New guidelines on diabetes self-management education and support

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Management of diabetes is multidisciplinary and a team approach is the basis of care of the patient with diabetes, who is at the center of this team.

Diabetes self-management education (DSME) is a very important aspect of management in all patients with diabetes, including those with prediabetes. Optimal control of blood sugar is important; but, it is also important to control other risk factors such as hypertension, dyslipidemia in order to prevent the macrovascular and microvascular complications of diabetes. Because of the need for lifestyle modifications, patients with diabetes are themselves responsible for the day to day management of diabetes, but with the support of the doctor.

For the first time, the American Diabetes Association (ADA) and American Association of Diabetes Educators (AADE) have combined education and support (DSMES) and released new standards to help diabetes educators and medical providers establish and sustain patient care models, programs and teams for people with diabetes and their caregivers. These guidelines will be published in the September 2017 issues of Diabetes Care and The Diabetes Educator.

These standards relate to organizational structure, participation of community stakeholders, access, program coordination, instructional staff, individualizing diabetes education to the need of each patient, monitoring of patient progress and quality improvement. An up-to-date, evidence-based, and flexible curriculum provides education.

These standards emphasize that DSME alone does not translate into effective self care. Ongoing support is very important to improve patient outcomes.

The standards defined in these recommendations can be applied to both small solo practices, as well as large, multicenter facilities.

(ADA Press Release, July 28, 2017)
Dr KK Aggarwal
National President IMA & HCFI

Recipient of Padma Shri, Dr BC Roy National Award, Vishwa Hindi Samman, National Science Communication Award & FICCI Health Care Personality of the Year Award
Vice President Confederation of Medical Associations of Asia and Oceania (CMAAO)
Past Honorary Secretary General IMA
Past Senior National Vice President IMA
President Heart Care Foundation of India
Gold Medalist Nagpur University
Limca Book of Record Holder in CPR 10
Honorary Professor of Bioethics SRM Medical College Hospital & Research Centre
Sr. Consultant Medicine & Cardiology, Dean Board of Medical Education, Moolchand
Editor in Chief IJCP Group of Publications & eMedinewS
Member Ethics Committee Medical Council of India (2013-14)
Chairman Ethics Committee Delhi Medical Council (2009-15)
Elected Member Delhi Medical Council (2004-2009)
Chairman IMSA Delhi Chapter (March 10- March 13)
Director IMA AKN Sinha Institute (08-09)
Finance Secretary IMA (07-08)
Chairman IMAAMS (06-07)
President Delhi Medical Association (05-06)

A healthy lifestyle can reduce risk of dementia

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Lifestyle has a major role to play in the health and well-being of a person. It’s not just physical health that benefits from a healthy lifestyle, but also mental health.

Dementia is usually regarded as a part of the normal aging process. But it is not always so. Dementia is also associated with lifestyle factors. And, the risk of dementia can be reduced by simple but effective lifestyle modifications. This is the key message from a new report of The Lancet Commission on Dementia Prevention, Intervention, and Care, presented at the recently concluded Alzheimer’s Association International Conference (AAIC) 2017 on July 20, 2017 and also published in The Lancet.

The report has identified nine lifestyle factors (as below) during the course of life – early, middle and later – that influence the risk of dementia. Many of these factors can co-occur.

The Report has for the first time considered social isolation and hearing as being pertinent to dementia. The level of education was also found to be an important risk factor. Poor education has been correlated with poor cognition.

1. Early life level of education
2. Midlife hypertension
3. Midlife obesity
4. Midlife hearing loss
5. Later life smoking
6. Later life physical inactivity
7. Later life social isolation
8. Later life depression
9. Later life diabetes

Prevention is always better than cure. These factors are potentially modifiable and addressing them timely can prevent dementia in a large number of people.

In addition to well-controlled hypertension and diabetes, early treatment of depression, weight loss, smoking cessation, being socially active, increasing physical activity, it is also important to engage in mentally stimulating and challenging exercises to keep the brain active. Develop a hobby, solve crossword puzzles, play chess or such challenging games to stay mentally active.

A healthy lifestyle adopted early in life builds up cognitive reserve for later life. It is important that we also advise our patients to start making positive lifestyle changes for a healthy old age.

(Source: Medscape)

Dr KK Aggarwal
National President IMA & HCFI

Recipient of Padma Shri, Dr BC Roy National Award, Vishwa Hindi Samman, National Science Communication Award & FICCI Health Care Personality of the Year Award
Vice President Confederation of Medical Associations of Asia and Oceania (CMAAO)
Past Honorary Secretary General IMA
Past Senior National Vice President IMA
President Heart Care Foundation of India
Gold Medalist Nagpur University
Limca Book of Record Holder in CPR 10
Honorary Professor of Bioethics SRM Medical College Hospital & Research Centre
Sr. Consultant Medicine & Cardiology, Dean Board of Medical Education, Moolchand
Editor in Chief IJCP Group of Publications & eMedinewS
Member Ethics Committee Medical Council of India (2013-14)
Chairman Ethics Committee Delhi Medical Council (2009-15)
Elected Member Delhi Medical Council (2004-2009)
Chairman IMSA Delhi Chapter (March 10- March 13)
Director IMA AKN Sinha Institute (08-09)
Finance Secretary IMA (07-08)
Chairman IMAAMS (06-07)
President Delhi Medical Association (05-06)

May Measurement Month

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As you are well aware, hypertension has been long recognized as one of the major risk factors for cardiovascular disease and premature deaths worldwide. It is estimated to cause 9.4 million deaths and 7.0% of disability-adjusted life years (DALYs).

In India, it exerts substantial public health burden on cardiovascular health status and the health care system. It is estimated to account for 10.8% of all the deaths and 4.6% of DALYs in the country.

Indian Medical Association is collaborating with Indian Council of Medical Research (ICMR), who in turn, is collaborating with Centre for Chronic Disease Control – WHO Collaborating Centre and Public Health Foundation of India to observe May 2017 as “May Measurement Month”, which is a joint initiative between the International Society of Hypertension and World Hypertension league.

As a part of this international project, it has been decided to monitor the blood pressure of over 25 million people around the globe with India getting a target of 2.5 million in this month.

Indian Medical Association has been assigned, as a participant of this initiative, to ensure that each and every member of the Association monitors the blood pressure of at least 20 patients per day for the whole month starting from 1st May 2017.

Under this project, all patients between 18-65 years of age are to undergo blood pressure monitoring 3 times in one go with a gap of one minute each through mid-left arm sitting position.

A link to download the data collection tool for Android phones is appended below.

We call for the participation of one and all in IMA to achieve the set target for the project as above and raise the IMA flag higher in the international arena.

(Dr KK Aggarwal) (Dr RN Tandon)
National President, IMA Hony Secy Gen, IMA

For Study material, click to download:-
1. Patient_Information_sheet
2. FAQs
3. 10 Tips
4. Project Flyer
5. Matter for Standee
6. Patient Informed Consent format
7. Information sheet for volunteers to use when advising members of the public found to be hypertensive with blood pressure readings of 140/90 or above
8. Measurement card format
9. Printable Excel sheet format for records of persons checked

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