COMMUNITY DIAGNOSIS FOR DIABETES MELLITUS
... Economic Impact/Cost of the Disease The cost of treatment refers to the overall expenses related to confinement, drugs and medications, and diagnostic tests are computed using this formula: average cost x no. cases. The drug of choice depending on the type of diabetes varies. In IDDM the drug of choice and only choice is insulin. Two major manufacturer Eli lilly and Novartis produce Humalin and Novalin respectively. However, there is a diverse array of treatment for NIDDM. One of the most popular and cost effective treatment options being glyburide and glipizide. With the exception of Glyburide extended release trade name ¡§ Glucotrol XL¡¨ manufactured by Pfizer and taken once a day; others need to be taken 2-3 times a day. However, the previously mentioned treatment alone does not control the blood sugar, drugs to control the absorption is added. Drug of choice being metformin, is available 500mg, 850mg and 1000mg take 3 times a day with meals and it costs approximately P8, 891/ year. Recently drugs such as Acrabose and Voglibose have been gaining popularity. Acrabose is available in 50mg and 100mg taken with 1st bite of each meal. Its cost for 50mg is P8, 289/ year. However due to its unpleasant side effects such as flatulence; its use have been less favored among patients. These also include the expenses for confinement in the hospital. A typical room in a hospital costs Php 800-1000 per day, and a typical confinement 3-5 days which depend on the complications from hyperglycemia/hypoglycemia. The computed cost of illness is the income lost due to illness or the cost not being able to work. It can be computed using minimum daily wage (Php275), number of days lost due to illness (3-5 days) and no. of persons ill (75M x 4.1%=3,075,000 persons). Therefore the total cost of illness is Php 2,536,875,000. The cost of early death using the difference of retirement age (65y.o.) and average death for diabetics (60y.o.) multiplied by annual income (Php275 x 240 days) is Php330,000 per person which further multiplied by total # of deaths (3,075,000 x 10%). And the total cost of early death is Php101,675,000. Cost of prevention covers the information campaign expenses to educate the people, which amount to a million per television advertisements and program in diabetes prevention. And lastly, the total economic cost is the sum of all mentioned above. II. APPRAISAL OF FACTS As mentioned earlier, DM is a non-communicable disease which affects all age groups. However, studies have elucidated that people are more prone to DM as they age. There are also more cases of DM in urban areas than in rural areas. Among the regions in the Philippines, DM is highly prevalent in the National Capital Region. The following are the factors that the occurrence of disease: Host Characteristics, Risk Factors and Time Determinant DM is classified as chronic, non-communicable disease observed in most people that have sedentary lifestyle and have incomplete consumption of fats. People who smoke, drinking alcohol and obesity can increase the risk of acquiring the disease. Also high fat diet, stress and menopausal period are also associated with DM. When a person has a fasting glucose equal to or greater than 110 and less than 126 mg/dl, they are said to have impaired fasting glucose. This is considered a risk factor for future diabetes, and will likely trigger another test in the future, but by itself, does not make the diagnosis of diabetes. A person is said to have impaired glucose tolerance when the 2-hour glucose results from the oral glucose tolerance test are greater than or equal to 140 but less than 200 mg/dl. This is also considered a risk factor for future diabetes. There has recently been discussion about lowering the upper value to 180 mg/dl to diagnose more mild diabetes to allow earlier intervention and hopefully prevention of diabetic complications. Diabetic person also have classical symptoms of polydypsia, polyuria and weight loss. Gender (esp. female), age with at least 45y.o., family history of diabetes which includes all blood relatives , hypertension >130/85 mmHg in adults gives a high tendency to get the disease Some of the factors involved in the development of insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes, which may account for 5% to 10% of all diagnosed cases are autoimmune, genetic, and environmental factors. While for non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes, may account for about 90% to 95% of all diagnosed cases of diabetes. Risk factors include older age, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes. In some studies, nearly 40% of women with a history of gestational diabetes developed diabetes in the future.Other specific types of diabetes result from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses. Such types of diabetes may account for 1% to 2% of all diagnosed cases of diabetes. IV. PRACTICAL APPLICATION Managing diabetes requires ongoing, daily self-management—ggood nutrition, regular physical activity, monitoring of blood sugar levels, and taking prescribed medications. Research shows that physical activity makes a great deal of difference in preventing or reducing the effects of Type II diabetes, as well as insulin resistance. A new emphasis on treating diabetes comprehensively; that is, managing not only blood glucose, but also blood pressure, and cholesterol; could save lives. Many organizations are helping prevent and treat diabetes by informing the public about this silent disease. First degree prevention First line of prevention would always be promoting health education to the ...