As the theme of the world diabetic day, we need to promote the importance of cost effective management of diabetes mellitus in Sri Lanka. This will highlight the importance of affordable and accessible diabetic care for women. All women at risk or living with diabetes need to have easy access to diabetes medicine, self-management education, and information they need to achieve optimal outcome and ability to prevent type 2 diabetes.
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. The most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn't make enough insulin. In the past three decades, the prevalence of type 2 diabetes has risen dramatically in countries of all income levels.
The Primary Care Diabetic Group Sri Lanka was registered as a voluntary Social services/Non-Governmental Organization under Voluntary Social Services Organization Act No. 31 of 1980 as amended by Act No. 8 of 1998 on January 23, 2009. Its Head Office is at CeyMed, Stanley Thilakaratne Mawatha, Nugegoda. We do promote public education on Diabetes and render assistance to the needy patients with Diabetes Mellitus.
As the theme of the world diabetic day, we need to promote the importance of cost effective management of diabetes mellitus in Sri Lanka. This will highlight the importance of affordable and accessible diabetic care for women. All women at risk or living with diabetes need to have easy access to diabetes medicine, self-management education, and information they need to achieve optimal outcome and ability to prevent type 2 diabetes.
Key messages
All women with diabetes in Sri Lanka need to have easy access to diabetic care and health education to manage their diabetes and improve their health outcomes at an affordable price.
Currently there are over 199 million women living with diabetes in the world. This total is projected to increase to 300 million by 2040. The majority of this rise will affect the South Asian region of the world. Furthermore, two out of every five women with diabetes are of reproductive age, accounting for over 60 million women worldwide.
Diabetes is the ninth leading cause of death in women globally, causing over 2 million deaths annually and women with type 2 diabetes mellitus are 10 times more likely to develop ischemic heart disease than women without the condition.
Women with type 1 diabetes have an increased risk of early miscarriage or having a baby with malformations.
What needs to be done?
Health systems in Sri Lanka must recognize and give adequate attention to the specific needs and priorities of women with diabetes mellitus.
This is in addition to all women with diabetes needing to have easy access to cost effective management and anti-diabetic drugs and investigations such as FBS, HbA1c, self-management education and information they need to achieve good glycemic control.
All women with diabetes should have access to pre-conception planning and screening services to reduce risk to the mother and fetus during pregnancy. All women and girls should have access and encouragement to physical activity and nutrition to improve their health outcomes and prevent childhood obesity.
Pregnant women require improved access to screening, care and education to achieve positive health outcomes for mother and child.
Supporting evidence
One in six births is affected by diabetes in pregnancy. (Gestational Diabetes Mellitus - GDM) International Diabetes Federation estimates that 20.9 million or 16.2% of live births to women in 2015 had some form of hyperglycemia during pregnancy. Approximately half of women with a history of GDM go on to develop type 2 diabetes within five to ten years after delivery. Half of all cases of high blood sugar (hyperglycemia) in pregnancy occur in women under the age of 30 years.
Most cases of hyperglycemia in pregnancy were in low and middle income countries, where access to maternal care (Antenatal care) is often limited.
What needs to be done?
Prevention of Type 2 diabetes must focus on women health and nutrition and other health behaviours before and during pregnancy. Antenatal care visits during pregnancy must be encouraged for health promotion in young women and early detection of diabetes and GDM.
Furthermore, screening for diabetes and GDM should be integrated into other maternal health interventions and services at primary healthcare level to ensure early detection, better care for women and reduced maternal mortality. This is now in progress in Sri Lanka in antenatal clinics.
Primary health care workers should be trained in the identification, treatment, management and follow-up of diabetes during pregnancy.
It is important that women and girls adopt healthy lifestyles to improve the health of future generations. Up to 70 percent of cases of type 2 diabetes could be prevented through the adoption of a healthy lifestyle. In addition, 70 percent of premature deaths among adults are largely due to behavior initiated during adolescence.
Women, as mothers, have a huge influence over the long-term health status of their children and research has shown that when mothers are granted greater control over resources, they allocate more to food, children’s health and nutrition, and education.
Women are the gatekeepers of household nutrition and lifestyle habits and therefore have the potential to drive prevention from the household and beyond.
What can be done towards prevention?
Women and girls should be empowered with easy and equitable access to knowledge and resources to strengthen their capacity to prevent type 2 diabetes in their families and better safeguard their own health.
Promoting opportunities for physical exercise in adolescent girls, particularly in developing countries, must be a priority for diabetes prevention.
Cornerstones of diabetes management with the use of PCDG App
The PCDG with IT support is hoping to achieve the following to all diabetic patients who register:
a. Diabetes Self-Management Education (DSME)
b. Diabetes Self-Management Support (DSMS)
c. Medical Nutrition Therapy (MNT)
d. Counseling on smoking cessation
e. Education on physical activity
f. Guidance on routine immunizations
g. Psychosocial care
This is our proposed diabetes patients' empowerment program for the year 2017 – 2018 and our vision is to ‘achieve empowerment for each Sri Lankan diabetic patient’ and the mission is ‘to lay the information foundation for the total diabetes patient empowerment’.
The following is the process for registration:
1) Go for the empowerment model
2) National Diabetes Registry - name, age, sex, duration of diabetes, current treatment
All what the patients have to do to achieve empowerment:
a) Register with PCDG - National Diabetes Registry
b) Fill up the post consultation form - this is a form to be filled up by each patient after a usual consultation - earlier the better
What the registrants have to do – email or contact our hotline
What PCDG does: the benefits for the registrants
1) Observation of Daily Living - Digital record of sleep, activity, emotions, physical activity etc. on a daily record basis using our proposed App
2) Pre-consultation report - this consists of:
a) Summary of medical reports so far
b) Trends of the past lab data
c) Medical consultation support data - a report on new symptoms, drug effects, adverse effects, QOL, complications development
d) ODL Report for the time period between the last consultation and next consultation
e) Tele-consultation facility - to detect diabetes complications early and referral for treatment (2016 WDD theme)
For registration contact our hotline 0764641031 or e-mail [email protected]
Add new comment