1、世界卫生组织全球糖尿病报告-PPTScope of the report Burden of diabetes Preventing diabetes Managing diabetes National response Recommendations Burden of DiabetesDiabetes is a serious,chronic disease characterized by elevated blood glucose occurs either when the pancreas does not produce enough insulin(type 1)or th
2、e body cannot effectively use the insulin it produces(type 2).Diabetes is one of the four major NCDsRisk factors Type 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 Fetal&early childhood
3、nutrition affect future riskComplications of diabetes108 million422 millionRise in diabetes19802014Rise is faster in low-and middle-income countries0%2%4%6%8%10%1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014PrevalenceLow-incomeLower middle-incomeUpper middl
4、e-incomeHigh-incomeIncrease in diabetes is most marked in the WHO Eastern Mediterranean RegionDeaths due to high blood glucose 3.7 MillionDeaths due to diabetes1.5 MillionMortality from diabetes43%of deaths occurred under the age of 70 yearsEconomic impact of diabetes Catastrophic medical expenditur
5、e 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 2030Diabetes and the global NCD agenda2011 UN Political Declaration on NCDsNCD Global Action Plan 2013-2020NCD Targets for 2025 H
6、alt the rise in DiabetesSDG target-One third reduction in premature mortality from NCDs(including Diabetes)PREVENTING DIABETESOverweight and obesity increasing20141 in 3 overweight1 in 10 obesePreventing type 2 diabetes at the population levelMultisectoral approaches to reduce the prevalence of modi
7、fiable 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.Healthy work placesSchool-based approachPreventing type 2 diabetes in people at high risk Diabetes can be delaye
8、d or prevented in people who are overweight and have impaired glucose tolerance(IGT).Diet and physical activity are more effective than medication.The high-risk approach needs to be implemented in accordance with available resources.MANAGING DIABETESDiagnosing diabetes Diabetes is diagnosed by measu
9、ring glucose in bloodFasting2 hours after a 75g oral load of glucosemeasuring glycated haemoglobin(HbA1c)High proportion of type 2 diabetes is undiagnosed.Management of diabetesGood management can prevent complications and premature death using:standard guidelines and protocols(WHO Package of Essent
10、ial NCD interventions)small set of generic medicines diet and physical activity patient education about self-care regular screening for early detection and treatment of complications.Access to affordable insulinEarly detection and treatment of complicationsIntegrated management of diabetes and other
11、 chronic health conditions Diabetes management should be integrated with management of other NCDs,and in some settings with tuberculosis and HIV/AIDS.NATIONAL RESPONSENational capacity for prevention and control of diabetes(NCD CCS 2015-177 countries)156 countries have a national diabetes policy,pla
12、n or strategy,only 127 are funded and operational.68%of countries 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.Only 47%of countries report full implementatio
13、n of guidelines for 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 measurement Blood 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)RECOMMENDATIONSRecommendationsWHO responseNoImage
