Shriraam Vanishree, Mahadevan Shriraam, Anitharani M, Sathiyasekaran Bwc
Department of Community Medicine, Sri Ramachandra Medical College and Research Institute, Porur, Tamil Nadu, India.
Department of Endocrinology and Diabetes, Sri Ramachandra Medical College and Research Institute, Porur, Tamil Nadu, India.
Indian J Endocrinol Metab. 2014 Jan;18(1):7-12. doi: 10.4103/2230-8210.126521.
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.
儿童肥胖、糖尿病、高血压、碘缺乏症、维生素D缺乏症和骨质疏松症等内分泌和代谢疾病是主要的公共卫生问题。包括国家癌症、糖尿病、心血管疾病和中风预防控制项目在内的不同项目都在解决这些问题，尽管有些问题仍有待解决。全国性调查显示这些疾病及其危险因素的患病率很高。大多数项目旨在提高认识、改变生活方式（一级预防）以及对疾病状况进行筛查（二级预防），因为与各种并发症的晚期诊断和治疗相比，这些措施已被证明具有成本效益。当下需要在国家农村卫生使命的框架下，紧急协调一致地全面实施这些项目，并进行良好的协调。转诊系统以及二级和三级医疗保健都需要加强。在城市地区实施这些项目时也应给予充分关注，因为在城市贫困人口中，这些疾病的患病率几乎相同甚至更高，而他们几乎无法获得一级和二级预防措施，且治疗费用高昂。
