Epidemiology of Endocrine.pdf

Epidemiology of Endocrine diseases Dr.Amal Al-Nafisi Assistant professor and consultant Preventive Medicine and Public Health Outlines 1. Definition, types, and WHO classification of DM 2. The prevalence of DM Worldwide & in KSA 3. Risk factors, Screening and Prevention for Diabetes 4. Prevalenc...

Epidemiology of Endocrine diseases Dr.Amal Al-Nafisi Assistant professor and consultant Preventive Medicine and Public Health Outlines 1. Definition, types, and WHO classification of DM 2. The prevalence of DM Worldwide & in KSA 3. Risk factors, Screening and Prevention for Diabetes 4. Prevalence, prevention of goiter 5. Prevalence, risk factors, and assessment of obesity 6. Obesity Prevention and control Diabetes Mellitus Definition and types of DM Definition of Diabetes Mellitus Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves. (WHO) Diabetes is a chronic (long-lasting) health condition that affects how your body turns food into energy. (CDC) Types of Diabetes Mellitus o Type 2 diabetes o Type 1 diabetes o Gestational diabetes o Impaired glucose tolerance and impaired fasting glycaemia WHO WHO classification of Diabetes Mellitus. Classification systems can broadly be used for three primary aims: o o o Guide clinical care decisions Stimulate research into aetio-pathology Provide a basis for epidemiological studies The prevalence of Diabetes Mellitus Worldwide & in Saudi Arabia The prevalence of Diabetes Mellitus Worldwide The number of ppl with DM rose from 108 million in 1980 to 422 million in 2014. Prevalence has been rising more rapidly in low- and middleincome countries than in high-income countries. The prevalence of Diabetes Mellitus Worldwide Between 2000 and 2019, there was a 3% increase in diabetes mortality rates by age. In 2019, diabetes and kidney disease due to diabetes caused an estimated 2 million deaths. The prevalence of Diabetes Mellitus KSA The prevalence of Diabetes Mellitus KSA The prevalence of Diabetes Mellitus KSA Risk factors for Diabetes Risk factors for Diabetes MODIFIABLE RISK FACTORS 1. Lifestyle Patterns and Urbanization The urban population of KSA has 25.5% diabetics compared with the 19.5% of the rural population. 2. Dietary Pattern, alcohol consumption, and smoking 3. Physical Activity 4. Obesity obese people run seven times higher risk of developing diabetes, and overweight people have a three times higher risk of diabetes. Risk factors for Diabetes NON-MODIFIABLE RISK FACTORS 1. Gender Differences -the global numbers projected a slight gender difference in the population with diabetes for 2013 or 2035 -the incidence of the disease being higher in men than in women 2. Age 3. Genetic factors the first-degree relatives of diabetic patients are the ones at a higher risk of developing DM Screening for Diabetes Screening, US PREVENTIVE SERVICES TASK FORCE RECOMMENDATION 1. The American Association of Clinical Endocrinology recommends universal screening for prediabetes and diabetes for all adults 45 years or older, regardless of risk factors 2. The American Diabetes Association recommends screening adults who have overweight or obesity (BMI ≥25 or ≥23 in Asian American persons) with 1 or more risk factors, regardless of age. if the results are normal, it recommends repeat screening at a minimum of 3-year intervals. Screening, Screening tests, US PREVENTIVE SERVICES TASK FORCE RECOMMENDATION by measuring fasting plasma glucose or HbA1c level, or with an oral glucose tolerance test A fasting plasma glucose level of 126 mg/dL (6.99 mmol/L) or greater, an HbA1c level of 6.5% or greater, or a 2-hour post-load glucose level of 200 mg/dL (11.1 mmol/L) or greater are consistent with the diagnosis of type 2 diabetes. A fasting plasma glucose level of 100 to 125 mg/dL (5.55-6.94 mmol/L), an HbA1c level of 5.7% to 6.4%, or a 2-hour postload glucose level of 140 to 199 mg/dL (7.77-11.04 mmol/L) are consistent with prediabetes. Prevention and intervention for DM MOH, DM Awareness https://www.moh.gov.sa/Health Awareness/MedicalTools/Pages/ Prediabetes-Risk-Test.aspx Goiter Introduction to goiter Iodine deficiency is the most common cause of goiter, a condition defined when “each of the lateral lobes of the thyroid gland is larger than the terminal phalanges of the thumb of the person examined” Goiter is an indicator of chronic iodine deficiency and is a major public health problem in several areas of the world, especially in developing countries Prevalence of goiter • Globally, 30% of the world’s population is affected by iodine deficiency disorders (IDDs). • More than 150 000 million people are affected by IDDs. • Worldwide, the prevalence of goiter in the general population is estimated to be 15.8% varying between 4.7% in America and 28.3% in Africa Prevention and interventions The preferred strategy for the control of iodine deficiency disorders remains universal salt iodization. However, iodine supplementation is also an option in high-risk communities that are unlikely to have access to iodized salt. The effectiveness of iodine prophylaxis in preventing endemic goiter has shown that iodine deficiency is a necessary cause of the disorder. Obesity Prevalence of obesity worldwide Worldwide obesity has nearly tripled since 1975. In 2016, more than 1.9 billion adults, 18 years and older, were overweight. Of these over 650 million were obese. 39 million children under the age of 5 were overweight or obese in 2020. . Prevalence of obesity, KSA According to Saudi Health Interview Survey (SHIS) conducted in 2013: The prevalence of obesity among adult males and females was 24.1% and 33.5% respectively, while 33.4% adult males and 28.0% females were overweight Risk factors Assessment of obesity Prevention and control. Thank you References • Diabetes Mellitus in Saudi Arabia: A Review of the Recent Literature. Mohamed Abdulaziz Al Dawish, Asirvatham Alwin Robert*, Rim Braham, Ayman Abdallah Al Hayek, Abdulghani Al Saeed, Rania Ahmed Ahmed and Fahad Sulaiman Al Sabaan. https://www.researchgate.net/publication/280317020_Diabetes_Mellitus_in_Saudi_Arabia_A_Review_of_the_Recent_Literature • WHO, Diabetes. https://www.who.int/news-room/fact-sheets/detail/diabetes • US Preventive Services Task Force Recommendation, Screening for Prediabetes and Type 2 Diabetes. https://jamanetwork.com/journals/jama/fullarticle/2783414#:~:text=The%20American%20Association%20of%20Clinical,diabetes%2 0(regardless%20of%20age). • Iodine deficiency in Saudi Arabia : A R Al-Nuaim 1, Y Al-Mazrou, M Kamel, O Al-Attas, N Al-Daghari, R Sulimani • WHO, Goitre as a determinant of the prevalence and severity of iodine deficiency disorders in populations • MOH, Saudi guidelines on obesity, https://www.moh.gov.sa/Ministry/About/Health%20Policies/008.pdf