National health programs in the field of endocrinology and metabolism - Miles to go

Abstract

The endocrine and metabolic diseases of childhood obesity, diabetes mellitus, hypertension, iodine deficiency disorders, vitamin D deficiency, and osteoporosis are major public health problems. Different programs including National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke address these problems although some are yet to be addressed. National surveys have shown high prevalence of these disorders and their risk factors. Most of the programs aim at awareness raising, lifestyle modification, (primary prevention) and screening (secondary prevention) for the disease conditions as these are proven to be cost-effective compared to late diagnosis and treatment of various complications. Urgent concerted full scale implementation of these programs with good coordination under the umbrella of National Rural Health Mission is the need of the moment. The referral system needs strengthening as are the secondary and tertiary levels of health care. Due attention is to be given for implementation of these programs in the urban areas, as the prevalence of these conditions is almost equal or even higher among urban poor people where primary and secondary prevention measures are scarcely available and treatment costs are sky-high.

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“…The city administration and health department should work in tandem to create institutional support for Heart Smart and Sugar Smart initiatives. Existing national programs [6] Medical and curative services for diabetes and heart disease should be freely available in Sugar Smart and Heart Smart cities. Both Karnal and Faridabad have government medical colleges, which provide yeoman care to people from both within and beyond their cities.…”

Association of Respiratory Tuberculosis with Incident Bone Fracture: Bridging the Tuberculosis Airway Infection and the Osteoporotic Bone

“…Osteoporosis is the most common type of bone disease [1] and is a major public health problem [2]. Osteoporosis increases the risk of breaking a bone [3].…”

Primary Prevention of Congenital Anomalies: Recommendable, Feasible and Achievable

“…Another related metabolic condition, obesity, shares many features with T2D. The global rise in obesity involves low- and middle-income countries [31,33]. Obesity has a complex pathogenesis involving lifestyle (high-density caloric diets, low physical activity), genetic predisposition and probably also developmental exposures to endocrine disrupters [34].…”

“…However, T2D represents the highest public health concern; its incidence is rising globally, calling for primary prevention strategies based on awareness raising and lifestyle modifications also in emerging economies [31]. Notwithstanding its complex pathogenesis and undisputed genetic predisposition, the risk of T2D may be reduced by the diffusion of healthier nutritional choices and increased physical activity, adjusted to reflect local food availability and the individual's needs [32].…”

“…Therefore, primary prevention of obesity-related birth outcomes should integrate community actions, including a safer environment, and targeted preconceptional care for women that are obese, both levels emphasizing the empowerment to healthier diets and reasonable physical activity [26]. The primary prevention of T2D and obesity share many features and should be integrated in a concerted and cost-effective public health plan for the population as a whole, but with special reference to pregnancy [31]. …”