महामारी विज्ञान: खुली पहुंच

अमूर्त

Primary Prevention of Obesity and Type 2 Diabetes Mellitus

Zbigniew Szybiński

The prevalence of type 2 diabetes mellitus has exceeded 22million people in Europe and according to WHO, it will increase from 135 million in 1935 to 300 million in 2025. In 1989 Saint Vincent Declaration, elaborated by the International Diabetes Federation (IDF) called all the European countries to take action aimed at reducing the prevalence of type 2diabetes mellitus and its complications on the population level. Poland has signed the Declaration within the “Polish Multicenter Study in Diabetes Epidemiology (PMSD) program (implemented in the cities of Kraków, Å�ódź, and Lublin), financed by the Ministry of Health, and developed within the years of 1998– 2000. The program was coordinated by the Chair and Department of Endocrinology, Jagiellonian University, Collegium Medicum in Kraków. It revealed over 2 million diabetics in Poland, half of which represented the so-called unknown diabetes, diagnosed for the first time in the course of investigation. The prevalence of type 2 diabetes mellitus is still growing up owing to the increasing prevalence of its main risk factors: overweight and obesity, mainly the visceral type. The basic method of preventing of the type 2 diabetes mellitus within the PMSD is body weight reduction with an increase in physical activity and an appropriate educational program. The second basic goal of the program in the highest risk group of type 2 diabetes mellitus is to decrease blood pressure in hypertensive patients. Hypertension management is based on salt intake reduction, however, salt is the main carrier of iodine in the iodine prophylactic system in Poland so iodine must be additionally supplemented with additional carriers, such as milk or iodized mineral water: “Ustronianka” “Jodavit” or “Wysowianka”. The results of the program point out that the process of type 2 diabetes mellitus formation is reversible, but under the condition of early intervention. Additional parts of the program are economic burden evaluation and resort management. The resort of “Wysowa S.A.” has already been prepared to implement prevention and management in patients with overweight, obesity, and type 2 diabetes mellitus. On July 4-5, 2013, the International Ministerial Conference in Vienna took place. It was the first conference in the context of the “Global Plan of WHO Action in Prevention and Control of Non-communicable Diseases 2013-2020” (Health 2020) program, approved of by the 66th World Health Assembly and the 8th Global WHO Conference on Health Promotion in Helsinki. The conference also resulted in issuing the Vienna Declaration, which points at continuing the Ministerial Conference on Counteracting Obesity that took place in Istanbul in 2006. The documents raised the problems of healthy food and preventing food-related non-communicable diseases, as well as lead the way to renew the WHO “Action Plan for Food and Nutrition Policy” program, which expired in 2012.