Working Draft v.1 For Input
Diabetes Awareness Education
May 2013
Lesley Shane, Pfizer Global Health Fellow
Partnering with GBCHealth Beijing, China
B.Sc.Pharm., Pharm.D.
1
AGENDA
• Introductions

Pfizer GHF Program & GBCHealth Diabetes Initiative – Background
• Diabetes Awareness Education
For you and to share with your family/ relatives






45 min
Diabetes: What is it? Who gets it? Why important?
Diabetes burden in China
Know the diabetes signs and symptoms ?
How to prevent diabetes
Diabetes self management tips and treatments
Pre-session quiz - questions and answers
• Questions
• Short Feedback Survey on Today’s session
2
5 min
10 min
2 min
GBCHealth China Diabetes Initiative
 GBCHealth is a coalition of more than 220 companies united to keep the
fight against HIV/AIDS, tuberculosis, malaria, and non-communicable
diseases (including diabetes) a global priority
 Since early 2012, GBCHealth has been exploring the growing diabetes
epidemic in China and has identified two program paths to help drive
improvements in raising diabetes awareness:
i.
Workplace Employee Education (e.g. this current job assignment)
ii. In the future, using social media as a knowledge source
3
Pfizer’s GHF Program: Applying Pfizer Expertise to Strengthen Health Care Delivery
Mission &
Goals
• Promoting access, quality and efficiency
of health care delivery for people in
greatest need
• Informing emerging Pfizer leaders on
global health challenges & patient
populations in emerging markets
Key Facts
• Over 300 Pfizer colleagues have served as
Fellows & Teams in over 40 countries
since 2003
• Focus areas align with Pfizer Expertise:
Optimizing supply chains, Health
prevention/promotion & Health workforce
Partners
Recent
Awards &
Media
• Partnerships with thought leaders &
innovators in health
• Over 40 NGO, govt & multilateral partners
over life of program; 12 partners in 2013
• 2013 PRNews Award finalist for Employee
Volunteer Program
• 2012 Health Volunteers Overseas Golden
Apple Award
• Featured in Forbes, Fortune, Huffington
Post, Wall Street Journal
Visit: http://ghf.pfizer.com to learn more!
Diabetes Awareness Workplace Education Session
Objective of Today’s Session:
• To provide Diabetes Awareness Education to enhance Company
Employee diabetes disease awareness for future prevention and to
promote the sharing of the knowledge with your Family / Relatives
who may be at risk for diabetes
5
Source: Diabetes photos website
Diabetes
Diabetes is serious
Diabetes is often silent
Diabetes can kill
More and more people have diabetes
Diabetes has a large burden to Patients,
Families and is costly to China
6
Adapted From sources:
www.cdschina.org; www.idf.org;
Diabetes photos website
Diabetes: What Is It ?
Diabetes = Too much sugar in the blood and
this hurts the Body
People with diabetes need life-long treatment
There is no cure for diabetes BUT….
You can prevent and control diabetes
You can be healthy and restore balance
7
Adapted From sources:
www.cdschina.org; www.idf.org;
Diabetes photos website
Balancing Blood Sugar
 Your system is in balance when
the body keeps blood sugar
levels between 4 and 6 mmol/L
 Sugar levels in your blood
increase from eating food and
drinking beverages
(except water)
 Sugar levels in the blood are
decreased by Insulin helping
to move sugar from the blood
into nourish our body cells
8
Food in sugar
in blood
Insulin acts
on sugar to
enter cells
Adapted From sources:
www.cdschina.org; www.idf.org;
Diabetes photos website
Who Gets Diabetes?
Three main types of diabetes:
 Type 1 (5% of diabetes): Natural cause with no
insulin production; Usually strikes children
 Must use insulin for lifetime
 Type 2: Most common kind (90-95% of diabetes)
 Usually strikes people over 30 years old (the
breadwinners in the Family of working age)
 Alarmingly, diabetes is increasing in younger people
(adolescents, collage students)
 Common: Overweight, poor lifestyle and family history
 May need to use pills or insulin for treatment
 Gestational and Other (5% of diabetes):
9
 Gestational happens during pregnancy; Mother needs
extra care to have a healthy baby
 4th group includes special types such as genetic,
environmental and drug induced
People With One Or More Risk Factors Can Get
Type 2 Diabetes
10
Certain
Medications
Ethnicity
Chinese risk
higher, 1.6 x
Caucasian risk
Inactivity
Pregnancy
Smoking,
Hypertension
Stress
30+ in China
Age
10
Excessive Alcohol
High
Cholesterol
In China, people > age 30,
overweight, or in well-off
urban areas where Western
fast food chains are common
and more sedentary lifestyle,
face a particularly high risk.
Overweight
(Obesity)
Male waist circumference ≥ 90 cm,
Female waist circumference ≥ 85cm;
Family
History
Adapted From sources:
www.cdschina.org; www.idf.org;
Diabetes photos website
Diabetes: Why Important ?
Diabetes is important because if not controlled you could lose:
More than 20 per cent could
 Your sight not name the types of
complica ons most closely
 Your feet associated with poorly
diabetes - blindness,
 Your sexualcontrolled
ability
amputa ons, kidney failure,
cardiovascular disease and
early death. (Hong Kong Survey
2011
Too much sugar in the blood can hurt:





Your
Your
Your
Your
Your
heart
brain
kidneys
• the main problem for Type 2 diabe cs in
the city is the misconcep on that diabetes
bloodisvessels
not a serious condi on. 'Diabetes can
to blindness or leg amputa on if not
teeth lead
well controlled, and is also associated with
around 30 per cent increase in risk of
different cancers
Eye Damage
Blindness
Heart Attack
Kidney Damage
Reduced Blood
Supply
There is no cure for diabetes BUT….
1
You can prevent and control diabetes
You can be healthy and restore balance
11
Stroke
Sexual Problems/
Difficulty Passing
Urine
Numbness
Foot ulcers
Foot amputation
Adapted From sources:
www.cdschina.org; www.idf.org;
Diabetes photos website
Symptoms of Diabetes Are Often Silent in Early Stages
If You or Family/ Relative
members have one or more of
these symptoms, it is important
to talk to your Medical Doctor
12
Source: diabetes photos
China’s Diabetes Rates Are High
 In China (2012), 1 out of 10 people
over 18 years old have diabetes
 +92 million diabetics in China;
Largest number of diabetes cases in
the World, surpassing India & USA
− More common in men than women
(10.2% vs. 9%, respectively)
− Higher in the urban than rural areas
(12.3% vs. 8.4% respectively)
 15.5% of Chinese people (148 million) have pre-diabetes risk factors;
20–30 million pre-diabetic move to full-blown diabetes/year
 Majority, 60%+, of the Chinese diabetic population remain undiagnosed
13
Sources: http://www.chinadaily.com.cn/china/2010-05/26/content_9892334.htm; www.idf.org; www.cdschina.org
Chinese Ministry of Health, 2010; (CDS); http://www.diabetes.co.uk/global-diabetes/diabetes-in-china.html
Alarming Epidemic Growth - Diabetes In China
 Two decades ago, diabetes was very rare in China
 Over the last decade, there has been a dramatic
3-fold growth increase in diabetes prevalence due to:
 Increased economic development & status
 Urban growth
 Aging
 Lifestyle change: bad diets, less exercise
(with resulting increased obesity)
 By year 2030, 130 million diabetes in mainland China
 20 years ago average diabetic patient = Age 50+
 Now Average age is 30+ (also growing number
of teen and collage age diabetics)
14
Sources: http://www.chinadaily.com.cn/china/2010-05/26/content_9892334.htm; www.idf.org; www.cdschina.org
Chinese Ministry of Health, 2010; (CDS); http://www.diabetes.co.uk/global-diabetes/diabetes-in-china.html
China Has High Diabetes
Burden And Costs
 Diabetes complications (e.g. heart, kidney, eye diseases and death)
impose heavy physical, mental, and economic burdens on patients
and their families
 13% of total medical expenditures in China are directly cause by
diabetes: RMB 173.4 billion or US$25 billion (2010 data); also,
RMB 3.4 trillion economic loss for both heart disease and diabetes
 Widespread epidemic of diabetes is a serious threat to China’s public
health and adds high medical costs to the country
 Prevalence is skyrocketing, but China has a window of opportunity
to prevent an epidemic of serious diabetes complications and costs
15
Sources: http://www.chinadaily.com.cn/china/2010-05/26/content_9892334.htm; www.idf.org; www.cdschina.org
Chinese Ministry of Health, 2010; (CDS); http://www.diabetes.co.uk/global-diabetes/diabetes-in-china.html
China Has Low Awareness Of Diabetes –
Education Is Important
Diabetes awareness low in China
in local/community, healthcare
provider, patients and their families,
and the general public
•
 More than half of people with
diabetes are not aware they have
the disease
 Only 1/3 of the people treated have
successfully managed to control their
blood sugar
The Chinese Ministry of Health and CDS have introduced large-scale
diabetes awareness and education programs to address diabetes
16
Sources: http://www.chinadaily.com.cn/china/2010-05/26/content_9892334.htm; www.idf.org; www.cdschina.org
Chinese Ministry of Health, 2010; (CDS); http://www.diabetes.co.uk/global-diabetes/diabetes-in-china.html
Causes Of Diabetes ?
Diabetes can have many causes, such as:
 Change of lifestyle:
Cholesterol
High High
Fat Diet
bad diet, not enough exercise,
alcoholism, smoking, stress
 Aging
 Better economy (higher
Blood
Pressure
High Fat &
Cholesterol
Levels
Overweight
/ Obesity
&
TYPE
Type 22
DIABETES
Diabetes
Smoking
Sedentary
Lifestyle/
Inactivity
incomes contributing to obesity,
sedentary lifestyles),
growing urbanization
 Overweight and obesity
Overweight
Alcohol Use
Sedentary
Lifestyle
Smoking
 Other risk factors: genetics, etc.
17
Adapted From sources:
www.cdschina.org; www.idf.org;
Diabetes photos website
Type 2 Diabetes And Our Bodies
 Diabetes symptoms are often silent in the early stages
 Usually discovered by route blood tests – Awareness is very important
 In earlier stages diabetes is amendable by behavior / lifestyle changes
18
Adapted From sources:
www.cdschina.org; www.idf.org;
Diabetes photos website
Obesity Is A Pre-Diabetes Risk Factor
 Obesity is a risk factor and key precursor to diabetes
 Diet Changes, particularly excessive
consumption of western type foods
 The sedentary lifestyle favored by western
people has infiltrated Chinese culture, leading
to people eating more and exercising less

Pre-Diabetic phase can last 10 to 12 years before
evolving into Type 2 diabetes

What you do in your 20s and 30s age is a
total down payment for the life you want to live
when you are in your 40s, 50s and 60s and beyond
19
Adapted From sources:
www.cdschina.org; www.idf.org;
Diabetes photos website
Prevention:
You Can Take Charge To Stop Diabetes:
Prevention at the pre-diabetes stage can reduce the risk of getting diabetes by 50%
20
Better Nutrition, Lifestyle and Active Exercise
Fitness Can Prevent Diabetes
Avoid Tobacco
Avoid Alcohol
Diabetes Free Life
Eating For Good Health
 Healthy food is important
 Healthy weight is important
 The body needs the right amount of food
 Eat 3 meals a day (do not skip meals)
 Eat a variety of good goods
 Fresh food with fiber, low sugar and good
healthy fats is very good
21
Source: diabetes photos
Avoid the Bad Foods For Good Health
 Avoid fried or “Fast foods” with
bad fats – Eat less of them
 Remove and switch out foods with
sugar, salt and bad fats
Replace with good foods with
low sugar, low salt, good fiber
and good healthy fats
 Less salt, less oil
 Avoid alcohol
22
Source: diabetes photos
TIPS for Eating Healthy Foods
Diabetes Prevention – Chinese Version
23
23
Exercise: Being Active Reduces Diabetes Risk
 Healthy weight is important;
The body must be able to move
 Exercise boosts the metabolic rate
 CDS recommends exercise for at least
150 minutes per week of moderate
intensity, such as over 5 days per week,
every day for 30 minutes
24
Adapted From sources:
www.cdschina.org; www.idf.org;
Diabetes photos website
If You Have Symptoms, How Do You Know If
You have Diabetes ?
 Only your doctor can tell if you have diabetes
 Your doctor may do one of the following
laboratory blood tests to confirm diabetes:
Fasting Plasma Glucose (FPG)
(No food for at least 8 hours before
in the morning)
2 hour Oral Glucose Tolerance Test (OGTT)
(Glucose level tested 2 hours
after drinking 75 g of sugar)
≥ 7.0 mmol/L
≥ 11.1 mmol/L
< 7.0 mmol/L
< 11.1 mmol/L
≥ 6.1 mmol/L
7.8 mmol/L
< 6.1 mmol/L
< 7.8 mmol/L
>2.6 mmol/L
FPG
Adapted From sources:
www.cdschina.org; www.idf.org;
Diabetes photos website
>2.6 mmol/L
OGTT
If You Have Diabetes It is Important to Test
Your Blood Sugar At Home For Safe Levels
Good safe blood sugar levels that you test at home keeps you healthy
Normal
Too Low
Safe Good Level
Too High
Below 6.1 mmol/L
Below 2.6 mmol/L
2.6 to 6.5 mmol/L before you eat
Above 11.9 mmol/L
Under 9 mmol/L after you eat
Feel balanced
Feel shaky
and sweaty
Feel balanced
Feel tired
and sleepy
Are you sick today? Then you should:



Test your sugar
Stay safe
Drink plenty of water
Test your Sugar when:


26
The doctor asks you to
You feel “odd” and not yourself
Source: 2010 Chinese Diabetes Society (CDS) Guidelines http://wenku.baidu.com/view/bff4fb48e45c3b3567ec8b98.html
* IDF 2012 http://www.idf.org/sites/default/files/IDF-Guideline-for-Type-2-Diabetes.pdf
Diabetes Monitoring Management:
Blood testing, blood pressure and cholesterol testing
27
Source: diabetes photos
Diabetes Treatment
 1st Step = Lifestyle Modification
(better diet, more daily exercise,
weight management)
 2nd Step = Medications
 Some people take pills
 There are many kinds
 Some people take insulin
 Take your medicine on time;
Take it every day
28
Source: diabetes photos
Save Your Feet
Feet Can Last:
 Look at your feet every day
 Wash your feet daily and dry them
 Socks must be clean and smooth
 Shoes must fit
 If you have a sore, go to the doctor;
Do not wait !
 Do not go barefoot
 Save your feet
29
Source: diabetes photos
Tips for Diabetes Self Management
You Can Take Charge Prevent Diabetes
Take an active role !
Engage in healthy lifestyle !
Restore balance !
Having an action plan is my first step to successful diabetes management











30
Keep my average blood sugar, cholesterol and blood pressure at a healthy level
Follow a healthy eating plan, do not smoke and avoid alcohol
Take the right amount of diabetes medications at the right time
Be physically active with exercise I like: Try to do It every day
Test my blood sugar regularly and record these test results
Visit my diabetes educator and doctor regularly
Check my feet every day
Have an eye exam every year
Aim to lose 1 - 1.5 kgs per month if I am overweight
Seek my family support
Feel happy
Diabetes Myth Busters
Quiz Assessment for Correct Answers
0-3 points – Still looking for magical cures? Maybe you should take the
quiz again and see if you're ready to demystify these
myths.
4-7 points – Not much gets by you, but there's still some information left
to learn. Ask questions, get the right answers, and help
make short work of diabetes mis-informers!
8-11 points – Nice job, Mythbuster! You know your stuff, and you won't
be duped by any diabetes misinformation. Now help
others know more by spreading your knowledge!
32
Source adapted from: http://www.dlife.com/diabetes/quiz/showQuiz.html?quizId=35
Diabetes Myth Busters

33
Source adapted from: http://www.dlife.com/diabetes/quiz/showQuiz.html?quizId=35
Diabetes Myth Busters

dfsafdadddddd

34
Source adapted from: http://www.dlife.com/diabetes/quiz/showQuiz.html?quizId=35
Diabetes Myth Busters

dfsafdadddddd


35
Source adapted from: http://www.dlife.com/diabetes/quiz/showQuiz.html?quizId=35
Thank-You !!
Questions?
Please fill out the survey
你是领导者 - 预防糖尿病
!!!
!!!
!l
!
!
!
!
!
!
!
!
不要
忽视糖
!"
尿病
"!
!
q
!
,!
1 1.5
!
q
q
q
q
q
q
q
q
q
q
Please share the Handout Tools
with your family / relatives
保持我的平均血糖，
!
胆固醇和血压在一个健康的水平
适时适量服用糖尿病药物
l遵循健康的饮食计划, 不吸烟，不饮酒
尝试喜欢的体育锻炼：坚持每天锻炼
定期检测 血糖并记录结果
定期拜访糖尿病专家和医生
每天检 查足部
年进行眼部检 查
如果超重，目标每月减重1至1.5公斤
我的家庭可以帮忙
保持愉悦
Ques*ons?!!Email:!Chinadiabetesinfo@gmail.com!!
Adapted from Sources: www.aadi.joslin.org; www.idf.org; www.cdschina.orrg
36
37
疑问？邮件：Chinadiabetesinfo@gmail.com