Diet, physical activity, healthy life style modifications are key factors for diabetes control-Prof. Zaman sheikh


 World Diabetes Day by SSIDE

Diet, physical activity, healthy life style
modifications are key factors for
diabetes control-Prof. Zaman sheikh

Life style changes, Metformin are still first choice
Management of diabetes-Prof. Ejaz Ahmad Vohra

KARACHI: Diet, physical activity and healthy life style modification are the key factors for diabetes control. It is a silent killer disease and not reversible and is also cause of major complications. This was stated by Prof. M. Zaman Sheikh, Professor of Medicine at Sir Syed College of Medical Sciences and Director SSIDE Karachi, while speaking at World Diabetes Day function organized by Sir Syed College of Medical Sciences at a local hotel here on 5th November 2018.

Continuing Prof. Zaman Sheikh said that Increase in prevalence of diabetes is closely linked to marked increase in obesity. The health risks associated with diabetes are heart diseases, high cholesterol, stroke high blood pressure joints pain (osteoarthritis), psychological disorders such as depression and psychological difficulties due to social stigmatization. Diabetes causes tremendous increase in health costs. To decrease the epidemic of diabetes and to prevent it one should participate at least 60 minutes daily in moderate to vigorous physical activity and avoid Fast Foods. It is a painless disease and about 26% people of Pakistan are diabetics and majority of the people are not aware of it. One should do blood sugar level regularly and get it noted and should bring when he or she visits the doctor. It needs lots of investigation to avoid further complications, he added.

Sir Syed College of Medical Sciences organized World Diabetes day on 5th November
2018. Photograph taken on the occasion shows sitting on the dais from (L to R) Dr. Niaz
Ahmed Brohi, Dr. Khalid Ahmed Khalil, Mrs. Afazl Begum, Prof. Ejaz Ahmed Vohra,
Prof. Anisuddin Bhatti and Prof. M. Zaman Sheikh (Organizer of the event).

Prof. Ejaz Ahmed Vohra Chairman Department of Medicine, Ziauddin University speaking about the advances in the management of Diabetes Mellitus type 2 said that our media is more interested in politics rather than public issues. According to recent survey conducted in 2016-2017 about (27.4 million people of age 20 and above) of adult population are diabetics in Pakistan while there were 2.7 million diabetics in a National Health Survey in 1994. Life style changes and Metformin are still first choice for the Management of diabetes. For patients in whom ASCVD predominates, a GLP-1 receptor agonist with proven CVD benefit or SGL2 inhibitor with proven CVD benefit are beneficial provided kidney function is adequate? Sulfonylurea is also very effective but it increase weight. New insulin are more effective but expensive. Expenditure of insulin analog is thrice the cost of human insulin in terms of their relative benefits in clinical practice, and there is no significant difference regarding the risk for hypoglycemia related emergency visits and improvement in glycemic control.

Prof. Ejaz Ahmed Vohra further stated that increase in diabetes prevalence is major health and economic burden. Prevention is most effective strategy, which can be achieved by promotion of education, prevention of obesity, promotion of physical activity, cost effective medications, provision of health care facilities and universal health insurance. Government should increase total health expenditure from 2.6% of GDP. Allocation of financial resources more for primary prevention, control of NCDs water and sanitation. Creation of Health Advocacy Group can be very effective. Health and education should be on top priority of Political agenda, he added.

Prof. Anisuddin Bhatti talking about Diabetic foot said that every thirty second a lower limb is lost somewhere in the World and it is a consequence of Diabetes. Two percent of diabetics develop ulcer each year, 15% develop foot ulceration in their lifetime and 70% foot ulcers reoccur in less than three years. The prime risk factors of Diabetic foot Ulceration are diabetic neuropathy, Diabetic vasculopathy, structural foot deformity and poor glycemic control. The presence of just one of these conditions put the diabetic foot at risk of ulceration. Inadequate patient education, inadequate patient motivation, physical disability and limited access to podiatry services are the other risk factors.

Continuing Prof. Anisuddin Bhatti said that Chronic hyperglycemia & Hyperlipidemia are two major contributors to macro & microvasculopathy, neuropathy and glycolisation of proteins and collagen bundles complicates to foot deformities. The diagnosis of infection in a foot ulcer of a patient with diabetes is based on clinical findings and not culture testing. The best method to retrieve true pathogens are curettage of the ulcer base, a deep tissue biopsy/culture or the sampling of frank pus draining from a wound. The early, aggressive, clinical targeted antibiotic treatment and minimal debridement can save toes and limbs. Amputation for infected feet are not inevitable Prof. Anisuddin Bhatti concluded.

Dr. Khalid Ahmed Khalil talking about cardiovascular complications in diabetes said that daily exercise, low carbohydrate diet, reduction of triglycerides, raise in HDL levels, lower BP level and flexed oil are the important step which must be followed. Dr. Niaz Ahmed Brohi discussed diabetes and eye complications.

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