THESIS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY (PhD) - PDF Free Download

Insulin dependent diabetes mellitus type 2 icd 10

According to latest International Diabetes Federation IDF estimations more than million people suffered from diabetes worldwide inand the number of T2DM patients részletes típusú cukor dia cukorbetegség kezelési módszerek reach million by [1]. The number of patients increasing continuously as population grows insulin dependent diabetes mellitus type 2 icd 10 societies grow old.

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The most important risk factors behind this epidemiological trend are urbanization, obesity and physical inactivity. The estimations for the T2DM prevalence in Hungary show considerable heterogeneity. The routine data collection systems, which register different prevalences, are the following: Hungarian Central Statistical Office HCSO collects data on diabetes mellitus prevalence without having a formal case definition.

The general practitioners are obliged to report the age and sex specific number of cared patients in every second year. The national report on diabetes mellitus prevalence is published by HCSO biannually. Nowadays, 11 counties are involved and more than GPs. It monitors incidences and prevalences of diseases with great public health importance with declared case definition and quality checking system in a sample representative by age and gender for the adult Hungarian population.

Diabetes is one of the monitored diseases.

According to specification, - 4 - 5 it should be repeated every five years, to create a statistical dataset, from which predefined health-indicators could be calculated. Eurostat experts designed the standard questionnaires to collect self-assessed data.

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The survey was conducted on a representative sample. Comparing the data, collected in in these diabetes-related data collection systems, reliable system e.

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The estimations for younger age groups do not differ from each other []. Figure 1 Figure 1.

the International Diabetes Federation - IDF DIABETES ATLAS

The corresponding incidences were 0. It was in harmony with a survey based diabetes mellitus prevalence, which estimated the prevalence of diabetes mellitus among year-old population as 7. These observations show that although T2DM occurrence is not neglectable in younger age groups, a sharp increase can be detected from the age of Figure 2 - 5 - 6 Figure 2.

Costs of drug treatment and hospitalizations have a large impact on economic burden.

THESIS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY (PhD)

Beside the huge economic burden the quality of life also decreases due to complications and comorbidities of T2DM [11]. Most of this burden is related to the non-fatal major adverse outcomes blindness, neuropathy, renal failure and loss of a toe or footand nearly half of T2DM patients die of cardiovascular diseases [12]. Diabetes mellitus related death is a significant part of premature mortality.

In Hungary it was 1. Clear and convincing evidences exist that early diagnosis and the appropriate glucose control play a key role in this respect [].

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In many insulin dependent diabetes mellitus type 2 icd 10 certain data are completely lacking, others are quite old [17]. Hungary is not an exception in this respect, unfortunately. The prevalence of peripheral artery disease was lower as well The difference was slighter, but Hungary had still better values by coronary heart disease By stroke prevalence Hungary had higher values 7.

This set involves four process indicators annual HbA1c testing, annual LDL cholesterol testing, annual screening for nephropathy and annual eye examinationtwo proximal outcome indicators HbA1c control, LDL cholesterol control and three distal outcome indicators lower extremity amputation rates, kidney disease in persons with diabetes mellitus, cardiovascular mortality in patients with diabetes mellitus [21].

Diabetes mellitus (type 1, type 2) \u0026 diabetic ketoacidosis (DKA)

Many countries try - 7 - 8 to implement as much OECD indicators as they can afford [], but there are many countries with survey-based programs, in which only process indicators are used []. Establishment of a monitoring system is essential for this goal.

These indicators are the referral rates of adult diabetes mellitus patients in annual HbA1c check HC and annual ophthalmologic examination OE. GPs are evaluated and partly financed based on these indicators [30]. HDA recommends patients ophthalmologic examination once a year before manifestation of retinopathy. Ophthalmologists decide the frequency of control examinations whether diabetic retinopathy is presented [31]. According to HDA recommendations HbA1c test is suggested at least 4 times a year for patients treated with insulin and 2 times a year in other cases [31].

Despite of the international usage of outcome indicators in monitoring, and the fact that the physicians evaluate the patients status routinely by HbA1c level, only process indicators are used in Hungary for evaluation and financing.

HbA1c level as an outcome indicator, to measure the effectiveness of glycemic control is not applied by the HNHIF monitoring. Current guideline on diagnosing, screening and treating diabetes of HDA is in harmony with international recommendations.

However, in when the data collection of our study had been carried out- the recommended target level for HbA1c was 6. Nowadays, recommendations suggest a target range of 6. The primary level of prevention is the elimination of risk factors to prevent the disease development. This primary prevention uses, inter alia, health promotion tools e.

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The secondary level of prevention is screening. It could result early diagnosis in preclinical phase, in order to the start the treatment as soon as possible. Tertiary prevention means proper care for diagnosed patients to prevent or at least postpone the development of complications for a better quality of life.

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