Preventions of Type II Diabetes Mellitus

Diabetes is a common, chronic and costly condition which imposes a huge burden on the Australian community. Diabetes affects people of all socio-economic and cultural backgrounds, but with an uneven distribution across society. Type 2 diabetes can involve both insulin resistance and impaired insulin production, either of which may pre-dominate. In determining the risk of developing diabetes, environmental factors such as food intake and exercise play an important role. The majority of individuals with type 2 diabetes are either overweight or obese. Inherited factors are also important, but the genes involved remain poorly defined. Type 2 diabetes is strongly familial but it is only recently that some genes have been consistently associated with increased risk of type 2 diabetes in certain populations. (WHO, 2002a). There are levels of prevention to prevent type 2 diabetes mellitus, such as: 1. Primary Prevention The primary prevention involves the protection of health by measures that eliminate or reduce the causes or determinants of departures from good health, control exposure to risk, and promote factors that are protective of health. (adapted from Brownson et al 1998). Primary prevention can be implemented with 1) a population approach, i.e., altering the life-style and environmental determinants that are known to be risk factors for diabetes mellitus, and 2) a high-risk approach, i.e., implementing preventive measures only in individuals or groups that are at a specific high risk of developing diabetes in the future.

The risk of developing the disease and hence reducing risk for the many complications associated with it can be reduced by these following step: Increase physical activity. Research shows that people who are more physically active, regardless of their weight, are less likely to develop type 2 diabetes. Physical activity does not have to mean running or wheeling a marathon. Great choices for being more active include going for a walk or wheel after dinner or taking up a new sport or activity. People can reap excellent health benefits from being physically active for 30 minutes, 3 times per week. Healthy diet. Improving eating habits can greatly improve your health and help to maintain a healthy weight, which also helps lower the risk for developing type 2 diabetes.

Eating plenty of fiber, including whole grain breads and pasta, brown rice, legumes, fruits and vegetables. Choose lean meats, fish, poultry and/or meat alternatives. Choose low-fat and fat-free dairy products. Drink plenty of water. Limit saturated fat and trans fats. Choose foods low in salt (sodium). Limit your alcohol intake if you choose to drink. Consume only moderate amounts of sugars and foods containing added sugars.

Counseling with a dietitian can help to improve eating patterns and set you on the right track for a healthier lifestyle. Dont smoke. Smoking increases blood pressure and narrows the arteries, leading to poorer circulation. If you do have type 2 diabetes, do not give up. Millions of people live very healthy lifestyles with diabetes. Its important to be diligent about health. Check blood glucose regularly. Stay active.

Maintain a healthy weight. Take medications. See doctor on a regular basis.

2. Secondary Prevention Consists of early detection of asymptomatic biological changes, disease precursors or asymptomatic disease, and prompt and effective intervention to correct these departures from good health. (adapted from Brownson et al 1998). The major objective for setting up such a secondary prevention program would be to identify individuals at high risk of having the prediabetic states: Impaired Fasting Glucose (IFG) and Impaired Glucose Tolerance (IGT) in order to implement practical lifestyle interventions based on the RCT evidence to prevent or delay the onset of diabetes in these people. Case detection of undiagnosed diabetes would also be improved although the focus of interventions would primarily be on patients with IFG and IGT, and cases of previously undiagnosed diabetes would be referred to usual care. Secondary prevention of diabetes mellitus entails 1) early intervention to avert the progression of the disease and to prolong the partial recovery period, commonly known as the "honeymoon period," and 2) intervention methods implemented to prevent the development of major complications and disabilities, e.g., cardiovascular disease, retinopathy, neuropathy, and nephropathy.

3. Tertiary Prevention Tertiary Prevention consists of measures to reduce or eliminate long-term impairments, disabilities and complications from established disease and prevent or delay subsequent events. (adapted from Brownson et al 1998). Tertiary prevention programs are concerned with reducing symptoms and improving quality of life through such initiatives as improving community support structures for diabetics, enhancing capacity for self-management, improving service pathways and

providing for a systematic and coordinated approach to prevention in some instances through a statewide chronic disease strategy. Counseling is on of the way to prevent the people who are already experienced the diabetes so it wont be worse. On tertiary prevention counseling for subjects who were targeted are those who have experienced complications. So the things that are very important to be told are: The purpose, objectives and ways of treatment on chronic complications of diabetes. Rehabilitation efforts can be done. Patience and devotion to be able to receive and utilize state of living with chronic complications. In terms of treating patients who have experienced chronic complications, to achieve patient treatment goals should be to work with a team that will help him in the treatment process so that his or her treatment goals can be achieved. Management conducted by multidisciplinary team is a group of multiple disciplines who share a together in the field of health / diabetes. The team consists of doctors, nurses proficient / special diabetes and diet expert. Each member of the team responsible for revenue and responsible decisions in their respective fields in order to attain the goal of treatment of patients. Tertiary prevention can be done by tight glycemic control warranted, control blood pressure to below 150/80 mm Hg, Lipid management, Anti-platelet therapy, etc.

References http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/diabetes _type_2 http://www.ncpad.org/nutrition/fact_sheet.php?sheet=657 http://www.nphp.gov.au/publications/research/diabetes_prevention_bg_j an05.pdf http://care.diabetesjournals.org/content/10/2/238.full.pdf+html http://repository.usu.ac.id/bitstream/123456789/3665/1/fkmhiswani3.pdf http://www.jfponline.com/Pages.asp?AID=1694