Diabetes in the adult population is essentially a cardiovascular disease. This viewpoint is especially true of the type-2 variety of this condition. The constellation of clinical symptoms and signs mediated by a combination of obesity, insulin resistance and hyperlipidaemia is often associated with diverse complications and co-morbidities representing a much wider spectrum of chronic neurological, gynaecological, renal and mental health conditions.
The escalating and complex burden of type-2 diabetes is a demographic feature of population statistics in most parts of the world. Often underestimated in this context is the socioeconomic and financial burden of the disease, manifest in entire communities and population groups in the low and middle-income countries of western and sub-Saharan Africa.
75 percent of African countries lack the necessary primary data on diabetes prevalence to assess the overall impact on productivity and consumption of health resources. 70 percent of diabetics in this region remain undiagnosed while per capita expenditure on diabetes care remains significantly behind most other regions of the world.
The total estimated cost of diagnosed diabetes in the United States in 2017 was $327 billion, including $237 billion in direct medical costs and $90 billion in reduced productivity.
By comparison, the UK National Health Service (NHS) spends an estimated £14 billion each year (10 percent of its annual budget) on the treatment of 3.5 million patients diagnosed with diabetes and associated co-morbid illnesses, a figure not calculated to include the cost of absenteeism, early retirement due to complications or the cost of social benefits and other entitlements applicable as a result of chronic ill health.
Far from being a statement about affordability, this raises significant concern regarding the reality of a worldwide diabetes ‘epidemic’ and the current capability of the world’s most vulnerable nations and communities to withstand the clinical, socioeconomic and fiscal requirements of this debilitating and aggressive chronic disease.
Diabetes in the adult population is essentially a cardiovascular disease. This viewpoint is especially true of the type-2 variety of this condition. The constellation of clinical signs and symptoms mediated by a combination of obesity, insulin resistance and hyperlipidaemia is often associated with diverse complications and co-morbidities representing a much wider spectrum of chronic metabolic conditions affecting several systems of the body.
Diabesity ’23 focuses on the evidence-based management of diabetes and obesity in primary and secondary care. It is the first in a series of 7 continuing medical education Masterclasses and seminars aimed at ‘Navigating Diabetes Care’ through the complexities and challenges frequently encountered in the diagnosis and treatment of this serious and debilitating disease.
The Diabesity ’23 Masterclass is organised and hosted by BeyHealth Consulting in collaboration with the Duchess International Hospital and in partnership with Medtronic. The Navigating Diabetes Care series comprises 7 CME accredited workshops and Masterclasses leading up to the 2023 edition of the annual primary care diabetes conference.
This Masterclass contributes a specific dimension to the discussion on evidence-based approaches to the management of type-2 diabetes and related cardiovascular disease. It outlines both surgical and non-surgical treatment options aimed at encouraging weight loss and addressing the effects of type-2 diabetes and associated metabolic disease.
The programme highlights the true financial cost of managing type-2 diabetes and examines the clinical, psychological and social implications of this complex and increasingly sub-Saharan healthcare phenomenon.
The Diabesity ’23 Masterclass is suitable for General Practitioners (GPs), specialist doctors in secondary care, nurses, medical directors, hospital administrators, pharmacists, dieticians, allied health professionals and primary and secondary care providers and practitioners involved in the management of type-2 diabetes and associated chronic disease.
Speakers at the 2023 Navigating Diabetes Care series will present a fresh and expert appraisal of the subject through a variety of clinical and allied health perspectives. Each session will broaden delegates’ understanding of this vast and significant global health challenge and aim to focus attention on a specific area of consideration in relation to the wider aims of the programme. The lecture schedule includes a full list of speakers for each session of the 7 Masterclass programmes.
Themes and objectives throughout Navigating Diabetes Care 2023 are organised into the following key Masterclass streams:
M1 – Type 2 diabetes and cardiovascular risk
M2 – Macrovascular and microvascular complications
M3 – T2DM guidelines, diagnosis and treatment
M4 – T2DM and mental health
M5 – Diabetes multi-morbidity and complications
M6 – Healthcare funding, policy and administration
By the end of the series, delegates will be expected to have:
This Masterclass qualifies you for 10 CPD Points provided you physically attend the Masterclass
This session introduces the central themes of the programme. It emphasises the importance of adopting an individualised approach to diabetes care, tailored to the needs and circumstances of the patient and taking into account personal preferences, co-morbidities, life-expectancy and overall quality of life. It examines the pros and cons of aggressive long-term treatment interventions in frail, elderly patients and considers available evidence to support individualised treatment decisions in such circumstances.
This session focuses on criteria, tools and thresholds for making a diagnosis of diabetes in adult patients. It highlights important differences between type 1 and type 2 diabetes and examines the increasingly blurred distinctions between these conditions. The session considers intermediate variations, such as MODY and LADA and examines aetiological differences in comparison with the more established forms of the disease. The so-called “type 3 diabetes” provides an early introduction to the concept of insulin resistance and lays the foundation for the subsequent session on Alzheimer’s disease and mental health.
This session examines the combination of metabolic abnormalities arising from insulin resistance and adipose tissue dysregulation. It discusses the concept of “Diabesity” and evidence-based modalities for the treatment of type 2 diabetes in ageing and overweight patients. The session identifies risk factors contributing to the presentation of Metabolic Syndrome X and explores the condition’s causal relationship with coronary heart disease in general.
There is no cure for type 2 diabetes. Reversing the condition to a state of diet-control is, however, possible through engaging with the discipline of a well-balanced diet, regular exercise and maintaining a healthy weight. This session explores practical dietary steps and lifestyle choices necessary to maintain wellbeing, regulate blood sugar and prevent the onset of complications despite the presence of the disease.
Despite increasing evidence that Bariatric surgery offers significant benefit in achieving effective weight reduction, good glycaemic control and overall reduction in cardiovascular risk in obese patients with type 2 diabetes and metabolic disease, these procedures are associated with increased surgical morbidity and mortality, longer hospitalization, and increased rates readmission in patients with a higher BMI. This session explores the less invasive approach offered by Intragastric Balloon Therapy (IGBT) and considers the relatively recent development of endoscopic bariatric therapies in general.
This session explores the causal links and associations between diabetes and mental health disorders such as depression and cognitive decline in older adults. It builds on earlier discussions on atherosclerosis and cardiovascular complications in highlighting an increased predisposition towards Alzheimer’s and vascular dementia in patients with poorly controlled type-2 diabetes. It discusses the diabetogenic potential of commonly prescribed antipsychotic medication and corresponding effect of mental illness on drug compliance and treatment. The session goes further to explore the question of mental capacity and informed consent in the treatment of co-existing dementia and diabetes-associated chronic disease.
Retinopathy is the most common ocular manifestation of type 2 diabetes. This session discusses the aetiology and effects of this insidious and sight-threatening microvascular complication and examines the correlation between diabetic retinopathy, nephropathy and long-term glucose control. It outlines the benefits of retinopathy screening in effective treatment and care of type 2 diabetic patients and sets out the evidence in support of population screening as an integral part of a periodic diabetic review.
This session lays a useful foundation for subsequent sessions on type 2 Diabetes and cardio-renal disease by examining the management of high blood pressure in a variety of clinical circumstances. It provides an overview of hypertensive disease and contextualises evidence-based treatment guidelines relevant to the management of this commonly occurring condition. The session focuses eventually on precise implications of high blood pressure in patients with type 2 diabetes and chronic kidney disease (CKD) and discusses treatment guidelines directly applicable to this diverse and vulnerable group of patients.
Most oral agents used in the treatment of diabetes function either by encouraging production of Insulin or by enhancing its action on peripheral organs and tissues. A grasp of the nature and mode of action of this important peptide hormone is fundamental to our understanding of the aetiology and treatment of type 2 diabetes. In this final session of the Diabesity Masterclass, Dr Fasanmade discusses the central role and significance of Insulin in the management of type 2 diabetic patients. He considers important indications, advantages and potential pitfalls of new generation (oral) DPP-4 and SGLT2 inhibitors vis-s-vis treatment regimens based on “older”, established antidiabetic agents such as Metformin, Sulphonylureas and Thiazolidinedione’s (Glitazones). The session traces the care pathway of the typical patient and presents helpful evidence to support the use of various treatments in optimising care in elderly patients with co-morbid chronic conditions and co-existing cardiovascular disease.