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Most Prevalent Disease

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Last Updated: 02 July 2021

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General | Latest Info

The straightforward way to assess the health status of the population is to focus on mortality - or concepts like child mortality or life expectancy, which are based on mortality estimates. Focus on mortality, however, does not take into account that the burden of diseases not only kills people, but that they cause suffering for people WHO live with them. Assessing health outcomes by both mortality and morbidity PROVIDE more encompassing view on health outcomes. This is the topic of this entry. The sum of mortality and morbidity is referred to as Burden of Disease and can be measured by metrics called Disability adjusted Life Years. Dalys are measuring lose health and are standardized metric that allows for direct comparisons of disease burdens of different diseases across countries, between different populations, and over time. Conceptually, one DALY is the equivalent of losing one year in good health because of either premature death or disease or disability. One DALY represents one lost year of healthy life. The First Global Burden of Disease was GBD 1990 and the DALY metric was prominently featured in World Banks ' 1993 World Development Report. Today it is published by researchers at the Institute of Health Metrics and Evaluation and Disease Burden Unit at the World Health Organization, which was created in 1998. Ihme continues work that started in the early 1990s and publishes the Global Burden of Disease study. This entry presents data on the Burden of Health across the world, breakdown by age, types of disability and disease, and regional / country breakdowns. Visualizations which follow can be explored by any country or region using the Change country option in the charts below. Human potential that is lost due to poor health is immense: Global Burden of Disease project aims to quantify this loss by estimating the number of healthy life years lost globally. This metric takes into account both, human life years lost due to early death and life years compromised by disease and Disability. It is a massive study that takes into account thousands of datasets to capture the burden of diseases globally. 55. 9 million people die in 2017. If we sum up all life years lost due to premature death - the sum of differences between each person's age of death and their life expectancy at that age - we find that the world population lost 1. 65 billion years of potential life due to premature death in that year. Disease and Disability meant that an additional 853 million years of healthy life years were lose. 1 it is hard to get a sense of the scale of these enormous numbers. One way to illustrate it is to put it in relation to the global population, which was 7. 53 billion in that year. The Global Burden of Disease, viewed in this way, sums up up to a third of the year lost for each person on the planet. 2 this map shows DALYs per 100 000 people in the population.

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1. Introduction

Infectious diseases are disorders that are caused by organisms, usually microscopic in size, such as bacteria, viruses, fungi, or parasites that are pass, directly or indirectly, from one person to another. Humans can also become infected following exposure to an infected animal that harbors pathogenic organisms that are capable of infecting humans. Infectious diseases are the leading cause of death worldwide, particularly in low income countries, especially in young children. Three infectious diseases were ranked in the top ten causes of Death worldwide in 2016 by the World Health Organization. They are lower respiratory infections, diarrheal diseases, and tuberculosis. Hiv / AIDS, which was previously on the list, has dropped from the global list of top ten causes of Death, but it is still the leading cause of Death in low income countries. Another infectious disease, malaria, accounts for the top cause of death in low income countries. Lower respiratory infections and diarrheal diseases are caused by a variety of infectious agents. Other infectious diseases on the list - HIV / AIDS, tuberculosis, and malaria - are due to single infectious agent. Infectious diseases can be caused by several different classes of pathogenic organisms. These are viruses, bacteria, protozoa, and fungi. Almost all of these organisms are microscopic in size and are often referred to as microbes or microorganisms. Although microbes can be agents of infection, most microbes do not cause disease in humans. In fact, humans are inhabited by a collection of microbes, know as microbiome,s that play important and beneficial roles in our bodies. The majority of agents that cause disease in humans are viruses or bacteria, although the parasite that causes malaria is a notable example of protozoan. Examples of diseases caused by viruses are HIV / AIDS, influenza, Ebola, MERS, smallpox, diarrheal diseases, hepatitis, and West Nile. Diseases caused by bacteria include anthrax, tuberculosis, salmonella, and respiratory and diarrheal diseases. There are a number of different routes by which person can become infected with infectious agent. For some agents, humans must come in direct contact with the source of infection, such as contaminated food, water, fecal material,s body fluids or animal products. With other agents, infection can be transmitted through air. The route of transmission of infectious agents is clearly an important factor in how quickly infectious agents can spread through the population. An agent that can spread through air has greater potential for infecting larger number of individuals than agent that is spread through direct contact. Another important factor in transmission is survival time of infectious agent in the environment. An agent that survives only a few seconds between hosts will not be able to infect as many people as an agent that can survive in an environment for hours, days, or even longer. These factors are important considerations when evaluating risks of potential bioterrorism agents. Infectious diseases have plagued humans throughout history, and in fact have even shaped history on some occasions.


Estimated New HIV Infections (HIV Incidence)

2 million people in the United States aged 13 and older were living with HIV in the US at the end of 2018, most recent year for which this information is available. About 14% of people living with HIV in the US do know it and so need testing. Early HIV diagnosis is crucial. Everyone aged 13 - 64 should be tested at least once. People at higher risk of acquiring HIV should be tested at least annually. Sexually active gay and bisexual men may benefit from more frequent testing. Young people are most likely to be unaware of their infection. According to CDC analysis, in 2018, estimate 44. 9% of young people aged 13 - 24 who were living with HIV were unaware of their infection. From 2014 to 2018, percentage of people living with undiagnosed HIV infection increased among people ages 13 - 24, but decreased among people ages 35 - 44. According to another CDC report, of people with HIV in 2018, about 76% have received some HIV care, 58% were retained in care, and 65% were virally suppressed or undetectable. Having suppressed or undetectable viral load protects the health of person living with HIV, preventing disease progression. There is also major prevention benefit. A person living with HIV who takes HIV medicine daily as prescribed and gets and stays virally suppressed can stay healthy and has effectively no risk of sexually transmitting HIV to HIV - negative partners.

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Endnotes

This map shows distribution between countries. The poorest countries do suffer from much poorer health, but even in the world's richest countries, health problems are still very severe. This is a decline from 48% in 1990. It is also important to remember that this is a burden relative to life expectancies that are possible today. Suffering caused by age - associated morbidity and mortality remains a problem too, and solving it will increase the expected length of life. Sterck, O., Roser, M., Ncube, M., Thewissen, S. - Allocation of development assistance For Health: Is predominance of National income justify?. Sterck, O., Roser, M., Ncube, M., Thewissen, S. - Allocation of development assistance For Health: Is predominance of National income justify?. Murray CJL, Barber RM, Foreman KJ, et al. 2015. Global, regional, and National disability - adjusted life years for 306 diseases and injuries and healthy life expectancy for 188 countries, 1990 - 2013: quantifying epidemiological transition.

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Chronic Diseases and Conditions

Chronic diseases are defined broadly as conditions that last 1 year or more and require ongoing medical attention or limit activities of daily living or both. Chronic diseases such as heart disease, cancer, and diabetes are leading causes of death and disability in the United States. They are also leading drivers of nations $3. 5 trillion in annual health care costs. Many chronic diseases are caused by a short list of risk behaviors: tobacco use and exposure to secondhand smoke. Poor nutrition, including diets low in fruits and vegetables and high in sodium and saturated fats. Lack of physical activity.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

2. Stroke

See Factors Influencing Decline in Stroke Mortality: Statement From American Heart Association / American Stroke Association 55 For More in - depth coverage Of Factors contributing To Decline in Stroke Mortality Over the past Several decades. In 2017: on average, every 3 minutes 35 seconds, someone dies of a stroke. Strokes account for 1 of every 19 deaths in the United States. When considered separately from other CVDs, stroke ranks fifth among all causes of Death, behind Diseases of Heart, Cancer, CLRD, and unintentional injuries / accidents. The number of deaths with Stroke as underlying cause was 146 383; Age - adjusted Death rate for Stroke as underlying cause of Death was 37. 6 per 100 000, whereas the age - adjusted rate for any mention of stroke as cause of Death was 63. 3 per 100 000. Approximately 63% of stroke deaths occur outside of acute CARE Hospital. In 2017, NH black males and Females had Higher Age - adjusted Death Rates For Stroke than NH White, NH Asian, NH Indian or Alaska Native, and Hispanic males and Females in the United States. More females than males die of stroke each year because of the larger number of elderly females than males. Females accounted for 58% of US Stroke deaths in 2017. Conclusions About changes in Stroke Death Rates From 2007 To 2017 are as Follow 249: Age - adjusted Stroke Death rate decreased 13. 6%, whereas the actual number of stroke deaths increased by 7. 7%. The Decline in Age - adjusted Stroke Death Rates For males and Females was Similar. Crude Stroke Death Rates Decline most among people 65 to 74 years of age, 75 to 84 years of age, and 85 years of age. By comparison, Crude Stroke Death Rates Decline more modestly among those 25 to 34 years of age, 35 to 44 years, 45 to 54 years, and 55 to 64 years. Despite improvements noted since 2007, there has been recent flattening or increase in death rates among all age groups. Age - adjusted Stroke Death Rates Decline by 11% or More Among All Racial / Ethnic groups; However, in 2017, rates remain higher among NH Blacks than among NH whites, NH Asians / Pacific Islanders, NH American Indians / Alaska Natives, and Hispanics. There are substantial geographic Disparities in Stroke Mortality, with Higher Rates in the Southeastern United States, known as the Stroke belt. This area is usually defined to include 8 Southern States of North Carolina, South Carolina, Georgia, Tennessee, Mississippi, Alabama, Louisiana, and Arkansas. These geographic differences have existed since at least 1940, and despite some minor shifts, they persist. 251 Historically, overall average stroke mortality has been 30% higher in stroke belt than in the rest of the nation and 40% higher in stroke buckle. 55 Risk of dementia is also increasing in the Southeastern United States, geographic area of excess stroke risk.


Summary

Each year, American Heart Association, in conjunction with the National Institutes of Health and other government agencies, brings together in single document the most up - to - date Statistics relating to Heart Disease, Stroke, and cardiovascular Risk factors in AHAs My Life Check - Lifes Simple 7 1 which includes core health behaviors and health factors that contribute to cardiovascular Health. Statistical Update represent critical resource for public, policy makers, media professionals, clinicians, healthcare administrators, researchers, health advocates, and others seeking best available data on these factors and conditions. Cardiovascular Disease produce immense health and economic burdens in the United States and globally. The Statistical Update also presents the latest data on a range of major clinical heart and circulatory disease conditions and associated outcomes. Since 2007, annual versions of Statistical Update have been cited > 20 000 times in literature. Each annual version of Statistical Update undergoes revisions to include newest nationally representative data, add additional relevant published scientific findings, remove older information, add new sections or chapters, and increase the number of ways to access and use assembled information. This year - long process, which begins as soon as the previous Statistical Update is publish, is done by AHA Statistics Committee faculty volunteers and staff and government agency partners. This year's edition includes data on monitoring and benefits of cardiovascular health in the population, metrics to assess and monitor healthy diets, enhanced focus on social determinants of health, focus on the Global Burden of CVD, and further evidence - base approaches to changing behaviors, implementation strategies, and implications of AHAs 2020 Impact Goals. Below are a few highlights from this year's Statistical Update. Please see each chapter for references and additional information.


3. Smoking/Tobacco Use

According to NHIS 2015 data, 59. 1% of adult smokers have stopped smoking. 33 majority of adult smokers want to quit smoking; 55. 4% had tried in the past year, 7. 4% had stopped recently, and 57. 2% had received healthcare provider advice to quit. Receiving advice to quit smoking was lower among uninsured smokers than among those with health insurance coverage through Medicaid or those WHO were dual eligible for coverage. Receiving advice to quit also varies by race, with lower prevalence in Asian, American Indian / Alaska Native, and Hispanic smokers than in white smokers. The Periods from 2000 to 2015 reveal significant increases in the prevalence of smokers WHO had tried to quit in the past year, had stopped recently, had health professional recommended quitting, or had used Cessation counseling or medication. In 2015, fewer than one - third of smokers attempting to quit use evidence - base therapies: 4. 7% use both counseling and medication, 6. 8% use counseling, and 29. 0% use medication. Smoking Cessation reduces risk of cardiovascular morbidity and mortality for smokers with and without CHD. In several studies, dose - response relationship has been seen among current smokers between the number of cigarettes smoked per day and CVD incidence. 34 35 Quitting Smoking at any age significantly lowers mortality from smoking - related diseases, and risk declines more longer time since quitting smoking. 1 Cessation appears to have both short - term and long - term benefits for lowering CVD risk. Smokers WHO quit smoking at 25 to 34 years of age gain 10 years of life compared with those WHO continue to smoke. Those 35 to 44 years of age gain 9 years, those 45 to 54 years of age gain 6 years, and those 55 to 64 years of age gain 4 years of life, on average, compared with those WHO continue to smoke. 34 Cessation medications are effective for helping smokers quit. 36 37 EVITA was an RCT that examined the efficacy of varenicline versus placebo for Smoking Cessation among smokers WHO were hospitalized for ACS. At 24 weeks, rates of smoking abstinence and reduction were significantly higher among patients randomized to varenicline. Abstinence rates at 24 weeks were higher in the varenicline than in the placebo group. Continuous abstinence rates and reduction rates were also higher in the varenicline group. 38 EAGLES trial 39 demonstrates efficacy and safety of 12 weeks of varenicline, bupropion, or nicotine patch in motivated - to - quit smoking patients with major depressive disorder, bipolar disorder, anxiety disorders, posttraumatic stress disorder, obsessive - compulsive disorder, social phobia, psychotic disorders including schizophrenia and schizoaffective disorders, and borderline personality disorder. Of note, these participants were all clinically stable from a psychiatric perspective and were believed not to be at high risk for self - injury. 39 Extended use of nicotine patch has been demonstrated to be safe and efficacious in randomized clinical trials. 40 RCT demonstrates the effectiveness of individual - and group - oriented financial incentives for Tobacco abstinence through at least 12 months of follow - up.


4. Physical Inactivity

In dose - response meta - analysis of 9 prospective cohort studies, higher levels of sedentary time were associated with greater risk of CVD in a nonlinear relationship. 80 study of factors related to declining CVD among Norwegian adults over 25 years of age found that increased PA accounts for 9% of the decline in hospitalized and nonhospitalized fatal and nonfatal CHD events. 81 in Study that follow 1. 1 million females in the United Kingdom without prior vascular disease for an average of 9 years, those who reported moderate activity were found to be at lower risk of CHD, cerebrovascular event, or thrombotic event. However, strenuous PA was not found to be as beneficial as moderate PA. 82 in prospective cohort study of 130 843 participants from 17 countries, compared with low levels of self - report PA, moderate and high levels of PA were associated with graded lower risk of major cardiovascular events over average 6. 9 years of follow - up time. 83 in 2 - year LIFE Study of older adults, higher levels of PA, measured by accelerometer, were associated with lower risk of adverse cardiovascular events. 84 in dose - response meta - analysis of 12 prospective cohort studies, there was an inverse dose - dependent association between PA levels and risk of HF. Pa levels at guideline - recommended minimum were associated with a 10% lower risk of HF. Pa at twice and 4 times guideline - recommended levels was associated with 19% and 35% lower risk of HF, respectively. 85 Furthermore, recent individual - level pool analysis of 3 large cohort studies demonstrates that a strong, dose - dependent association between higher PA levels and lower risk of HF is largely driven by lower risk of HF with preserved EF but not HF with reduced EF. 86 in a large clinical trial involving 9306 people with impaired glucose tolerance, ambulatory activity as assessed by pedometer at baseline and 12 months was inversely associated with risk of cardiovascular event. 87 in WHI, every hour per day of light - intensity PA was associated with Lower CHD and Lower CVD. 88 Domains of PA, other than leisure time, are understudied and often overlook. Meta - analysis reported protective relation of transportation activity to cardiovascular risk, which was greater in females. 89 However, higher occupational PA has recently been associated with higher MI incidence in males 19 to 70 years old. 54 90 these relationships require further investigation, because protective association of occupational activity with MI has been reported in young males. 90 recent analysis from Rotterdam Study evaluates the contribution of specific PA types on CVD - free LIFE expectancy. Higher levels of cycling were associated with greater CVD - free LIFE span in males and females. Furthermore, high domestic work in females and high gardening in males were also associated with increased CVD - free LIFE span. 91 Cardiorespiratory fitness and PA levels are important determinants of HF risk in the general population.


5. Nutrition

Gbd 2017 Study 82 uses statistical models and data on incidence, prevalence, case fatality, excess mortality, and cause - specific mortality to estimate the disease burden for 359 diseases and injuries in 195 countries and territories. Age - standardized mortality attributable to dietary risks is highest in Oceania and Central Asia. An updated report from the GBD 2017 Study estimates the impact of 15 dietary risk factors on mortality and DALYs worldwide, using a comparative risk assessment approach. 83 in 2017, estimated 11 million deaths and 255 million DALYs were attributable to dietary risks. Leading dietary risk factors were high sodium intake, low whole grain intake, and low fruit intake. Low - middle Socio - demographic Index and high - middle Socio - demographic Index countries had the highest age - standardized rates of diet - related deaths, whereas high Socio - demographic Index countries had the lowest age - standardized rates of diet - related deaths. Age - standardized diet - related death rates decreased between 1990 to 2017 from 406 to 275 deaths per 100 000 population, although the proportion of deaths attributable to dietary risks was largely stable.


9. Diabetes Mellitus

During 2011 to 2012, estimated 17 900 people under 20 years of age in the United States were diagnosed with incident Type 1 DM, and 5300 individuals 10 to 19 years of age were newly diagnosed with Type 2 DM annually. 1 in SEARCH Study, incidence rate of Type 1 DM increased by 1. 4% annually. 19 increase was larger for males than for females and more for Hispanics and Asian or Pacific Islanders than for other ethnic groups. Also, incidence of Type 2 DM increased by 7. 1% annually. The annual increase was larger among females than males and among NH blacks, Hispanics, Asian or Pacific Islanders, and Native Americans compared with NH whites. Projecting disease burden for the US population under 20 years of age by 2050, number of youths with Type 1 DM is expected to increase from 166 018 to 203 382, and the number with Type 2 DM will increase from 20 203 to 30 111. Less conservative modeling projects the number of youths with Type 1 DM at 587 488 and those with Type 2 DM at 84 131 by 2050.


26. Economic Cost of Cardiovascular Disease

Cvd accounted for 14% of total US health expenditures from 2014 to 2015, more than any major diagnostic group. 1 by way of comparison, CVD total direct costs shown in Table 26 - 1 are higher than 2014 to 2015 Agency for Healthcare Research and Quality estimates for cancer, which were $84. 0 billion. 1 Table 26 - 2 shows direct and Indirect costs for CVD by sex and by 2 broad age groups. Chart 26 - 2 shows total direct costs for 21 leading chronic diseases on the MEPS list. Hd is the most costly condition. 6 estimated direct cost of CVD in the United States increased from $103. 5 billion in 1996 to 1997 to $213. 8 billion in 2014 to 2015.


TIA: Prevalence, Incidence, and Prognosis

The GBD 2017 Study uses statistical models and data on incidence, prevalence, case fatality, excess mortality, and cause - specific mortality to estimate the disease burden for 359 diseases and injuries in 195 countries and territories. In 2017 375: global prevalence of stroke was 104. 2 million people, whereas that of ischemic stroke was 82. 4 million, that of ICH was 17. 9 million, and that of SAH was 9. 3 million. Globally, there were 16. 1% increase in ischemic stroke prevalence rate from 2007 to 2017 and 10. 1% increase from 1990 to 2017. Globally, there were 8. 9% decrease in ICH prevalence rate from 2007 to 2017 and 15. 5% decrease from 1990 to 2017. Globally, there was 1. 0% decrease in SAH prevalence rate from 2007 to 2017 and 6. 5% decrease from 1990 to 2017. Overall, age - standardized stroke prevalence rates are highest in Eastern Europe, North Africa, Middle East, and Central and East Asia. Countries in Eastern Europe and Central and East Asia have the highest prevalence rates of ischemic stroke. The prevalence of ICH is high in East and Central Asia. The age - standardized prevalence of SAH is highest in Japan.

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6. Diabetes mellitus

Table

Types of drugHow they workExample(s)
Alpha-glucosidase inhibitorsSlow your bodys breakdown of sugars and starchy foodsAcarbose (Precose) and miglitol (Glyset)
BiguanidesReduce the amount of glucose your liver makesMetformin (Glucophage)
DPP-4 inhibitorsImprove your blood sugar without making it drop too lowLinagliptin (Tradjenta), saxagliptin (Onglyza), and sitagliptin (Januvia)
Glucagon-like peptidesChange the way your body produces insulinDulaglutide (Trulicity), exenatide (Byetta), and liraglutide (Victoza)
MeglitinidesStimulate your pancreas to release more insulinNateglinide (Starlix) and repaglinide (Prandin)
SGLT2 inhibitorsRelease more glucose into the urineCanagliflozin (Invokana) and dapagliflozin ( Farxiga )
SulfonylureasStimulate your pancreas to release more insulinGlyburide (DiaBeta, Glynase), glipizide (Glucotrol), and glimepiride (Amaryl)
ThiazolidinedionesHelp insulin work betterPioglitazone (Actos) and rosiglitazone (Avandia)

Description Diabetes is a chronic condition that occurs when islets of Langerhans in the pancreas do not produce enough insulin or when the body cannot effectively use insulin it produce. Type 1 Diabetes - in which the pancreas fails to produce insulin. Usually it has its onset in childhood and adolescence. Type 2 Diabetes - results from the body's inability to respond properly to the action of insulin produced by the pancreas. Type 2 Diabetes is more common and accounts for around 90% of all Diabetes cases worldwide 1. Classically, with onset later in life, Type 2 Diabetes is increasingly being diagnosed in children and young people. Gestational Diabetes mellitus, develops during some pregnancies and may result in several adverse outcomes, including congenital malformations, increased birth weight and elevated risk of perinatal mortality. Metabolic Control may reduce these risks to that of non - diabetic expectant mother 1. Hyperglycaemia can lead to damage to many of the body's systems, especially nerves and blood vessels. Type 1 - commonly: polyuria, polydipsia, weight loss, blurred vision and fatigue. Type 2 - symptoms may be less marked and are often diagnosed by complications. An estimated 50% of individuals with Diabetes are unaware of their condition. Worldwide, approximately 170 million people have Diabetes mellitus and it is estimated that this number may double by 2025 1. Much of this increase will occur in developing countries. There are estimate 2. 3 million people with Diabetes in England. This is approximately 4% of the population. The number of cases is expected to increase to over 2. 5 million by 2010. The NHS spends an estimated 5% of its budget on treating Diabetes and its effects. In the UK, Type 2 Diabetes is up to 6 times more common in people of South Asian descent and up to 3 times more common in those of African and African - Caribbean descent. Diabetes is a major risk factor for stroke, coronary heart disease, blindness and kidney failure. Diabetic retinopathy is leading cause of blindness and visual disability. An estimated 80% of people with Diabetes will die from Cardiovascular Disease. Persons with Diabetes are 2 - 3 times more likely to suffer a stroke. Family history - especially for Type 2 Diabetes Age - increases with age more prevalent in those aged > 45 years. Obesity Sedentary lifestyle Diet impairs glucose tolerance Ethnicity Hypertension raises serum lipids Smoking Certain genetic markers have been shown to increase the risk of developing Type 1 Diabetes. World Health Organization, Diabetes Fact Sheet No. 138. Available online: http: / www. Who. Int / mediacentre / factsheets / fs138 / en /


Overview

Diabetes mellitus refers to a group of diseases that affect how your body uses blood sugar. Glucose is vital to your health because it's important source of energy for cells that make up your muscles and tissues. It's also your brain's main source of fuel. The underlying cause of diabetes varies by type. But, no matter what type of diabetes you have, it can lead to excess sugar in your blood. Too much sugar in your blood can lead to serious health problems. Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible diabetes conditions include prediabetes when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes and gestational diabetes, which occurs during pregnancy but may resolve after the baby is deliver.


Prevention

Early diagnosis can be accomplished through relatively inexpensive testing of blood sugar. Treatment of diabetes involves diet and physical activity along with lowering of blood glucose and levels of other known risk factors that damage blood vessels. Tobacco use cessation is also important to avoid complications. Interventions that are both cost - saving and feasible in low - and middle - income countries include: blood glucose control, particularly in type 1 diabetes. People with type 1 diabetes require insulin, People with type 2 diabetes can be treated with oral medication, but may also require insulin; blood pressure control; and foot care. Screening and treatment for retinopathy; blood lipid control; screening for early signs of diabetes - related kidney disease and treatment.

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The takeaway

This investigation was based on the Child Heart and Health Study in England, 15 which examined markers of cardiovascular disease and type 2 diabetes risk and their determinants in a multiethnic population of children aged 9 - 10 years. Parents or guardians provide informed writing consent. Balanced numbers of children of South Asian, black African - Caribbean and white European origin were invited to take part from a stratified random sample of 200 primary schools in London, Birmingham and Leicester. This investigation is based on the last 85 schools, in which detailed information on eating patterns and dietary nutrient intakes was collect. Participants were asked about their eating patterns, including question how often you have meals from a takeaway restaurant?S With four response optionsnever: or hardly ever, < 1 / week, 1 / week and > 1 / week. The interviewer made it clear that this only included meals from takeaway outlets and not convenience stores or supermarkets and included foods such as burgers, fish and chips, Chinese, pizza and so on and not just drinks or snacks such as crisps or fizzy drinks. Because only a small number of children report consuming takeaway meals > 1 / week, top two categories were combined for analysis. Dietary intake was assessed using a single, structured 24 - hour recall including elements of the United States Department of Agriculture multiple pass method. 17 Memory cues were used to aid recall, such as orientating children on details of the previous day, and checking for any forgotten snacks or drinks that child may have had through the day. Photographs of common foods were used to help children estimate portion sizes. Children were also asked to report the sauce of each meal. Energy and nutrient intakes were calculated by the Medical Research Council Human Nutrition Research centre using an in - house food composition database. 18 Energy density was calculated by dividing report total energy intake from food by total weight of food report. 19 participating children had measurements of height, weight, waist circumference, multiple skinfold thicknesses and bioelectrical impedance, measured with Bodystat 1500 body composition analyser. Bioelectrical impedance was used as principal marker of body fat as it provides valid assessments in this ethnically diverse population. 20 Fat - free mass was derived using validated equations, and fat mass index was calculate, which is independent of height. 21 seat blood pressure was measured twice in right arm after 5 min rest using Omron 907 blood pressure recorder, with an appropriately sized cuff. Children provide fasting blood samples after overnight fast for measurement of all blood markers, including total cholesterol and high - density lipoprotein cholesterol and triglycerides; low - density lipoprotein cholesterol was obtained using the Fredrickson - Friedewald equation. 22 Serum insulin was measured using the ELISA method, 23 plasma glucose was measured using the glucose oxidase method and haemoglobin A1c was measured in whole blood by ion exchange high - performance liquid chromatography. Homeostasis model equations were used to provide an estimate of insulin resistance.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

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Sources

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

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