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The concept of Diabetes & CV risk: A lifetime risk challenge

Cardio Diabetes Master Class European chapter Munich, Germany May 6-8, 2011. The concept of Diabetes & CV risk: A lifetime risk challenge. Presentation topic. Priorities in the management of type 2 diabetes: Past, present and future. Slide lecture prepared and held by:.

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The concept of Diabetes & CV risk: A lifetime risk challenge

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  1. Cardio Diabetes MasterClass Europeanchapter Munich, Germany May 6-8, 2011 The concept of Diabetes & CV risk:A lifetime risk challenge Presentation topic Priorities in the management of type 2 diabetes: Past, present and future Slide lecture prepared and held by: Sir George Alberti, MD Diabetes UK Chairman Newcastle, United Kingdom

  2. TYPES OF DIABETES “Diabetes mellitus … manifests itself in two principle clinical forms (a) acute and (b) chronic. Acute diabetes usually occurs in persons under 40 years of age … in children and young adults. Chronic diabetes … occurs as a rule in elderly people … and often in those who are … decidedly obese. Saundby, 1907

  3. GROWING RATES OF DIABETES WORLDWIDE • 30 millionpeople in 1985 • 100 million in 1994 • 200 million in 2003 • 380 millionby 2025 • 3.8 milliondeaths per year

  4. 53.2 64.1 21% 28.3 40.5 43% 24.5 44.5 81% 67.0 99.4 48% 16.2 32.7 102% 10.4 18.7 80% 46.5 80.3 73% World 2007 = 246 million 2025 = 380 million Increase 55% Global projections for the diabetes epidemic: 2007-2025 (millions) IDF Atlas 2006 Diabetes Atlas, 3rd edition, IDF 2006

  5. 93.2 100 Women 54.0 70 Men 40.3 42.1 40 27.6 21.3 15.8 11.6 Risk of type 2 diabetes 10 8.1 6.7 5.0 4.4 4.3 5 2.9 2.2 1.5 1.0 1.0 1.0 0 <22 <23 23- 24- 25- 27- 29- 31- 33- 35+ 23.9 24.9 26.9 28.9 30.9 32.9 34.9 Body mass index (kg/m2) The relationship between BMI and the risk of developing type 2 diabetes Type 2 diabetes, the metabolic syndrome and cardiovascular disease in Europe

  6. Android (Apple) vsGynoid (Pear) Obesity Jean Vague 1947

  7. PRIORITIES FOR THE MANAGEMENT OF TYPE 2 DM • Early aggressive management of glucose • ?start at “prediabetic” levels? • Early aggressive management of CVD risk factors

  8. PRIORITIES FOR THE MANAGEMENT OF TYPE 2 DM Key Challenges • Prevention • Behavioural change • Cellular and molecular mechanisms • Genetic basis?? • Stem cell therapy • B-cell replacement/regeneration • Safe, effective insulin sensitisers • Anti-obesity agents • CVD prevention

  9. THE UNMET NEEDS: TREATMENT • Better education • Effective behavioural therapy • Preservation of B-cell function • Specific prevention of complications • Better monitoring of control • Prevention of cardiovascular disease • Societal interventions • INDIVIDUALISED THERAPY

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