Monthly Archives: November 2019

World Diabetes Day | 2019 Awareness

Awareness Day/Month, , , , , ,

The campaign “World Diabetes Day (WDD)” was launched in 1991 jointly by International Diabetes Federation (IDF) and the World Health Organization (WHO) to address the growing concerns about the rising health issues posed by diabetes. It was officially recognized by United Nations in 2006 and is marked every year on November 14th, to commemorate the birth anniversary of Sir Frederick Banting, who along with Charles Best co‑discovered insulin in 1922 (1).

The condition

Diabetes is a metabolic disorder characterized by hyperglycemia which results from defects in insulin, secretion, insulin action, or both. A long‑term uncontrolled hyperglycemia can cause damage, dysfunction, and failure of the eyes, kidneys, nerves, heart, and blood vessels (2).

Classification:

Diabetes can broadly be classified into two main categories:

  • Type 1: In this case, body’s own immune system attacks and destroys the cells in pancreas that produce insulin. Although it can occur at any age, but it is prevalent more among children and young adults who require daily dose of insulin to stay alive.
  • Type 2: This situation arises when body does not make or use insulin efficiently. it is the most common type and can occur at any age, but middle‑aged and older people suffer from this condition mostly.

Other forms of diabetes include: Gestational diabetes, monogenetic diabetes, and cystic fibrosis related diabetes (3).

Symptoms

Symptoms associated with diabetes in general includes:

  • Increased thirst and urination
  • Increased appetite
  • Fatigue
  • Blurred vision
  • Numbness or tingling in the feet or hands
  • Sores that do not heal

Unexplained weight loss (4).

Causes

  • Type 1 diabetes is a result of auto immune destruction of beta cells of the pancreas. It may also occur due to certain genetic and environmental factors, such as viruses.
  • Several factors are involved in causing type 2 diabetes such as obesity, physical inactivity, insulin resistance, genes, and a history of diabetes in the family.
  • It is believed that gestational diabetes can be caused by hormonal changes during pregnancy along with genetic and lifestyle factors (4).

Prevalence and some statistics

  • People with diabetes have risen sharply from 108 million in 1980 to 422 million in 2014. Prevalence of diabetes among adults over 18 years of age has almost doubled from 4.7% to 8.5% within the same time period.
  • Prevalence of diabetes has become a serious health concern specially in middle‑and‑low‑income countries.
  • As of 2016, approximately 1.6 million deaths were attributed to diabetes only and in 2012, around 2.2 million deaths were reported globally due to high blood glucose.
  • As per an estimate by WHO, diabetes was the 7th leading cause of death in the year 2016 (5).

The campaign and the aim

At present WDD is the largest diabetes campaign having presence in more than 160 countries and a reach to more than 1 billion people. It is represented by a blue circle logo adopted by the UN resolution on diabetes on 2007. The color blue signifies the unity among global diabetes community against the epidemic (6).

WDD serves as:

  • Platform for promoting IDF advocacy efforts throughout the year.
  • Global driver to promote the importance of taking coordinated and concerted actions to confront diabetes as a critical global healthcare (1).

What’s in store for 2019?

WDD will be observed November 14th on Thursday this year which is just around the corner. On this day, millions of people around the globe organize events and activities raising awareness about diabetes (6). The campaign projects a dedicated theme every year which runs for one or more year. For the year 2019, the theme is ‘Family and Diabetes’ with an intent to raise awareness about the effect that diabetes has on the family and support network of those who are suffering as well as promoting the role of family in the management, care, prevention, and education (1).

Diabetes affecting family members

Diabetes can be considered as a family disease since the other members of the family somehow get affected if someone, specially a child is diagnosed with it. It is for this reason that it can be regarded as a form of chronic illness like any other chronic illnesses (7).

In a survey named DAWN2 involving 2000 family members of those affected by diabetes reported that 1/3rd of those experienced a notable burden and negative impact of diabetes, including effects on their emotional wellbeing, financial situation, leisure activities, and physical health (8).

Some of the risks, that family members of those affected by diabetes, experience, can be categorized as (9):

  • Biological risk: it has been shown that there exists a correlation (0.34 and 0.38) on BMI ranges of those suffering from diabetes and their partners. Partners of those with diabetes have been found to have higher BMI than their counterparts with non‑diabetic partner.
  • Health behavioral risk: a study involving multiethnic sample of > 500 patients suffering from type 2 diabetes and their partners showed that significant correlation exists between factors such as; consumption of fat, consumption of carbohydrates, total physical activity, and indulging in smoking and alcohol.
  • Affective/emotional risk: it is reported that female partners of diabetic patients have higher mean level of depressive effect. For male partner, the mean level of depressive effect was comparatively lower but still higher than that of the control subjects.

Role of family members in diabetes management

A family can play a crucial role in managing diabetes of the affected member. Having them involved in the self‑care interventions may help in achieving positive outcomes for the diabetics (10).

Families are required to share responsibilities and reconsider role of family as a result of diabetes. Reports have suggested that low level of conflicts, unity, and efficient organization patterns are linked with better treatment adherence (11).

The Family Approach to Diabetes Management (FADM) is a novel model that focusses on determining and exploring different ways of intra family communication having either positive or negative impact on clinical outcomes while keeping patient and family self‑management at forefront. It has been shown that engagement of entire family is easy to adjust as well as cost‑effective into standard diabetes care in addition to offering positive clinical outcome pertaining to general quality of life and A1C results (12).

Studies have shown that family members while participating in health interventions for diabetes care improves their own knowledge about the disease and inculcate skills necessary to support their loved ones. Family’s participation benefits their own health behaviors and health outcomes (10).

Turacoz Healthcare Solution is committed to raise awareness about diabetes management, prevention and educating people so as to make them help their near and dear ones suffering from this chronic lifestyle disorder to maintain and live a healthy life. Family’s engagement in diabetes care can significantly improve the outcomes and also make other family members learn about the management of diabetes.

If you have any queries, email us at [email protected]

 

References 

  1. About World Diabetes Day. International Diabetes Federation. Available at: https://worlddiabetesday.org/about/
  2. Diagnosis and classification of diabetes mellitus. American Diabetes Association; 2013: 36(S1). 67‑74. Available at:https://care.diabetesjournals.org/content/36/Supplement_1/S67
  3. What is diabetes? National Institute of Diabetes and Digestive and Kidney Disease. Available at: https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes
  4. Symptoms and causes of diabetes. National Institute of Diabetes and Digestive and Kidney Disease. Available at:https://www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes
  5. World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/diabetes
  6. Getting Ready for World Diabetes Day 2019. Diabetes self‑management. Available at: https://www.diabetesselfmanagement.com/blog/getting-ready-world-diabetes-day-2019/
  7. The family approach to diabetes management: Theory into practice toward the development of a new paradigm. Diabetes Spectrum. 2004; 17(1): 31‑36. Available at: https://spectrum.diabetesjournals.org/content/17/1/31
  8. Family matters in diabetes. The Lancet Diabetes and Endocrinology. 2018; 12(6): 911. Available at: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(18)30317-6/fulltext
  9. Fisher L. Family relationships and diabetes care during the adult years. Diabetes Spectrum. 2006; 19(2): 71‑74. Available at: https://spectrum.diabetesjournals.org/content/19/2/71
  10. Baig AA, Benitez A, Quinn MT et al. Family interventions to improve diabetes outcomes for adults. 2015; 1353(1): 89‑112. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624026/
  11. Ahmed Z, Yeasmeen F. Active family participation in diabetes self‑care. A commentary. Diabetes Management. 2016; 6(5): 104‑107. Available at: https://www.openaccessjournals.com/articles/active-family-participation-in-diabetes-selfcare-a-commentary.pdf
  12. Solowiejczyk J. The family approach to diabetes management: Theory into practice toward the development of a new paradigm. Diabetes Spectrum. 2004; 17(1): 31‑36. Available at:  https://spectrum.diabetesjournals.org/content/17/1/31

Diabetes Prevention Tips

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According to statistics by the WHO, “The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014.” Also, “In 2016, an estimated 1.6 million deaths were directly caused by diabetes. Another 2.2 million deaths were attributable to high blood glucose in 2012.”
It is astounding how many people are affected by this chronic disease. Diabetes occurs when the pancreas does not produce enough amounts of insulin for the body or when the body cannot effectively make use of the insulin it produces. Insulin is essential to the body as it is responsible for regulating blood sugar. Unbalanced (high) blood sugar levels are what causes diabetes.
Diabetes is categorized into the following four types:

Figure 1: Types of diabetes

Insulin is the hormone which is highly essential for maintaining proper blood sugar levels, for the adequate functioning of the entire body. If, for some reason the body produces unbalanced levels of this hormone, over time, high blood glucose can lead to the following problems:

Figure 2: Problems due to high blood glucose levels

 

Diabetes imposes many restrictions on life and one can take several steps to prevent developing it. Here are some of the suggested diabetes preventions tips:

Exercise daily:

The most common advice anyone can give to stay mentally and physically fit is to workout daily. The applications of exercising daily are endless and when it comes to preventing diabetes, it is highly beneficial. Exercising regularly increases the insulin sensitivity of your cells. This basically means that less insulin is used up to keep your blood sugar levels under control.

A study published on NCBI found that people with prediabetes who trained under moderate-intensity experienced an increase in insulin sensitivity by 51%. And people who adopted high-intensity exercises measured an increase of 85%.

Even though the results vary, it’s totally up to you to choose what style of training program you wish to follow. Straining your body will do you no good, but also taking it casually will never be beneficial.

Quit Smoking:

Smoking has been associated with many major diseases and conditions. It has been proven to be the major cause of many health conditions, which includes heart diseases and cancer to various organs, such as the lungs, mouth, breast, digestive tract and prostate. Tobacco usage has no proven benefits and even second-hand exposure to tobacco smoke can be very harmful.

A research paper published in 2012 on the NCBI website states that smoking and second-hand smoke exposure is linked to type 2 diabetes.

An analysis of over one million people, showed that smoking was found to increase the risk of diabetes by 44% in average smokers.

Once you quit smoking, the effects on the body it had seem visible as they subside. Smoking is closely linked to the risk of diabetes, and quitting has been shown to reduce this risk.

Avoid processed foods:

Fitness cannot be achieved if you aren’t doing justice with your diet. Any experienced athlete or bodybuilder will always say one thing, 70% diet and 30% gym is what results in a fine toned body. Processed or “junk” food damages your body from both the inside and outside. It is linked to various heart diseases, obesity and to diabetes.

These food products are high in vegetable oils, refined grains and preservatives, which when consumed over a long period of time, increase the risk of developing diabetes. Cutting back on these unhealth packaged foods can prove to be very helpful.

To be healthier, from both the inside and outside, it is recommended to adopt a diet consisting of minimum amounts of carbs and a diet high in fiber. Also portion control is one thing that people should be conscious about. Believe it or not, eating an unhealthy amount of healthy food can also lead to many unwanted problems.

Visit your doctor from time to time:

Get yourself checked annually. One of the best ways to stay on top of any disease or ailment is to be aware of it before the symptoms start to set in. At your annual physical, make sure to get a blood pressure check, an eye exam, and screenings for other complications such as kidney damage, nerve damage, and heart disease. To make sure you aren’t developing diabetes, blood-glucose levels also need to be measured.

Prevention is always better than cure! Follow these tips to notice a change in your lifestyle.

Turacoz Healthcare Solutions aims to spread awareness about diabetes. We urge the people to exercise regularly and stay fit. Adopting a balanced diet and limiting the intake of sweet substances is highly beneficial and helps in cutting down the risk of developing diabetes. Smoking is one habit that should be dropped. Quitting the use of tobacco products not only helps with reducing the risk of diabetes but also other bodily diseases such as cancer and heart diseases.

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Medical Writing for Disease Management Platforms

Disease and Treatment, , , , ,

Disease management programs (DMPs) are defined as “structured treatment plans that aim to help people manage their chronic disease in a better way and to maintain as well as improve quality of life”. The main components of disease management programs are mentioned in Figure 1.

Figure 1: Components of Disease Management Software

By application, the care management solution is classified into chronic care management, disease management and utilization management.

Disease Management Software’s

According to Markets and Markets™ report, the disease management software market is expected to reach USD 37.94 billion by 2027 from USD 14.12 billion in 2019. This may be attributed to the rising geriatric population and burden of chronic diseases.

The disease management software is used to manage, monitor, and process patient data by connecting to electronic health record (EHR) and other healthcare data sources. It aims to reduce healthcare costs and promote government initiatives to assist patient-centric care. The high growth in this segment can be attributed to the ability of these solutions to reduce the cost of care with the help of protocol management and prevent episodes of ill health through comprehensive health management.

To be included in Disease Management Software category, a product must have the following characteristics as mentioned in Figure 2.

Figure 2: Characteristics of Disease Management Software

Some of the examples of disease management software are mentioned in Figure 3.

Figure 3: Examples of Disease Management Software

Mobile Health Apps for Disease Management

Due to widespread use of smart phones and tablet computers, disease management via mobile health apps is easy and is expanding rapidly. Around 3.7 billion apps were downloaded in 2017 and is expected to grow by 16% within the next year. Many apps are available in play store and iTunes for clinical disease management and patient self-management of conditions including asthma, diabetes, heart disease, cancer, and even autism and insomnia. These apps help both doctors and patients as money can be saved by patients and doctors can save on labour force. Some of the apps for chronic disease management are mentioned in Figure 4.

Figure 4: Examples of Disease Management Applications

Poor Usage of Disease Management Software’s and Mobile Apps

One of the reasons why the healthcare apps or software’s fail is because of the lack of understanding about the healthcare apps. Most of the health care apps get uninstalled either due to the highly scientific content which is difficult for the laymen to understand. Apps with very basic scientific content also fail to impress the audience. Therefore, it essential to involve a medical writer who has a scientific background and knows the subject comprehensively. The content for such software’s or apps must be developed based on patient’s requirement, target audience and should be specific to a region.

Role of Medical writing in Developing Health Related Software’s and Mobile Apps

According to Grand View Research, global medical writing industry is expected to reach USD 3.75 billion by 2026. Medical writers are involved in analysis and reporting of retrospective and prospective clinical trials, research methods (descriptive and predictive), health economics, and evaluation of disease management initiatives. Medical writers also play a key role in developing applications for mobile devices that are used in multiple ways, such as:

  • Disease management
  • Continuing education and training
  • Medical reference and information-gathering
  • Practice management and monitoring

The medical writer creates informational or instructional materials for use in health or medical context. These materials allow different audiences to understand health and medical situations or practices, perform certain health or medical-related activities, or use a health/ medical product/ mobile health apps or device. Medical writers must have the following skills to develop medical content:

  • They must possess medical and therapeutic knowledge, and must have understanding about the recent regulations and technical guidelines
  • They must have mastery in language and grammar, proof reading and editing skills, ethical and legal issues related to writing
  • They must have creative writing skills to articulate the scientific information in clear and approachable language
  • As scientific writers are involved in creating content for mobile medical apps and other disease management software’s, it is essential for them to possess instructional designing skills

Writer Groups Initiative in Developing Disease Management Programs

The heterogeneity of disease management programs has made it difficult to compare and evaluate different programs. The American Heart Association’s Disease Management Taxonomy Writing Group developed a taxonomy or system of classification to classify and compare different disease management programs and to inform efforts to identify specific factors associated with effectiveness.

The writers did a MEDLINE (Medical Literature Analysis and Retrieval System Online) search on the terms heart failure, diabetes, and depression, together with disease management, case management, and care management. English articles published between the time period 1987 and 2005 were considered for the program. The following studies were considered:

  • Interventions designed to improve outcomes and/or reduce medical resource utilization in patients with,
  1. Heart failure
  2. Diabetes
  3. Depression
  • Clearly defined protocols with at least two prespecified components traditionally associated with disease management

A taxonomy was developed by the writer’s group with eight domains. A graphic representation of the taxonomic structure and subdomains are found in the Figure 5.

Figure 5: Taxonomic Structure and Subdomains

Turacoz Healthcare Solutions understands its professional responsibility and takes an initiative to make authors and medical writers aware about their role in developing disease management programs. Turacoz is a medical communication company that provides scientific/medical writing support to the industry and academicians.

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