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what is the prognoses of type 1 diabetes? (2)
- cannot be prevented or cured at this time
- can delay or prevent long-term complications through strict control of blood glucose
what is the prognoses of type 2 diabetes? (2)
- can be prevented or delayed through lifestyle interventions (weight loss, exercise)
- can delay or prevent long-term complications through strict control of blood glucose and blood pressure
what is the goal of primary prevention? what is the target by two approaches?
- goal= reducing modifiable risk factors for diabetes
- Target by two approaches= general population and high-risk groups
what does the high-risk approach focus on in primary prevention?
focuses on those individuals who have other risk factors (obesity, physical inactivity, smoking, high BP, family history)
what are some solutions for the high risk approach? (3)
- dietary changes
- weight reductions
- increased physical activity
what are some specific dietary strategies in the primary prevention of diabetes? (5)
- reduction of saturated fat
- avoidance of trans fat
- limiting alcohol consumption to max of 2 drinks daily
- frequent consumption of whole grain products and mono-unsaturated fat
- daily intake of at least 14 g of fiber
what is the message of primary prevention? what is the current delivery models of primary prevention?
- message= healthy lifestyle choices
- delivery models= population health & primary care
what are some potential barriers to effective clinical-system based lifestyle intervention programs? (3)
- clinical health systems lack structure and expertise to change lifestyle
- too expensive and not "scalable"
- waiting until people have elevated glucose is too late
what is the focus of population-based approach in primary prevention? (2)
- focuses on prevention strategies for the whole population
- these interventions introduce strategies that change the environment and communities in which they live to make healthy choice the right choice
population-based approach to primary prevention make healthy choice the right choice by integration of: (4)
- social and healthcare settings
successful population health promotion and disease prevention strategies combine what elements? (7)
- market regulation and restriction
- interventions by primary health care providers
- education and public information intervention
- school based intervention
- community support
- socio-environmental interventions
- workplace interventions
how can market regulation and restriction help population health promotion successful?
- access-restriction or ease of access depending on the program intended
- strategic pricing- affordability of the product or program
what are some policy options to influence diabetes risk in primary prevention? (3)
- taxation (alcohol)
- food and menu labeling
- school food and physical education policies
what is the role of primary care physician in successful population health promotion in primary prevention strategy? what is the problem?
- to promote healthy lifestyle: healthy diet, physical activity, healthy body weight
- problem= 96% of family physicians think lifestyle counseling and programs should be provided by others
what are some examples of effective education and public information that contributes to a change in individual behaviour? (2)
- instituting educational campaigns that enable people to read and understand food labels
- providing training to staff and volunteers for the skills required to promote population health
well designed school prevention strategies and programs that are known to be effective for children include? (2)
- increasing time for physical activity in the school curriculum
- teaching young people to cook nutritious, low-fat foods
what are some community-based and community-wise approaches promoting health? (2)
- providing access to community recreational facilities
- urban design and transportation (trails, safe bike lanes)
what are some policies that allow socio-environmental and workplace interventions in primary prevention of diabetes?
- smoke-free work and public places
- physical activity at work (lunch time aerobics program)
what is the goal for secondary prevention? what is the target?
- goal= early detection of those with dysglycemia
- target= high-risk individuals and groups
what is the message for secondary prevention and what is the current delivery model for secondary prevention?
- message= diabetes awareness
- delivery method= relies on primary care
what are 2 factors that need to be considered in secondary prevention of type 2 diabetes?
- cost-effective methods of screening and treatment
- sufficient, appropriate and organized resources to deliver both screening and treatment
who is included in the high risk populations for diabetes? (5)
- age 45 or older
- physically inactive
- high blood pressure
- family history of diabetes
what is the goal in screening under secondary prevention?
to identify asymptomatic patients who may have diabetes or pre-diabetes
A number of clinical studies have shown that type 2 diabetes may be present ______________ before its clinical diagnosis.
up to 10 years
The diagnostic criteria for diabetes include: (2)
- symptoms of diabetes (polyuria, polydipsia, weight loss)
- elevated blood glucose levels
how is elevated blood glucose levels measures?
- FBS- fasting blood suagr
- RBS- random blood sugar (rare)
- OGTT- oral glucose tolerance test
Define Fasting blood sugar test. (FBS)
blood collected after overnight fast
define random blood glucose test. (RBS)
blood collected at a random (non-fasting) time
define oral glucose tolerance test. (OGTT)
blood collected after fasting and again 2 hours after drinking glucose-rich drink.
what is the glycated hemoglobin A1c test? (2)
- measures percentage of hemoglobin molecules that have glucose attached
- indicates average blood glucose level for past 2-3 months
____________ is a protein that makes your red blood cells red-colored.
when hemoglobin picks up glucose from your blood stream, the hemoglobin becomes ___________.
what is HbA1c? what is HbA1c test?
- HbA1c is glycosylated hemoglobin
- HbA1c test measures percentage of HbA1c in blood
If your plasma glucose level is abnormal following the FBS/FPG, you have ________________.
impaired fasting glucose (IFG)
If your plasma glucose level is abnormal following the OGTT, you have _________________.
impaired glucose tolerance (IGT)
impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) are both also known as?