Non-communicable diseases

• Non-Communicable Diseases


  • Lifestyle-Related Diseases
  • Chronic diseases (long duration)
  • Result of a combination of genetic, physiological, environmental, and behavioral factors (WHO, 2023)
  • Cannot be passed from one person to another via direct or indirect means (Not-transmissible)
• Causes of Non-Communicable Diseases

  • Lifestyle
  • Hereditary
  • Environmental
• Lifestyle


  • Result of unhealthy habits
  • Behavioral and modifiable risk factors like: smoking, alcohol abuse, consuming too much fat, salt and sugar and physical inactivity
• Hereditary


  • Passed from parent to child
  • Involves the genetic origin of an individual, as to how traits are passed from the parent towards his/her child
• Environmental


  Where you live or work
• Types of Non-Communicable Diseases

  • Diabetes Mellitus
  • Cardiovascular Diseases
  • Cancer
  • Chronic Obstructive Pulmonary Disease
• Diabetes Mellitus


  • A group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both
  • Defined as 8-hour fasting glucose level of 126 mg/dL or higher
  • This is a chronic disease that occurs when: The pancreas does not produce insulin or The body cannot effectively use the insulin it produces
• Classification of Diabetes Mellitus

  • Type I Diabetes Mellitus (IDDM)
  • Type II Diabetes Mellitus (NIDDM)
• Type I Diabetes Mellitus (IDDM)

  • Insulin dependent
  • Juvenile-onset Diabetes Mellitus
  • An autoimmune condition caused by the body attacking its own pancreas with antibodies
• Type II Diabetes Mellitus (NIDDM)


  • Non-insulin dependent
  • Most common type which is mainly a condition where the pancreas usually makes insulin, but hyperglycemia either results from: Insufficient amount of insulin (hyposecretion) or Insulin resistance (Inability of cells to use the insulin hormone, which inhibits the cell's capability to absorb and then use glucose in metabolic processes)
• Risk Factors for Type II Diabetes Mellitus


  • Family hx
  • Overweight
  • Sedentary Lifestyle
  • HPN
  • HDL (high-density lipoprotein) cholesterol < 35 mg/dl (0.90 mmol/L) & triglyceride level > 250 mg/dl (2.82 mmol/L)
  • Hx of gestational DM or delivery of a baby weighing 9 lbs
  • Previously identified to have impaired glucose tolerance
• Impaired glucose tolerance


  Resistance of the body in terms of insulin production
• Glucose serves as a primary energy source for cells, and insulin facilitates its uptake into cells for utilization. However, in cases of insulin resistance or insufficient insulin production, glucose accumulates in the bloodstream, leading to hyperglycemia. Consequently, cells struggle to access it for energy, causing disruptions in cellular function and metabolic processes. High blood glucose levels also increase blood viscosity, impeding efficient circulation and contributing to the development of heart and kidney diseases.
• The beta cells of the Islets of Langerhans of the pancreas produce insulin.
• Gestational Diabetes


  • Occurs in pregnancy and is caused by pregnancy hormones
  • Insulin is not working effectively
  • Usually goes away when the baby is born
  • Increases the risk of type 2 diabetes for the mother later in life
  • Mothers are advised to see the doctor yearly for diabetes test
• Signs and Symptoms of Diabetes Mellitus

  • Polyuria (Excessive urination)
  • Polydipsia (Excessive thirst)
  • Polyphagia (Excessive hunger)
  • Weight loss
• Screening for Diabetes Mellitus


  • Ask for the following: If he/she was diagnosed as having diabetes, Family History of Diabetes Mellitus, Signs and Symptoms of Diabetes Mellitus, Unexplained weight loss
  • Assess if at special risk: Hypertensive, overweight, women who delivered a 9 lb baby, those diagnosed with gestational diabetes
  • Check for tests: Fasting Blood Sugar Test, 2-Hour Blood Sugar Test/Oral Glucose Tolerance Test, Random Blood Sugar Test/Casual Blood Glucose Test
• Glucose solution - 75 grams of glucose dissolved in water
• Key Areas for Prevention and Control of Diabetes Mellitus

  • Maintain body weight and prevent obesity
  • Encourage proper nutrition
  • Promote regular physical activity and exercise
  • Smoking cessation for active smokers and prevent exposure to secondhand smoke
• Cardiovascular Diseases


  A group of disorders of the heart and blood vessels which include: Hypertension, Coronary Artery Disease and Cerebrovascular Accident
• Hypertension


  • Sustained elevation in mean arterial pressure
  • Presence of sustained systolic BP of 140 mmHg or more & sustained diastolic BP of 90 mmHg or more based on measurements done during at least 2 visits taken at least 1 week apart
  • Determines the pressure within the major arterial system of the body and are separated into: Systolic Blood Pressure (Involves maximum blood pressure during the contraction of the ventricles) and Diastolic Blood Pressure (The minimum pressure recorded just prior to the next contraction)
• Classification of Hypertension


  • Primary or Essential or Idiopathic HPN
  • Secondary HPN
• Primary or Essential or Idiopathic HPN

  This has no clear cause and is thought to be linked to genetics, poor diet, lack of exercise and obesity.
• Secondary HPN


  This is usually caused by another medical condition.
• Risk Factors for Hypertension

  • Family Hx
  • Age
  • High Salt Intake
  • Obesity
  • Excessive Alcohol Intake
• Key Areas for Prevention and Control of Hypertension

  • Encourage proper nutrition
  • Prevent becoming overweight or obese
  • Smoking cessation
  • Identify people with risk factors and encourage regular checkups for possible HPN and modification of risk factors
• Coronary Heart Disease


  • Ischemic Heart Disease
  • A heart disease caused by impaired coronary blood flow
• Etiology/Cause of Coronary Heart Disease

  Atherosclerosis which usually occurs when a person has high levels of cholesterol in the blood
• Risk Factors for Coronary Heart Disease

  • Elevated blood lipids/cholesterol
  • HPN
  • Smoking
  • DM
  • Obesity
  • Physical inactivity/sedentary lifestyle
  • Stress
  • Heredity/family hx
  • Gender
  • Increasing age
• Key Areas for Prevention of Coronary Heart Disease

  • Promote regular physical activity and exercise
  • Encourage proper nutrition
  • Maintain body weight and prevent obesity
  • Smoking cessation: active and passive smoking
  • Early dx, prompt tx, control of diabetes and HPN
• Cerebrovascular Disease or Stroke


  • Loss or alteration of bodily function that results from an insufficient supply of blood to some parts of the brain
  • One of the leading causes of disability
• Etiology/Cause of Cerebrovascular Disease or Stroke

  • Thrombotic Stroke
  • Embolic Stroke
  • Hemorrhagic Stroke
• Risk Factors for Cerebrovascular Disease or Stroke

  • Increasing age
  • Sex
  • Heredity & race
  • HPN
  • Smoking
  • DM
  • Heart Disease
  • High RBC count
  • Season and Climate
  • Socio-economic Factors
  • Excessive alcohol intake
  • Certain kinds of drug abuse
• Key Areas for Prevention and Control of Stroke

  • Tx & control of HPN
  • Smoking cessation, smoke free environment
  • Prevent thrombus formation in RHD & arrhythmias with appropriate medications
  • Limit alcohol consumption
  • Avoid intravenous drug abuse & cocaine
  • Prevent all other risk factors of atherosclerosis
• Screening for Hypertension


  • Classification of BP (Joint National Convention 7 Report): Normal, Prehypertension, HPN stage 1, HPN stage 2
• Screening for Elevated Cholesterol in the Blood

  • Prior to testing, fasting at least 8 hours
  • Drinking water is acceptable
  • Recommended Guidelines: Cholesterol Level < 200 mg/100ml (Normal), 200 - 239 mg/100ml (Elevated, maybe at risk), 240 mg/100ml & above (Elevated, at risk)
• Cancer


  A condition that is characterized by uncontrolled growth and spread (proliferation) of abnormal cells which leads to formation of huge mass or tumor
• Types of Cancer According to Location

  • Localized (Found only in the tissue or organ where it first began and that has not spread to nearby lymph nodes or to other parts of the body)
  • Metastasis or Direct Extension (If cancer cells separate from the original tumor and spread into other tissues, entering the blood and lymph vessels, they may invade other parts of the body and develop into new tumors)
• Mechanisms of Cancer Spread

  • Invasion (Direct migration and penetration by cancer cells into neighboring tissues)
  • Metastasis (Ability of cancer cells to penetrate into lymphatic and blood vessels, circulate through the bloodstream, and then invade normal tissues elsewhere in the body)
• 40 mg/100ml


  Elevated (at risk)