Long term conditions including Type II Diabetes Flashcards
What is a Long term condition ?
Long term conditions are health conditions that last a year or longer, impact on a person’s life and may require ongoing care and support
What are the issues with long term conditions ?
Issues with long term conditions:
- What in and whats out ?
- Broad term with multiple definitions
- Multiple data sources and measures
- Difficult to define and measure
- Difficult to interpret or analyse any Intel
What do they mean by long term conditions, what did 1 study include and the other didn’t - mutli morbidity classifications may vary
What age group has the highest number of chronic disorders?
More chronic conditions the older you get
Exponential rise after 55+ in this graph
How does deprivation influence multimorbidity age in Scotland ?
- Deprivation contributes to more multimorbidity
- Gap closes at the top as most deprived are dying sooner
- Link between socio-economic group and long-term conditions prevalence and severity
What is the scale of Type 2 diabetes in Scotland?
- 17,000 people are diagnosed with Type 2 diabetes in Scotland every year
- 500,000 people in Scotland at High Risk of developing type 2 diabetes
- 87% of people with type 2 diabetes are above their ideal weight
- Being overweight and obese is the most significant risk factor for developing type 2 diabetes
- NHS spends around 9% of total health expenditure treating type 2 diabetes
- 50% of women diagnosed with gestational diabetes develop type 2 diabetes within 5 years of the birth of their baby
We are seeing a gradual increase each year for the number of people being diagnosed with diabetes in Scotland each year
What happens to the relative risk of developing type 2 diabetes as BMI increases?
Hardly increases until in overweight/pre-obese (25-29.9) then steadily increases once it hits each overweight category increases more rapid with each class, class 2+ (35+) being the highest jump
What is the correlation between Age of onset of diabetes ?
Diabetes will occur earlier the higher a BMI you have;
- Normal BMI looking at ages 60-80
- Obese class 3 looking at age 20
What is the significance of Visceral Obesity ?
Visceral Obesity;
- Insulin resistant (type 2) diabetes is closely linked to abdominal obesity
- As body weight increases, insulin resistance increases
- Reducing abdominal obesity improves insulin sensitivity
What is the ‘Healthier Future’ Framework?
Looks at 4 factors of;
- Prevention whole population (core messages, risk awareness, health campaigns)
- Early detection those at risk (Self assessment risk, professional risk stratification, accessible info, weight management programs)
- Early intervention those at high risk (Professional risk stratification, early diagnosis, targeted support, specialist intervention)
- Early intervention those with type 2 (Early diagnosis, structures education, specialist intervention, person centred care plans)
What are the Levels of Intervention ?
Level 1 - Public health awareness and early detection;
- Public health campaign
- Targeted messaging with core messages
- ‘At Risk’ stratification
- Case finding
- Local level action
Level 2- Early intervention (for those at moderate or high risk);
- Pre-diabetes education programme
- Metabolic antenatal clinics
- Maternal and infant nutrition pathways
- Weight management programmes
Level 3 - Targeted intervention (for those diagnosed with type 2 diabetes, at high risk, with pre-diabetes or gestational, diabetes);
- Structured education for those with diabetes
- Intensive weight management for remission
- Weight management programmes
- Psychological support
Level 4- Complex case management:
- Advanced weight management input and specialist intervrentions
What do prevention strategies try to tackle and teach us?
Prevention strategies focus on some key
issues that contribute to high burden LTCs —
physical activity, mental wellbeing, healthy
diet, and reducing substance use
Have to be informed by our understanding of
the impact of deprivation, adverse childhood
experiences, and trauma
E.g - Less likely to take care of themselves and more likely to do things that are of detriment to their health
What is Scotland’s Public Health priority outcome 6?
For example of diabetes, linked to all of
Scotland’s Public Health priorities, but
especially outcome 6…
Public Health Priority 6 - Eat well, healthy weight, be active
How do we need to approach Diabetes ?
As a Whole System Approach (looking at whole picture);
- Reduce health inequalities
- Person-centred
- Reduce stigma
What do people need access to to prevent diabetes?;
- Gym
- Healthy supermarket
- School/Education
- Hospital
- Green space to be active in
What is the outcomes in “Underpinning the Diabetes prevention & early intervention framework: A healthier future: Scotland’s diet and healthy weight delivery plan”?
Underpinning the Diabetes prevention & early intervention
framework: A healthier future: Scotland’s diet and healthy weight
delivery plan;
- Outcome 1: Children have the best start in life — they
eat well and have a healthy weight - Outcome 2: The food environment supports healthier
choices - Outcome 3: People have access to effective weight
management services - Outcome 4: Leaders across all sectors promote
healthy diet and weight - Outcome 5: Diet-related health inequalities are
reduced
What does Lean BMJ 2006 state about foods we are given?
Lean, Gruer, Alberti, Sattar - BMJ, 2006:
“What is provided is what is eaten …. So what is provided has to change.”
E.g average Mcdonalds portion was 2.4oz and 210 calories in 1955 and is now 7oz and 610 calories in 2012
Levy on sugar in soft drinks 2018 — indications are it is working!
