Diabetes is a significant and growing concern, with over 246 million people around the world living with the disease and another 308 million with impaired glucose tolerance. Depending on the resources of different nations, intervention has generally focused on optimizing overall glycaemic control as assessed by glycated haemoglobin (HbA 1c ) and fasting plasma glucose (FPG) values. Nevertheless, increasing evidence supports the importance of controlling all three members of the glucose triad, namely HbA 1c , FPG and postmeal glucose (PMG) in order to improve outcome in diabetes. As part of its global mission to promote diabetes care and prevention and to find a cure, the InternationalDiabetesFederation (IDF) recently developed a guideline that reviews evidence to date on PMG and the development of diabetic complications. Based on an extensive database search of the literature, and guided by a Steering and Development Committee including experts from around the world, the IDF Guideline for Management of Postmeal Glucose offers recommendations for appropriate clinical management of PMG. These recommendations are intended to help clinicians and organizations in developing strategies for effective management of PMG in individuals with Type 1 and Type 2 diabetes. The following review highlights the recommendations of the guideline, the supporting evidence provided and the major conclusions drawn. The full guideline is available for download at www.idf.org.
Three definitions of MS have been proposed by the National Cholesterol Education Program Adult Treat- ment Panel III (NCEP ATPIII), the World Health Organization (WHO) and the InternationalDiabetesFederation (IDF) [17-19]. Regardless of the criteria, five factors, are thought to comprise MS — large waist cir- cumference (WC; as indicator of central obesity), ele- vated triglycerides (TG), low high-density lipoprotein cholesterol (HDL-C) concentration, high blood pressure and elevated fasting plasma glucose. The most com- monly used definitions for the MS are the NCEP ATPIII, and the adapted ATP-III A proposed by the American Heart Association (AHA) following the ADA lowering of the threshold for impaired fasting glucose to 100 mg/ dl [20,21]. The IDF stressed the importance of waist circumference, using both more stringent and ethnic-/ race-specific criteria in the definition of MS. Recently,
Now a day in this our global world different challenges are occurring. The challenges are not limited to those challenges are including health problem. As we now currently, Education, Healthcare industries, government and non- governmental organization is worried about human life. Some health problems are very chronic and needs special treatment in order to save human life. Diabetes Diseases is clustered on such chronic diseases, therefore it needs special treatment in order to recover the patient. Mostly this diabetes disease (DD) found on women rather than men. In 2014, 8.5% of adults whose ages 18 and more than 18 had diabetes mellitus. By 2012 blood glucose was one of the causes of 2.2 million population death . According to the InternationalDiabetesFederation (IDF) report on 4 Nov 2017 more than 199 million women are living with diabetes as the report indicates .From those women most of them are reproductive based on the above information it is easy to think about this problem and it makes our heart think about it because those women are our mother, sister, wife and so on .As the report indicates in 2040 the number of women who are living with diabetes will increase from 199 million to 313 million .in this time this chronic and serious diseases killed a young people specially women throughout the world .In developing country like south Africa,sudan,nigeria,somalia,india,this Dangerous diseases distributed and killing up the young people that t affects both in economic and social development of the country Women are not aware how to treat the diseases using different mechanism including food type are recommended that is why we planned to do this system .this expert system has great role to minimize the death of people who have diabetes by providing advice and treatment for the patient as
Background. The World Health Organization reports a grim picture of the type 2 diabetes mellitus (T2DM) epidemic with sub-Saharan Africa bearing the brunt of this outbreak and South Africa is at the forefront. In South Africa, T2DM accounts for 58 deaths per day and is the fifth highest cause of death. Central to this alarming T2DM epidemic is the overweight and obesity tsunami that can be prevented. The purpose of this study was to determine whether the waist circumference cutoff for overweight proposed by the InternationalDiabetesFederation (IDF) are applicable to KwaZulu-Natal in monitoring overweight/obesity in rural and economically disadvantaged communities. Design and methods. Two hundred and forty nine nondiabetic adult subjects attending community health centers in KwaZulu-Natal Province who had not eaten any breakfast participated in the study. Anthropometric measures were done under trained supervision. Blood samples were collected for estimation of fasting insulin and fasting blood glucose levels. The following surrogate measures of insulin resistance were used: Homeostasis model assessment of insulin resistance
ADA: diagnosis according to criteria of the American Diabetes Association; AES: Advanced Encryption Standard; CHEERS: Consolidated Health Economic Evaluation Reporting Standards; CSRI: Client Service Receipt Inventory; EQ-5D-3 L: EuroQol-5D-3 L; GPs: general practitioners; ICERs: incremental cost- effectiveness ratios; ICTs: information and communication technologies; ICURs: incremental cost-utility ratios; IDF: InternationalDiabetesFederation; ISPOR: International Society for Pharmacoeconomics and Outcomes Research; iTAU: improved treatment-as-usual; MBCT: Mindfulness-Based Cognitive Therapy; MINI: Mini-International Neuropsychiatric Interview; NICE: National Institute of Clinical Excellence (UK); NNT: number needed to treat; PC: primary care; RCT: randomized controlled trial; WHO: The World Health Organization
There are several criteria for the assessment of the MetS, including the criteria produced by the WHO, the European Group for the Study of Insulin Resistance (EGIR), the National Cholesterol Education Program Third Adult Treatment Panel (ATP III) and the InternationalDiabetesFederation (IDF) . Diagnosis of the MetS requires certain risk factors, which are insulin resistance, obesity, hypertension, high TG, reduced HDL-choles- terol level, micro-albumin-uria and elevated plasma glucose. The WHO considered insulin resistance as the ma- jor risk factor required for MetS diagnosis. According to the EGIR, the presence of elevated plasma insulin plus two other factors (abdominal obesity, hypertension, elevated TG, reduced HDL-cholesterol or elevated plasma glucose) constitutes a diagnosis of the MetS. The ATP III criterion establishes the diagnosis by the presence of three of five factors of the MetS and there is no single factor required for this diagnosis . The IDF considers the presence of abdominal obesity, in the measure of waist circumference (WC), as the main factor, with two additional risk factors to be sufficient for MetS diagnosis -.
Abstract: Background: Biological and socio-behavioural variations exist in the epidemiology of metabolic syndrome (MetS). As the case detection of MetS increases in Nigeria describing its prevalence and risk factors remain relevant for proactive control interventions. Aim: This study was designed to describe the epidemiology of MetS among adult Nigerians in a rural hospital in Eastern Nigeria. Materials and Methods: A cross sectional study was carried out on 365 adult patients who were screened for MetS using InternationalDiabetesFederation(IDF) criteria: An Individual was considered to have MetS in the presence of WC ≥94 cm for men and ≥80 cm for women plus any two or more of the following: systolic and/or diastolic blood pressure ≥130/85 mmHg and/or hypertension on treatment; fasting blood glucose ≥ 100mg/dL and/or diabetes mellitus on treatment; triglyceride level ≥150 mg/dL and/or hypertriglyceridaemia on treatment and high density lipoprotein(HDL-C) cholesterol <40mg/dL for men or <50 mg/dL for women and/or HDL-C dyslipidaemia on treatment. The data collected included basic demographic variables, metabolic and nutri-behavioural risk factors. Results: The prevalence of MetS was 34.0%. MetS was significantly associated with old age(p=0.029), female sex(p=0.016) and physical inactivity(p=0.002). The most significant predictor of MetS was physical inactivity.(p=0.014, OR=4.58(1.52-9.63). The patients with MetS were four and half times more likely to be physically inactive compared to their non-MetS counterparts. Conclusion: This study has shown that MetS exist among the study population. The risk factors significantly associated with MetS were old age, female sex and physical inactivity. The most significant predictor variable was physical inactivity. Early primary and secondary prevention interventions should be a compelling health priority in the study area.
Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance occurring or recognised for the first time during pregnancy . GDM is a major global public health problem owing to its high preva- lence and adverse outcomes in the mother and the foe- tus or neonate. The InternationalDiabetesFederation (IDF) estimated that 21.4 million live births were affected with hyperglycaemia in pregnancy in 2013 globally, with GDM accounting for 90% of cases . The prevalence of GDM varies widely depending on the population and
There are currently two major definitions for metabolic syndrome provided by the InternationalDiabetesFederation (IDF) and the Revised National Cholesterol Education Program (NCEP) respectively. The revised NCEP and IDF definitions of metabolic syndrome are very similar and it can be expected that they will identify many of the same individuals as having metabolic syndrome. The two differences are that IDF excludes any subject without increased waist circumference, while in the NCEP definition metabolic syndrome can be diagnosed based on other criteria and the IDF uses geography-specific cut points for waist circumference, while NCEP uses only one set of cut points for waist circumference regardless of geography. These two definitions are much closer to each other than the original NCEP and WHO definitions.
BMI: Body mass index; CHD: Coronary heart disease; CI: Confidence intervals; DBP: Diastolic blood pressure; FPG: Fasting plasma glucose; HDL: High- density lipoprotein; IDF: InternationalDiabetesFederation; IRB: Institutional Review Board; LDL: Low-density lipoprotein; MENA: Middle East and North Africa; NCEP ATP III: National Cholesterol Education Program and Adult Treatment Panel III; NHANES: National Health and Nutrition Examination Survey; OR: Odds ratio; PHCC: Primary health care center; SAUDI-DM: Saudi Abnormal Glucose Metabolism and Diabetes Impact Study; SBP: Systolic blood pressure; SD: Standard deviation; UAE: United Arab Emirates; WHR: Waist-to-hip ratio
the InternationalDiabetesFederation (IDF) has estimated that 9.5 to 29.3 million people live with diabetes in the African Region of which, ¾ are undiagnosed . According to IDF, 80% of people with diabetes live in low- and middle-income countries. T2D represents 90% of cases and is associated with several complications, leading to morbidity, disability and premature mortality [2, 3]. Diabetes also carries a heavy economic burden for patients, households and health care systems [4, 5]. Prevention remains the best cost effective intervention to counteract this disease. Many studies have shown that interventions at pre-diabetic stage based on lifestyle changes [6-10] or medications  can prevent, or at least delay the progression of the disease. This means that early identification of people at high risk of T2D is necessary to enable faster implementation of preventive measures in order to reduce risk [12, 13]. The prevention of the disease is very cost-effective [14, 15]. Fasting blood glucose, 2h oral glucose tolerance test (OGTT) and glycated hemoglobin levels (HbA1c) are the recommended methods for diabetes screening . However, those methods are expensive for mass screening. Several risk scores are available and can help to identify subjects at risk for type2 diabetes. Before being used in practice, performance and validity of the tools should be evaluated in the population of interest . The FINDRISC for the Screening of Subjects at Risk for Type2 Diabetes is a powerful and valid tool in several Northern countries [18-22].
MetS . The World Health Organization (WHO) in 1998 and European Group for the Study of Insulin Resistance in 1999 provided definitions for MetS [10, 11]. The National Cholesterol Education Program- Adult Treatment Panel (NCEP/ATP) in 2001 , the American Association of Clinical Endocrinologists in 2003  and the InternationalDiabetesFederation (IDF) in 2005  also reported their definitions. It has believed that high prevalence of MetS is the reason for more recent study. Many studies have shown that the worldwide prevalence of MetS ranges from almost 10% to 84%. The prevalence of MetS is affected by geographic location, sex, age, race, sedentary lifestyle, high body mass index and ethnicity [15, 16]. Study of Cameron et al. indicated that the prevalence of MetS and its components is associated with genetic background, diet, levels of physical activity, smoking, family history of diabetes, and education level . Age-related study of Park et al. have revealed that the prevalence of MetS ranges from 20 to 70 years in males and females , while findings of Ponholzer et al. showed that prevalence of MetS ranges from 32.6% to 41.5% among
each region with the act “Provisions for the prevention and the cure of diabetes mellitus” . This law predates, by about 5 years, the recognition of special needs of chil- dren and adolescents with diabetes by the InternationalDiabetesFederation (IDF). In 2000, the International Society for Pediatric and Adolescent Diabetes (ISPAD) introduced guidelines stating that medical care should cover the whole territory and that all people with diabetes should have access to cost-effective evidence-based care . Since 2001, healthcare and its organization in Italy have been delegated to the 20 individual regions (political and administrative units); the legislative planning and its application vary widely among them [12, 13]. In 2003, the Italian Society of Pediatric Endocrinology and Diabetology (ISPED) developed clinical and organizational guidelines for the management of childhood/adolescent diabetes based on ISPAD guidelines and Italian law . A multi- disciplinary, specially trained team was established to assess the performance of each healthcare center. The impact of the new economical crisis in recent years makes this variation more evident and the “spending review” applied to the National Health Care System is matter of concern for many families with a child with diabetes. The aim of this study was to assess the organization of the pediatric care system in Italy, using data obtained from health care professional members of ISPED.
Methods: A cross-sectional study was conducted in 2017, among all adults ≥ 25 years of age. Participants were selected by strati ﬁ ed cluster sampling method, in ﬁ ve governorates (urban, camps and rural) of Gaza strip. Questionnaires on socioeconomic status, lifestyle and cardiovascular risk factors were completed for 2107 participants. The cardiovascular diseases included clinical history of coronary artery disease (CAD), Lower extremity artery disease (LEAD diagnosed as ankle brachial index < 0.90) and history of stroke. MetS was de ﬁ ned based on the InternationalDiabetesFederation criteria (IDF).
another global epidemic, that of diabetes mellitus (DM). Estimates from the InternationalDiabetesFederation show 285 million adults (corresponding to 6.4% of the world’s adult population) with diabetes in 2010, and this number is expected to increase to 439 million adults (corresponding to 7.8% of the world’s adult population) by 2030. The relation between these 2 epidemics is related not only to the above figures but also with the fact that there is an increased risk for type 2 DM with HIV infection  as well as its treatment, especially with protease inhibitors (PIs).[4-6] Antiretroviral therapy (ARVT)-induced type 2 diabetes is a challenging global burden and is of much concern due to the recognition of its long-term complications of cardiovascular risk associated with type 2 DM, especially in developing countries
care was the lack of drugs at the facilities (almost half of those interviewed 190/50.4%) Fig. 1. This forced clients to buy the necessary medicines from private outlets which was unaffordable to many. Other frequently re- ported challenges included: high cost of services such as paying for the glucose check and buying medicines due to stock outs in public facilities, lack of transport due to long distances to the facilities, long waiting times, shar- ing of service delivery points with other patients, late opening of the clinic, lack of laboratory equipment/sup- plies and inadequate number of health workers provid- ing diabetes services at the facilities. Some clients also reported poor attitude and tardiness of health workers in reporting to work, as well as lack of specialists as bar- riers to quality care.
While knowledge of diabetes risk factors is important to positively shift population distributions, no systematic review and meta-analysis, to our knowledge, has exam- ined the strength of associations between these risk fac- tors and T2DM in Africa as well as the role of urban and rural areas. Identifying the most important diabetes risk factors may (1) influence policies and improve the allocation of resources and (2) substantially halt diabetes incidence, increase health gains and prevent loss of productivity due to complications and premature death [1, 17]. However, since we cannot affect T2DM derived from non-modifiable risk factors such as family history, sex and age [18, 19], the study considers modifiable risk factors within the African context and aims to conduct a systematic review and meta-analyses of all available pub- lished data and qualified studies that have examined these risk factors and T2DM in Africa.
The association of IGT with MS and individual compo- nents of MS are shown in Table 2. Central obesity pre- sented the highest prevalence rate (52.7%) and followed by high blood pressure (44.7%) in this population. About 30% of the population displayed MS or any one of the other metabolic components. The odds ratio of IGT were increased 3.16-fold for MS, defined by the NCEP criteria, 2.84-fold for MS, defined by the IDF criteria, and 2.79-fold for the hyperglycemia factor, and all of them had greater than 60% probability to discriminate persons with IGT from persons without IGT. For AR%, the risk of IGT was over 60% attributable to both MS (by either definition) and hyperglycemia. For PAR%, about one third of IGT in the population might be at- tributable to MS (by either definition), hyperglycemia, central obesity and high blood pressure. In contrast, high TG and low HDL-C each had a lower association with IGT.