Transcript Slide 1
Egyptian Perspective On Prediabetes & Diabetes
Ibrahim El Ebrashy
Prof. Of Internal Medicine & Diabetes Faculty Of Medicine-Cairo University Dean National Institute Of Diabetes & Endocrinology (NIDE ) Cairo – MOH Egypt
Top 10 prevalence of diabetes (20-79 age groups) in 2007 (With 2025 prevalence) Country Nauru UAE Saudi Arabia Bahrain Kuwait Oman Tonga Mauritius Egypt Mexico 2007 2025 Prevalence (%) 0 5 10 15 20 25 30 35 40 International Diabetes Federation. Diabetes Atlas. Brussels, Belgium: IDF; 2007
Preventing CHRONIC DISEASES a vital investment World Health Organization 2007
The burden and costs of chronic diseases in low-income and middle-income countries
The Lancet
•
They estimated the burden and loss of economic output associated with chronic countries diseases in 23 selected
•
These countries were selected as leading countries accounting for around 80% collectively of the total mortality burden attributable to chronic diseases in developing countries .
• They aggregate estimates from
coronary heart disease, stroke, and diabetes
, since these disorders
greatest burden
represent the of the entire group of chronic diseases.
• All estimates are projected between
and 2015.
2005
Global Burden Of Diabetes Prevalence and Projections 2010 and 2030 IDF, 2009.
Number of people with diabetes (20-79 years)
TOP 10
10
2010 and 2030
11
T2DM trends in Egypt- Prevalence 15 10 5 7.0 10.4
8.6 Age Categories 42.6 % 8.8 % 20.3 % 25- 34 35- 44 45- 54 55 - 65 28.3 % 0 Male Female Total Egyptian Ministry of Health (MOH ) Preventive Sector, Central Epidemiology and Disease
Surveillance (ESU) 2006
T2DM trends in Egypt 25 20 15 10 5 Age Categories 25-34 35-44 45-54 55-65 Total 0 Prevalence Undiagnosed OAD use Insulin use Egyptian Ministry of Health (MOH) Preventive Sector, Central Epidemiology and Disease
Surveillance (ESU) 2006
T2DM trends in Egypt- Complications & Risk factors ( NIDE Data 2008 ) BMI < 25 BMI 25-30 BMI > 30 High Cholesterol Low HDL Hypertension Retinopathy Nephropathy Neuropathy 0 10 20 30 40 50 Prevalence (%) 60 70 80 90
T2DM trends in Egypt-Metabolic Syndrome NIDE Data 2008 90 % of T2DM patients in Egypt have Metabolic Syndrome
T1DM trends in Egypt NIDE Data 2009 ( 852 Patients )
Hereditary factors
35.00% 30.00% 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% 6.70% 5.20% 4% 31.30% Diabetic father Diabetic mother Diabetic siblings Diabetic grands Diabetic father Diabetic mother Diabetic siblings Diabetic grands 16
Infant feeding
13.10% 2.10% 80.60% Breast f eeding Artif icial cow s milk Artif icial milk f ormula 17
Age of onset of diabetes
25.20% 46% 23.80% Age of onset > 5y.
Age of onset = 5:<10y.
Age of onset =10-15y.
18
BMI in diabetic children
27% 14% 3% 56% BMI < 25 BMI= 25:<30 BMI=30:<40 BMI >40 19
HbA1c among diabetic children
33% 14% 22% 31% HbA1c<7% HbA1c7:8% HbA1c>8:9% HbA1c>9% 20
Beta cell function among diabetic children
21 6.30% 93.70% c-peptide < 1 c-peptide > 1
C ontinues H ome B lood G lucose
M
onitoring
22 39.40% 25.80% 34.80% CHBGM with Device CHBGM with visual strips No CHBGM
MOH – Curative Care Sector Project: Early Detection of Diabetes Mellitus
Salah El-Ghazaly Harb*, Ibrahim El-Ebrashy***, Mohamed Fahmy** and Madiha Said Abdel-Razik*
Faculty of Medicine Cairo* and Ain Shams** Universities and the National Institute For Diabetes & Endocrinology***
• The EDDP established "early detection of DM clinics (EDDMC) in 14 hospitals, in three phases.
• These hospitals are located in 12 governorates and distributed in the three Egypt Regions (Urban governorates, Lower Egypt and Upper Egypt).
• Throughout the period 2003-2009, more than
95000
at-risk ≥ 25 years of age individuals (hypertension, obesity, and positive family history of diabetes), but with negative history of DM had been examined.
Prevalence of Prediabetes & Undiagnosed Diabetes Among High Risk Subjects Dec. 2009 (Total number of subjects 95354 ) % 12.2
Pre diabetes % 14.0
Un diagnosed Diabetes % 73.8
Normal
Egypt
Country profile Percent with diabetes (20-79 years), 2010 (national)
10.4
27
Percent with diabetes (20-79 years), 2010 (comparative) 11.4
Percent with diabetes (20-79 years), 2030 (comparative)
13.7
Number of people with diabetes, 2010
4,787,100
Percent with impaired glucose tolerance (20-79 years), 2010 (national)
4.8
Percent with impaired glucose tolerance (20-79 years), 2010 (comparative) 5.1
New cases of type 1 diabetes in children (under 14 years) 2010 (new cases per 100,000 population per year) 8.0
Deaths attributable to diabetes (20-79 years), 2010 58,116 Mean health expenditure per person with diabetes (USD), R=2, 2010
116
T2DM trends in Egypt- Current treatment practice
• Guidelines followed • Majority follow ADA , EASD & IDF guidelines • local clinical practice recommendation since 2009 MOH.
• Management Practices • All oral anti-diabetic drugs available • Metformin remains the mainstay of treatment together with SUs.
• TZDs are prescribed after failure of Metformin and SUs.
• Newer agents like DPP-IV are launched in the market.
• All types of insulin and insulin analogues are available.
• National DPP is just launched