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Diabetes Awareness Education
May 2013
Lesley Shane, Pfizer Global Health FellowPartnering with GBCHealth Beijing, ChinaB.Sc.Pharm., Pharm.D.
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Working Draft v.1 For Input
• Introductions 5 min Pfizer GHF Program & GBCHealth Diabetes Initiative – Background
• Diabetes Awareness Education 45 min For you and to share with your family/ relatives
Diabetes: What is it? Who gets it? Why important? Diabetes burden in China Know the diabetes signs and symptoms ? How to prevent diabetes Diabetes self management tips and treatments Pre-session quiz - questions and answers
• Questions 10 min
• Short Feedback Survey on Today’s session 2 min
AGENDA
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GBCHealth China Diabetes Initiative
GBCHealth is a coalition of more than 220 companies united to keep the fight against HIV/AIDS, tuberculosis, malaria, and non-communicable diseases (including diabetes) a global priority
Since early 2012, GBCHealth has been exploring the growing diabetes epidemic in China and has identified two program paths to help drive improvements in raising diabetes awareness:
i. Workplace Employee Education (e.g. this current job assignment)
ii. In the future, using social media as a knowledge source
Pfizer’s GHF Program: Applying Pfizer Expertise to Strengthen Health Care Delivery
• Promoting access, quality and efficiency of health care delivery for people in greatest need
• Informing emerging Pfizer leaders on global health challenges & patient populations in emerging markets
• Over 300 Pfizer colleagues have served as Fellows & Teams in over 40 countries since 2003
• Focus areas align with Pfizer Expertise: Optimizing supply chains, Health prevention/promotion & Health workforce
• Partnerships with thought leaders & innovators in health
• Over 40 NGO, govt & multilateral partners over life of program; 12 partners in 2013
• 2013 PRNews Award finalist for Employee Volunteer Program
• 2012 Health Volunteers Overseas Golden Apple Award
• Featured in Forbes, Fortune, Huffington Post, Wall Street Journal
Mission & Goals
Key Facts
Partners
Recent Awards &
Media
Visit: http://ghf.pfizer.com to learn more!
Diabetes Awareness Workplace Education Session
Objective of Today’s Session:
• To provide Diabetes Awareness Education to enhance Company Employee diabetes disease awareness for future prevention and to promote the sharing of the knowledge with your Family / Relatives who may be at risk for diabetes
5 Source: Diabetes photos website
Diabetes
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Diabetes is serious
Diabetes is often silent
Diabetes can kill
More and more people have diabetes
Diabetes has a large burden to Patients,
Families and is costly to China
Adapted From sources:www.cdschina.org; www.idf.org; Diabetes photos website
Diabetes = Too much sugar in the blood and
this hurts the Body
People with diabetes need life-long treatment
There is no cure for diabetes BUT….
You can prevent and control diabetes
You can be healthy and restore balance
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Diabetes: What Is It ?
Adapted From sources:www.cdschina.org; www.idf.org; Diabetes photos website
Balancing Blood Sugar
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Your system is in balance when the body keeps blood sugar levels between 4 and 6 mmol/L
Sugar levels in your blood increase from eating food and drinking beverages (except water)
Sugar levels in the blood are decreased by Insulin helping to move sugar from the blood into nourish our body cells
Food in sugar in blood
Insulin acts on sugar to enter cells
Adapted From sources:www.cdschina.org; www.idf.org; Diabetes photos website
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Three main types of diabetes:
Type 1 (5% of diabetes): Natural cause with no insulin production; Usually strikes children
Must use insulin for lifetime
Type 2: Most common kind (90-95% of diabetes) Usually strikes people over 30 years old (the
breadwinners in the Family of working age) Alarmingly, diabetes is increasing in younger people
(adolescents, collage students) Common: Overweight, poor lifestyle and family history May need to use pills or insulin for treatment
Gestational and Other (5% of diabetes): Gestational happens during pregnancy; Mother needs
extra care to have a healthy baby 4th group includes special types such as genetic,
environmental and drug induced
Who Gets Diabetes?
People With One Or More Risk Factors Can Get Type 2 Diabetes
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30+ in China
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In China, people > age 30,
overweight, or in well-off
urban areas where Western
fast food chains are common
and more sedentary lifestyle,
face a particularly
high risk.
Smoking, Excessive Alcohol
Inactivity Certain Medications
Ethnicity Chinese risk higher, 1.6 x Caucasian risk Pregnancy
Hypertension
Stress
High Cholesterol
Overweight (Obesity)
Family History
Age
Male waist circumference ≥ 90 cm, Female waist circumference ≥ 85cm;
Adapted From sources:www.cdschina.org; www.idf.org; Diabetes photos website
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Diabetes: Why Important ?
Diabetes is important because if not controlled you could lose: Your sight Your feet Your sexual ability
Too much sugar in the blood can hurt: Your heart Your brain Your kidneys Your blood vessels Your teeth
There is no cure for diabetes BUT….You can prevent and control diabetes
You can be healthy and restore balanceAdapted From sources:www.cdschina.org; www.idf.org; Diabetes photos website
Symptoms of Diabetes Are Often Silent in Early Stages
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If You or Family/ Relative members have one or more of these symptoms, it is important to talk to your Medical Doctor
Source: diabetes photos
Sources: http://www.chinadaily.com.cn/china/2010-05/26/content_9892334.htm;
China’s Diabetes Rates Are High
In China (2012), 1 out of 10 people over 18 years old have diabetes
+92 million diabetics in China; Largest number of diabetes cases in the World, surpassing India & USA
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Majority, 60%+, of the Chinese diabetic population remain undiagnosed
− More common in men than women (10.2% vs. 9%, respectively)
− Higher in the urban than rural areas (12.3% vs. 8.4% respectively)
15.5% of Chinese people (148 million) have pre-diabetes risk factors; 20–30 million pre-diabetic move to full-blown diabetes/year
Chinese Ministry of Health, 2010; (CDS); http://www.diabetes.co.uk/global-diabetes/diabetes-in-china.html
www.idf.org; www.cdschina.org
Alarming Epidemic Growth - Diabetes In China
Two decades ago, diabetes was very rare in China Over the last decade, there has been a dramatic
3-fold growth increase in diabetes prevalence due to: Increased economic development & status Urban growth Aging Lifestyle change: bad diets, less exercise
(with resulting increased obesity)
By year 2030, 130 million diabetes in mainland China
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20 years ago average diabetic patient = Age 50+
Now Average age is 30+ (also growing number of teen and collage age diabetics)
Sources: http://www.chinadaily.com.cn/china/2010-05/26/content_9892334.htm;
Chinese Ministry of Health, 2010; (CDS); http://www.diabetes.co.uk/global-diabetes/diabetes-in-china.html
www.idf.org; www.cdschina.org
China Has High Diabetes Burden And Costs
Diabetes complications (e.g. heart, kidney, eye diseases and death) impose heavy physical, mental, and economic burdens on patients and their families
13% of total medical expenditures in China are directly cause by diabetes: RMB 173.4 billion or US$25 billion (2010 data); also, RMB 3.4 trillion economic loss for both heart disease and diabetes
Widespread epidemic of diabetes is a serious threat to China’s public health and adds high medical costs to the country
Prevalence is skyrocketing, but China has a window of opportunity to prevent an epidemic of serious diabetes complications and costs
15Sources: http://www.chinadaily.com.cn/china/2010-05/26/content_9892334.htm;
Chinese Ministry of Health, 2010; (CDS); http://www.diabetes.co.uk/global-diabetes/diabetes-in-china.html
www.idf.org; www.cdschina.org
China Has Low Awareness Of Diabetes – Education Is Important
• Diabetes awareness low in China in local/community, healthcare provider, patients and their families, and the general public
More than half of people with diabetes are not aware they have the disease
Only 1/3 of the people treated have successfully managed to control their blood sugar
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The Chinese Ministry of Health and CDS have introduced large-scale diabetes awareness and education programs to address diabetes
Sources: http://www.chinadaily.com.cn/china/2010-05/26/content_9892334.htm;
Chinese Ministry of Health, 2010; (CDS); http://www.diabetes.co.uk/global-diabetes/diabetes-in-china.html
www.idf.org; www.cdschina.org
Causes Of Diabetes ?
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Diabetes can have many causes, such as:
Change of lifestyle:
bad diet, not enough exercise,
alcoholism, smoking, stress
Aging
Better economy (higher
incomes contributing to obesity,
sedentary lifestyles),
growing urbanization
Overweight and obesity
Other risk factors: genetics, etc.
Smoking
High Fat & Cholesterol
Levels
Sedentary LifestyleOverweight
High Blood Pressure
Type 2 Diabetes
Overweight/ Obesity
Cholesterol High Fat Diet
&
Sedentary Lifestyle/ Inactivity
SmokingAlcohol Use
TYPE 2 DIABETES
Adapted From sources:www.cdschina.org; www.idf.org; Diabetes photos website
Type 2 Diabetes And Our Bodies
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Diabetes symptoms are often silent in the early stages Usually discovered by route blood tests – Awareness is very important In earlier stages diabetes is amendable by behavior / lifestyle changes
Adapted From sources:www.cdschina.org; www.idf.org; Diabetes photos website
Obesity Is A Pre-Diabetes Risk Factor
Obesity is a risk factor and key precursor to diabetes
Diet Changes, particularly excessive consumption of western type foods
The sedentary lifestyle favored by western people has infiltrated Chinese culture, leading to people eating more and exercising less
Pre-Diabetic phase can last 10 to 12 years before evolving into Type 2 diabetes
What you do in your 20s and 30s age is a total down payment for the life you want to live when you are in your 40s, 50s and 60s and beyond
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Adapted From sources:www.cdschina.org; www.idf.org; Diabetes photos website
Prevention: You Can Take Charge To Stop Diabetes:
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Avoid Tobacco
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Better Nutrition, Lifestyle and Active Exercise
Fitness Can Prevent Diabetes
Diabetes Free Life
Avoid Alcohol
Prevention at the pre-diabetes stage can reduce the risk of getting diabetes by 50%
Eating For Good Health
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Healthy food is important
Healthy weight is important
The body needs the right amount of food
Eat 3 meals a day (do not skip meals)
Eat a variety of good goods
Fresh food with fiber, low sugar and good
healthy fats is very good
Source: diabetes photos
Avoid the Bad Foods For Good Health
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Avoid fried or “Fast foods” with
bad fats – Eat less of them
Remove and switch out foods with
sugar, salt and bad fats
Replace with good foods with
low sugar, low salt, good fiber
and good healthy fats
Less salt, less oil
Avoid alcohol
22Source: diabetes photos
TIPS for Eating Healthy Foods Diabetes Prevention – Chinese Version
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Exercise: Being Active Reduces Diabetes Risk
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Healthy weight is important; The body must be able to move
Exercise boosts the metabolic rate
CDS recommends exercise for at least 150 minutes per week of moderate intensity, such as over 5 days per week, every day for 30 minutes
Adapted From sources:www.cdschina.org; www.idf.org; Diabetes photos website
If You Have Symptoms, How Do You Know If You have Diabetes ?
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2 hour Oral Glucose Tolerance Test (OGTT) (Glucose level tested 2 hours after drinking 75 g of sugar)
Fasting Plasma Glucose (FPG)(No food for at least 8 hours before
in the morning)
< 6.1 mmol/L < 7.8 mmol/L
≥ 7.0 mmol/L ≥ 11.1 mmol/L
< 7.0 mmol/L
≥ 6.1 mmol/L
< 11.1 mmol/L
7.8 mmol/L
Only your doctor can tell if you have diabetes
Your doctor may do one of the following laboratory blood tests to confirm diabetes:
FPG OGTT
>2.6 mmol/L >2.6 mmol/LAdapted From sources:www.cdschina.org; www.idf.org; Diabetes photos website
If You Have Diabetes It is Important to Test Your Blood Sugar At Home For Safe Levels
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Good safe blood sugar levels that you test at home keeps you healthy
Are you sick today? Then you should:
Test your sugar
Stay safe
Drink plenty of water
Test your Sugar when: The doctor asks you to
You feel “odd” and not yourself
Normal Too Low Safe Good Level Too High
Below 6.1 mmol/L Below 2.6 mmol/L 2.6 to 6.5 mmol/L before you eat
Under 9 mmol/L after you eat
Above 11.9 mmol/L
Feel balanced Feel shaky and sweaty Feel balanced
Feel tired and sleepy
Source: 2010 Chinese Diabetes Society (CDS) Guidelines http://wenku.baidu.com/view/bff4fb48e45c3b3567ec8b98.html
* IDF 2012 http://www.idf.org/sites/default/files/IDF-Guideline-for-Type-2-Diabetes.pdf
Diabetes Monitoring Management: Blood testing, blood pressure and cholesterol testing
27Source: diabetes photos
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1st Step = Lifestyle Modification (better diet, more daily exercise,
weight management)
2nd Step = Medications
Some people take pills
There are many kinds
Some people take insulin
Take your medicine on time;
Take it every day
Diabetes Treatment
Source: diabetes photos
Save Your Feet
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Feet Can Last:
Look at your feet every day
Wash your feet daily and dry them
Socks must be clean and smooth
Shoes must fit
If you have a sore, go to the doctor; Do
not wait !
Do not go barefoot
Save your feet
Source: diabetes photos
Having an action plan is my first step to successful diabetes management
Keep my average blood sugar, cholesterol and blood pressure at a healthy level Follow a healthy eating plan, do not smoke and avoid alcohol Take the right amount of diabetes medications at the right time Be physically active with exercise I like: Try to do It every day Test my blood sugar regularly and record these test results Visit my diabetes educator and doctor regularly Check my feet every day Have an eye exam every year Aim to lose 1 - 1.5 kgs per month if I am overweight Seek my family support Feel happy
Tips for Diabetes Self Management
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Take an active role !
Engage in healthy lifestyle !
Restore balance !
You Can Take Charge Prevent Diabetes
Diabetes Myth Busters
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Quiz Assessment for Correct Answers
0-3 points – Still looking for magical cures? Maybe you should take the quiz again and see if you're ready to demystify these myths.
4-7 points – Not much gets by you, but there's still some information left to learn. Ask questions, get the right answers, and help make short work of diabetes mis-informers!
8-11 points – Nice job, Mythbuster! You know your stuff, and you won't be duped by any diabetes misinformation. Now help others know more by spreading your knowledge!
Source adapted from: http://www.dlife.com/diabetes/quiz/showQuiz.html?quizId=35
Diabetes Myth Busters
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Source adapted from: http://www.dlife.com/diabetes/quiz/showQuiz.html?quizId=35
Diabetes Myth Busters
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