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Prospects of Diabetes in Sudan Mohamed Ali Eltom

Prospects of Diabetes in Sudan Mohamed Ali Eltom. Summarize the past Rescale the present Predict the future. Sudan after 9 July. Diabetes prevalence. National Diabetes Survey 1993 0.1 % Type 1 Diabetes 3.4 % Crude prevalence

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Prospects of Diabetes in Sudan Mohamed Ali Eltom

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  1. Prospects of Diabetes in SudanMohamed Ali Eltom

  2. Summarize the past • Rescale the present • Predict the future

  3. Sudan after 9 July

  4. Diabetes prevalence National Diabetes Survey 1993 0.1% Type 1 Diabetes 3.4% Crude prevalence 2.1% Unknown Diabetics 5.5% in the Northern State 8.3% in Dongla 14 % in Argo 6.0 % in Khartoum State 4.0 % in Gezeira State 1.0 % in NorthKurdofan State

  5. Sudan Household Health Survey 2006

  6. Natural History of Diabetes • Poor glycaemic control, adequate control only in12% • Low quality of life • Acute and long-termcomplications are common (67%) • High mortality rates amongchildren

  7. Micro vascular complications • Retinopathy 43% • Nephropathy 22% • Neuropathy 37% Macrovascular complications • Cardiovascular disease 28% • Peripheral vascular disease 10% • Cerebrovascular accidents 5.5%

  8. Factors Related to Poor Metabolic Control • Deficient patients awareness and compliance • Unaffordability and unavailability of drugs and monitoring equipment • Reduced level of well organized diabetes care • Poor health service organization

  9. Challenges to diabetes care in Sudan • Inadequate Financial Resources • Insufficient Health care system • Professionals • Patients

  10. Difficulties experienced in diabetes care • Patients • Limited access to care : less than 20% of patients have access to minimum standards of care + urban/rural differences • Insulin, other medications and supplies for testing metabolic control • Involvement of patients and families

  11. Difficulties experienced in Diabetes Care Patients, cont. • Lack of awareness and the challenge of • self- management • Reluctance to become empowered and • self- managing • Standards and materials for education

  12. Diabetes Education Facilities • Education is offered by doctors in a busy clinic atmosphere • Diabetes educator has not been integrated in diabetes management • No national diabetes patienteducation programs • to definepatient goals, monitor progress and • evaluate achievement • Lack of educational materials and equipment

  13. Diabetes Control Among Low and High Income Parents

  14. Ketone bodies in urine: 45.6% Hypoglycemia that needed special attention: 37% Acute Complications of Diabetes

  15. 56.6 % admitted at least once to the hospital within a year Hospital Admission

  16. Diabetic ketosis: 71.8% Hypoglycemia: 5.9% Malaria: 10.6% Other medical disorders or surgical intervention: 9.4% Main causes

  17. Families pay a considerable part of their income and receive insignificant support other than that from relatives and friends The direct cost of diabetes care requires 23% of the available economic resources of the parents The low costs reflect the minimal care given to the diabetic patients The present organization of diabetes care does not provide the patient with empowerment, knowledge and self-care ability Well-trained diabetic teams and education programs may improve this situation

  18. Prevalence 2025 • Estimate 16% (more than 3 Million Diabetic)

  19. Action • Primary prevention programs • Organized educational programs and proper medical services

  20. National Diabetes Policy Federal and state governments have identified priorities and agreed on anapproach to: • Diabetes prevention, early detection, management and treatment • In partnership with key organizations and service providers www.diabetesinsudan.org

  21. Areas of Development • Primary prevention strategies • Approved guidelines • Optimum practice models for service delivery • Partnerships between the different stakeholders in the diabetes sector • Alternative methods of funding for diabetes prevention and management

  22. Integrated Approach to Prevention and Care • Promotion of Healthy Life-Styles • Raising Community Awareness • Primary Prevention at onset • Screening for Type II DM • Development of National Strategy

  23. Optimum Practice Modelsfor Service Delivery Quality Care Diabetes Facilities (QCDF) • MDC in 25% of Primary Health Care Centers (1 MDC for a catchment area of 4000 diabetic) • 1 Diabetes Referral Unit for every 4 MDC

  24. Distribution of QCDF in the Country According to Prevalence Levels

  25. International Relations • Health Diplomacy • IDF • WDF • World Summit

  26. Regional Relations • Arab • African

  27. Arab World High income Middle income Low income • Research • Training • Education Material • Human Resources • Philanthropies • Civil Societies

  28. Cardiovascular risk factors (%) among adults in four Arab countries 2005

  29. Cardiovascular risk factors (%) among adults in four Arab countries

  30. موضة التدخين من الصعيد

  31. إلى الســـــودان

  32. Bilateral Relations • Egypt • Jordan • Saudi Arabia • Sweden

  33. Diabetes Care in the Nile Valley

  34. رمضان كريم

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