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1、Scope of the report Burden of diabetes Preventing diabetes Managing diabetes National response Recommendations 世界卫生组织全球糖尿病报告Scope of the report Burden of BURDEN OF DIABETES世界卫生组织全球糖尿病报告2BURDEN OF DIABETES世界卫生组织全球糖尿病报Diabetes is a serious, chronic disease characterized by elevated blood glucose occur

2、s either when the pancreas does not produce enough insulin (type 1) or the body cannot effectively use the insulin it produces (type 2).世界卫生组织全球糖尿病报告Diabetes世界卫生组织全球糖尿病报告Causative risk factorsTobacco useUnhealthy dietsPhysical inactivityHarmful use of alcoholNon-communicable diseasesHeart disease an

3、d strokeDiabetesCancerChronic lung diseaseDiabetes is one of the four major NCDs世界卫生组织全球糖尿病报告Causative risk factorsTobacco Risk factorsType 1 Exact causes are unknown. Type 2 Risk is determined by genetic and metabolic factors Overweight/obesity and physical inactivity are the strongest risk factors

4、 Fetal & early childhood nutrition affect future risk世界卫生组织全球糖尿病报告Risk factorsType 1世界卫生组织全球糖尿病报Complications of diabetes世界卫生组织全球糖尿病报告Complications of diabetes世界卫生组108 million422 millionRise in diabetes19802014世界卫生组织全球糖尿病报告108 million422 millionRise in Rise is faster in low- and middle - income coun

5、tries世界卫生组织全球糖尿病报告Rise is faster in low- and miIncrease in diabetes is most marked in the WHO Eastern Mediterranean Region世界卫生组织全球糖尿病报告Increase in diabetes is most mMortality from diabetes43% of deaths occurred under the age of 70 years世界卫生组织全球糖尿病报告Mortality from diabetes43% of Economic impact of di

6、abetesCatastrophic medical expenditure significantly higher in people with diabetes.Direct annual cost of diabetes globally US$ 827 billion.Losses in GDP worldwide estimated to be US$ 1.7 trillion from 2010 to 2030世界卫生组织全球糖尿病报告Economic impact of diabetesCatDiabetes and the global NCD agenda世界卫生组织全球糖

7、尿病报告Diabetes and the global NCD agPREVENTING DIABETES世界卫生组织全球糖尿病报告13PREVENTING DIABETES世界卫生组织全球糖尿病Overweight and obesity increasing20141 in 3 overweight1 in 10 obese世界卫生组织全球糖尿病报告Overweight and obesity increasPreventing type 2 diabetes at the population levelMultisectoral approaches to reduce the pre

8、valence of modifiable diabetes risk factorsA combination of fiscal policies, legislation, changes to the environment and raising awareness of health risks can promote healthier diets and physical activity.世界卫生组织全球糖尿病报告Preventing type 2 diabetes at Healthy work places世界卫生组织全球糖尿病报告Healthy work places世

9、界卫生组织全球糖尿病School-based approach世界卫生组织全球糖尿病报告School-based approach世界卫生组织全球糖Preventing type 2 diabetes in people at high riskDiabetes can be delayed or prevented in people who are overweight and have impaired glucose tolerance (IGT). Diet and physical activity are more effective than medication.The hi

10、gh-risk approach needs to be implemented in accordance with available resources. 世界卫生组织全球糖尿病报告Preventing type 2 diabetes in MANAGING DIABETES世界卫生组织全球糖尿病报告19MANAGING DIABETES世界卫生组织全球糖尿病报告Diagnosing diabetesDiabetes is diagnosed by measuring glucose in bloodFasting2 hours after a 75g oral load of gluc

11、osemeasuring glycated haemoglobin (HbA1c) High proportion of type 2 diabetes is undiagnosed.世界卫生组织全球糖尿病报告Diagnosing diabetesDiabetes isManagement of diabetesGood management can prevent complications and premature death using: standard guidelines and protocols (WHO Package of Essential NCD interventi

12、ons) small set of generic medicines diet and physical activity patient education about self-care regular screening for early detection and treatment of complications.世界卫生组织全球糖尿病报告Management of diabetesGood manAccess to affordable insulinPeople with type 1 diabetes require insulin for survival. Peopl

13、e with type 2 diabetes often need insulinLow-income countries generally pay most for insulin while high- and middle-income countries pay least. Only 23% of low-income countries report that insulin is generally available.世界卫生组织全球糖尿病报告Access to affordable insulinPeEarly detection and treatment of comp

14、licationsEnd-stage renal disease Measurement of urine protein progression to kidney failure can be slowed by essential drugsCardiovascular diseases Measure and control cardiovascular risk factorsBlindness Periodic eye examinations and timely laser photocoagulation Lower limb amputation Proper footwe

15、ar and regular examination of feet Provide rehabilitation世界卫生组织全球糖尿病报告Early detection and treatment Integrated management of diabetes and other chronic health conditionsDiabetes management should be integrated with management of other NCDs, and in some settings with tuberculosis and HIV/AIDS.世界卫生组织全

16、球糖尿病报告Integrated management of diabeNATIONAL RESPONSE世界卫生组织全球糖尿病报告25NATIONAL RESPONSE世界卫生组织全球糖尿病报告National capacity for prevention and control of diabetes (NCD CCS 2015- 177 countries)156 countries have a national diabetes policy, plan or strategy, only 127 are funded and operational.68% of countrie

17、s have operational policies for diet and physical activity. 50% of countries have conducted a national, population-based survey with measurement of blood glucose status within the past 5 years.世界卫生组织全球糖尿病报告National capacity for preventiOnly 47% of countries report full implementation of guidelines f

18、or management of diabetes.Only 1/3 of low- and lower-middle income countries have all three basic technologies in PHC blood glucose urine strip for glucose/ketone and height and weight measurementBlood glucose measurement is generally available in primary care in 50% of low-income countries.National capacity for prevention and control of diabetes (NCD CCS 2015- 177 countries)世界卫生组织全球糖尿病报告Only 47% of

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