to around not knowing that they have diabetes.
                                                                                                                                                                                        of the other people may be walking cope with the rising number
       pancreas. Consequently, people with type 1 diabetes                                                                                                                               of people with diabetes. The International Diabetes
     affects about 4% of all pregnant women. Maternal body weight during pregnancy                                                                                                      Therefore, within the next 20 years, this number is expected to grow to 380 million.
       produce very little or no insulin and must take insulin to                                                                                                                        Federation is working to identify and fill the gaps in the
                                                                                                                                                                                        Diabetes is a global epidemic with debilitating and life-threatening complications.
     Issurvive. Type 1 diabetes, which used to be called juvenile-
        a risk factor for GDM. It has few symptoms and usually disappears at the end of                                                                                                  provision of diabetes education worldwide. In 2003, the
       onset diabetes, risk to both mother and unborn child. Babies children
     pregnancy. GDM poses ais most commonly diagnosed inof mothers                                                                                                                       Federation produced International Standards for Diabetes
       and young adults.
     with GDM are at increased risk of being large for gestational age (which can lead to                                                                                               Prevention
                                                                                                                                                                                         Education. Revised and updated in 2009, these standards
     delivery complications), are at higher risk for some other medical complications after                                                                                              can be found online at www.idf.org/diabetes_education
       Type 2 diabetes
     delivery and often have an increased life-long risk of glucose intolerance and obesity.                                                                                             along type IDF’s cannot be prevented. The environmental triggers that
                                                                                                                                                                                        At present,with1 diabetesInternational Curriculum for Diabetes are
     Women previously diagnosed with GDM have a significantly higher risk of developing                                                                                                  Health Professional Education.
                                                                                                                                                                                        thought to generate the process that results in the destruction of the body’s insulin
       The development of type 2 diabetes is marked by insulin
     type 2 diabetes in the future. Reduction of body weight during pregnancy leads to         Complications include:                                                                   producing cells are still under investigation. Type 2 diabetes can be prevented through
       resistance. People with type 2 diabetes cannot use the                                  Gestational diabetes
       insulin that they produce types of diabetes also exist.
     prevention of diabetes. Other more rareeffectively. They can often                                                                                                                  Diabetes education is best provided by a 2 diates prevention.
                                                                                                                                                                                        the following steps obtained from the IDF Consensus on typemultidisciplinary
      manage their condition through exercise and diet.                                           Cardiovascular diabetes (GDM) is a condition in which women
                                                                                               •Gestational disease, which affects the heart and blood vessels and may cause             team. While multidisciplinary education is available in
                                                                                                  fatal complications such diagnosed disease (leading to heart blood
                                                                                                without previouslyas coronary heartdiabetes have ahigh attack) and                       some countries, in many others it is not available and its
      However, in many of diabetes
     Complications cases oral drugs are needed and often                                        glucose levels during their pregnancy. GDM affects about
                                                                                                  stroke.                                                                                value is not fully recognized by the medical of type The
                                                                                                                                                                                        Three-step plan for the preventionprofession.2
      insulin is required. Type 2 diabetes accounts for over 90%
     Diabetes ismore than 250 million peoplecareful monitoring and control.
      of the a chronic, life-long condition that requires living with diabetes                    Kidney disease (diabetic women. It has few symptoms and
                                                                                               •4% of all pregnant nephropathy), which may result in total kidney failure and           diabetes
                                                                                                                                                                                         World Diabetes Day campaign sets out to challenge this.
                                                                                                  in the need for dialysis or kidney the pregnancy ends. However,
                                                                                                usually disappears whentransplant.                                                       It is hoped that the awareness raised by the campaign will
      worldwide.
     Without proper management it can lead to very high blood sugar levels. These are           GDM poses a risk to both child and mother. Babies of
                                                                                               • Nerve disease (diabetic neuropathy), which can ultimately lead to ulceration and        encourage healthcare systems everywhere to at high risk
                                                                                                                                                                                        1. Identification of those who may be at higher risk - People recognize
      Both type 1 and type 2 and failure various organs and both
     associated with long-term damagediabetesofare serious and tissues. can                     mothers with GDM are at increased risk of being large for
                                                                                                  amputation of the feet and lower limbs.                                                the of developing diabetes must be identified through opportunistic screening
                                                                                                                                                                                                need to provide structured diabetes education and
     affect children. It is important to know the warning signs                                 gestational age (which can lead to delivery complications),                                    by doctors, nurse and pharmacists, and through self-screening using a
                                                                                                                                                                                         help establish access to skilled diabetes education as the
                                                                                               • Eye disease (diabetic retinopathy), characterized by damage to the retina of the eye
     of diabetes.                                                                               are at higher risk for some other medical complications                                  right of every person with diabetes.
                                                                                                                                                                                               questionnaire
                                                                                                  which can lead to vision loss.
                                                                                                after delivery and often have an increased life-long risk of                            2. Measurement of risk - Individuals at high risk must have their blood sugar
                                                                                               glucose intolerance and obesity. Women who have had                                             levels measured by a health professional. This will detect cases of undiagnosed
                                                                                               GDM have a significantly increased risk of developing type
                                                                                                                                                                                               diabetes and those who are pre-diabetic (with impaired fasting glucose or
                                                                                               2 diabetes.
            “There is no such thing as mild diabetes.”                                                                                                                                         impaired glucose tolerance)
                                                                                                                                                                                        3. Intervention to prevent the development of type 2 diabetes – Achieving a
                                                                                               Other rarer types of diabetes also exist.                                                       healthy body weight and moderate exercise can help prevent the development
                                                                                                                                                                                               of type 2 diabetes. Exercise at least 30 minutes daily by brisk waking, swimming,
                                                                                                                                                                                               cycling or dancing should be the initial intervention for all people at risk.
13                                                                                                                                                                                                                                                                                 16
                                                                                                                                                                                      World Diabetes Day Theme 2009-2013
      Diabetic Diet
       The International Diabetes Federation                                                                                                                                          DIABETES EDUCATION & PREVENTION
      Diet for diabetics is a healthy balanced diet which is vital for diabetes treatment. For optimum results, use
      the food pyramid for guidance on the foods required. The regulation of blood sugar in the non-diabetic                                                                          This 2009–2013 campaign calls on all those responsible for diabetes care to understand diabetes and take control.
      The International Diabetes Federation (IDF) is an umbrella                                       The content of this booklet draws on the following
      organization of to whatever national diabetes associations
      is automatic, adjusting over 200 foods are eaten. But, for the diabetic, extra caution is needed to
                                                                                                       sources:
      balance food intake with exercise, insulin injections and any other glucose altering activity.                                                                                  A) Diabetes caregivers and educators:
      in over 160 countries. It represents the interests of the                                                                                                                       Understand Diabetes & Take Control
      growing number of people with diabetes and those at                                         Riley P, McClaughlyn K. Understand diabetes and take
      risk. The Federation diabetes through education:
      Management ofhas been leading the global diabetes                                           control: World Diabetes Day 2009. Diabetes Voice, June                              B) People with Diabetes:
      community since 1950. IDF’s mission is to promote                                           2009.                                                                               Empower yourself through education about diabetes
      diabetes care, person with diabetes a their worldwide. provider
      It is important for theprevention andthatcurefamily, healthcare Led and diabetes caregiver
                                                                                                                                                                                      C) Government:
      workthe International Diabetes Federation, the Unite for
      by together to develop a diabetes management plan.                                          Metzger B, et al. New findings in gestational diabetes – the
                                                                                                  HAPO Study. Diabetes Voice, Special Issue: May 2009.                                Implement effective strategies and policies for the prevention and management of diabetes to ensure that our citizens
      Diabetes campaign secured a United Nations Resolution
      Whydiabetes in December 2006. The Federation continues
             diabetes education?                                                                                                                                                      with and at risk of diabetes receive the best possible care.
      on                                                                                          McGill M, McGuire H. The IDF framework for diabetes
      to lead the informed decisions
      • To take properglobal effort to implement Resolution 61/225                                                                                                                    D) Healthcare professionals:
                                                                                                  education – current status and future prospects.
      under the Unite changes
      • To make behavioural for Diabetes banner. The Resolution                                   Diabetes Voice. March 2009.                                                         Improve your knowledge of diabetes so that evidence-based recommendations are put into practice.
      encourages psychosocial issues presented by diabetes
      • To address the UN Member States to develop national policies
                                                                                                  International Diabetes Federation: a consensus on Type                              E) The general public
      for be empowered to manage diabetes effectively
      • Tothe prevention, treatment and care of diabetes in line
                                                                                                  2 diabetes prevention. Diabetic Medicine, 2007: 24, 451-                            understand the serious impact of diabetes,
      with the sustainable development of their health-care
                                                                                                                                                                                      know how to identify the condition;
      Poor management results in poor health outcomes, and increased development of complications 463.
      systems, taking into account the internationally agreed
                                                                                                                                                                                      know how to avoid or delay diabetes and its complications.
      development goals, including the Millennium Development                                     Patient Education and psychological care. Diabetes
      Understand diabetes: Know the warning signs*
      Goals.
      • Frequent urination                                                                        Voice, Supplement September 2006.                                                                                                                                              Find your campaign-
                                                                                                          Everyone including diabetes patients should follow the above food pyramid   Key messages of the campaign
      • Excessive thirst
      The International Diabetes Federation is engaged in action
      • Increased hunger
                                                                                                  Diabetes Atlas 3rd Edition, International Diabetes
                                                                                                  Federation, 2006.
                                                                                                                                                                                                                                                                                 toolkit online at:
      to tackle diabetes from the local to the global level from
      • Weight loss
                                                                                                                                                                                      • Know the diabetes risks and know the warning signs                                       www.worlddiabetesday.org/toolkit
      programmes at community level to worldwide awareness                                                                                                                            • Know how to respond to diabetes and who to turn to for help
      • Tiredness                                                                                                                                                                     • Know how to manage diabetes and take control
      and advocacy initiatives. IDF’s activities aim to influence
      policy, interest and public awareness and encourage health
      • Lack of increase concentration
      improvement, promote the exchange u)
      • Vomiting and stomach pain (often mistaken as the flof high-quality                                                                                                            World Diabetes Day
      • A tingling sensation or numbness in the hands or feet education for
      information about diabetes, and provide                                                                                                                                         • Promote the importance of structured diabetes education programmes in the
      people with diabetes and frequent infections and providers.
      • Other signs include blurred vision, their healthcare slow-healing wounds                                                                                                        prevention and control of diabetes.
                                                                                                                                                                                      • Advocate for opportunities for diabetes education within healthcare systems and
21 *These can be mild or absent in people with type 2 diabetes.                                                                                                                         communities                                                                                                                 22
All the information in this pamphlet was obtained from the World Diabetes Day website:
www.worlddiabetesday.org

and

International Diabetes Federation
www.idf.org


For further information, contact:

MRC/UWC Diabetes Research Group
Private Bag X17
Bellville
7535, South Africa
Phone: 021 959 3327
Fax: 021 959 3311

The World Diabetes Day campaign in 2009 aims to:
  Empower the diabetic patient to manage the disease effectively
  Raise awareness of the warning signs of diabetes
 Educate people without diabetes on how to prevent or delay the disease
 Distribute materials to request government to implement strategies and policies for the prevention and
    management of diabetes
 Promote healthy lifestyles to help prevent type 2 diabetes

								
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