Newer Community Based Initiatives to Detect Diabetic Neuropathy, Early

1. Newer Community Based Initiatives to Detect Diabetic Neuropathy, Early Madhav Oza Marketing Manager Nicholas Piramal India Ltd., Mumbai

2. Early Detection of Diabetic Neuropathy ??? • Prevention of progression at least can be instituted through early detection • Prevention of ulceration, gangrene and amputation can be instituted • Delayed diagnosis at a painless stage common • Prevalence large nearly 60 to 90% as sophistication of detection increases

3. Detecting Diabetic Neuropathy Early • Factors influencing early detection: • Awareness • Testing method • Man power • Platform to attract high risk individuals • Enthusiasm of health care providers

4. Detecting Diabetic Neuropathy Early • Awareness: • Doctors • Increased substantially due to efforts of DFSI and NNEF • Demonstrate…how easy is the detection process!!! • At Risk People • Massive task • Use of innovative/interactive tools (foot mats)- more effective

5. Detecting Diabetic Neuropathy Early • Selection of Testing method: • Sensitive enough to quantitate deficit and give broad range of gradation in deficit scale • Reproducible • Affordable (no recurrent costs), Portable • Widely accepted in field of diabetic polyneuropathy

6. Detecting Diabetic Neuropathy Early Selection of Testing method: VPTSensitometer

7. Detecting Diabetic Neuropathy Early • Man power : • Leveraging Services of 180 Territory Managers - Diabetes Business of Nicholas • Erstwhile Boehringer Mannheim team • Trained in conducting & reporting neuropathy testing • Dedicated Task Force of 20 people

9. Detecting Diabetic Neuropathy Early • Enthusiasm of health care providers: • Guidance of Dr.Sanjeev Kelkar, Dr.Arun Bal • Building partnerships with Local Health Care Team

10. Detecting Diabetic Neuropathy Early • Platform to screen high risk people: • Started with screening in clinical settings • Culminated into Community Screening Programs

14. Detecting Diabetic Neuropathy Early • Community Screening Programs: • Participation in Diabetic Exhibitions by Novo Nordisc Education Foundation • Community/Charitable Hospitals - Jain/Bohri Muslim hospitals • State/Central Govt. Employees Hospitals (Railways, Police force etc.) • Places of worship – Temples, Mosques • Corporates – Indian Oil, etc. • Collaborating with NGO’s

15. Detecting Diabetic Neuropathy Early • Current Level of Effort: • 250 in-clinic/community screening programs every month • Spread across the country involving at least 20 people with diabetes/program • 5000 Patients/Month • Our Experience: • Average detection rate (VPT > 15 volts): 20%

16. Detecting Diabetic Neuropathy Early Patient Screening Data : Feb-Jul’04 Close to 29000 Patients Screened

17. Detecting Diabetic Neuropathy Early NNEF Diabetic Exhibition

18. Detecting Diabetic Neuropathy Early Patient Screening Data : Feb-Jul’04 New Doctors’ Coverage Data Close to 800 New Doctors Participation

19. Challenges… • High risk population – 40 million people with diabetes • Early detection of diabetes • Reaching out to people in district/semi-district locations • Reaching out to low socio-economic strata of urban diabetes population

20. Challenges… Early Detection of Neuropathy  Early Detection of Diabetes

21. Detecting Diabetes & Neuropathy Early

22. Detecting Diabetes & Neuropathy Early • Massive Detection Drive - Diabetes & Neuropathy • 15th October onwards • Additional Task Force of 40 people to be positioned in metros & semi-metros • Aim to screen 50 people/day - Blood sugar, VPT Sensitometry testing • Duration – 3 months

23. Let Every One Be Aware Thank You