Diabetes treatment

English

Preparing a global healthcare workforce for the challenge of chronic conditions

Chronic conditions are increasing. The number of people affected by chronic non-communicable conditions, including diabetes and heart disease, is growing worldwide. Collectively, chronic conditions were responsible for 35 million – a full 60% – of all deaths in 2005. This is twice the number of deaths due to infectious diseases, poor maternal health and malnutrition combined. In addition to causing high death rates, chronic conditions account for almost half of the world’s disability.

Caring for people with chronic diseases: what should healthcare professionals know?

Much of the care given by healthcare providers around the world on a day-to-day basis can be described as ‘reactive’: people who think that they are ill present to a healthcare provider for a diagnosis and treatment. However, growing numbers of people with an established chronic disease need a different form of care, care that is structured and proactive. On a regular basis and following an agreed plan, they need to participate in regular review of their underlying chronic condition and its complications.

The effects of diabetes on depression and depression on diabetes

Diabetes can have both a daily and long-term impact on people with the condition – both physically and in terms of its psychosocial effects. It is now known that people with diabetes are at a substantially increased risk of experiencing mental distress, particularly depression. Furthermore, a growing bank of evidence points to a two-way relationship between the conditions. Yet depression is often under-diagnosed in people with diabetes.

Managing chronic disease as a team - new models of care delivery

As the world’s population ages, the impact of chronic diseases will drive health systems around the world in two ways – adding significantly to the cost, and imposing considerable constraints on the already strained healthcare workforce. It is estimated that the health budgets of most developed nations will consume 20% of their gross domestic product by the 2020s. The most recent World Health Organization Health Workforce Report suggests shortfalls of some 4.3 million healthcare workers over the next decade – including nurses, doctors and health administrators.

Global standardization of the HbA1c assay - the consensus committee recommendations

Since the late 1970s, HbA1c test results have been used to guide diabetes care. The International A1c-AG Study, under way in 10 centres in North America, Europe, and Africa, aims to explore the relationship between HbA1c and average blood glucose. Martin Silink and Jean-Claude Mbanya, who represent IDF on a consensus committee working towards the standardization of the HbA1c assay, report on developments in the measurement and reporting of long- term average blood glucose levels.

The frustrations of trying to lose weight and the alternative of bariatric surgery

Aged 42 years, ‘S’, friend and colleague of the author, weighed 204 kg. Now, three years later, after undergoing intensive dieting and psychotherapy, she has lost nearly 10% of her body weight. But she remains 38 BMI units over and above the 30 kg/m threshold for the ‘obese’ category; she is in the range of ‘morbid obesity’. In a few weeks she will undergo dramatic abdominal surgery for this condition. Rhys Williams tells her story.

The benefits of diabetes education: better health outcomes through successful self-management

Diabetes is mostly managed by people with the condition. In order to do so effectively, people with diabetes need to acquire and develop a broad base of knowledge and skills, and incorporate lifestyle choices into daily living which facilitate and enhance self-care. Diabetes education is an active process that supports people in building self-management skills, and provides for shared decision making about how best to fit diabetes treatment into daily life.

Insulin pump therapy in children and adolescents: risks and benefits

During the last decade, insulin pump therapy has gained widespread acceptance in the treatment of children and adolescents with type 1 diabetes. In some of the European and North American paediatric diabetes centres, more than half of the young people with diabetes try to simulate a normal pattern of insulin secretion by means of an insulin pump (continuous subcutaneous insulin infusion).

Prevention and management of diabetes: the role of the physiotherapist

As the diabetes epidemic grows in size and complexity, there is an increasing realization that physicians alone are unable to provide the care required by people with diabetes. To help them live life to the fullest, people with the condition need the services of a range of healthcare personnel, including diabetes nurses, dietitians, podiatrists, psychologists and eye specialists. The role of most of these is well defined; the multi-disciplinary team approach benefits increasing numbers of people with diabetes worldwide.

From adolescence to adulthood: the transition from child to adult care

Adolescence, the period of transition from childhood to adulthood, is a key phase of human development. It is characterized by rapid changes – physical, sexual, psychological, emotional, cognitive, and social. The psychological imbalance that prevails during adolescence is particularly significant in people with diabetes as it often leads to a decline in self-care. This brings about a deterioration in blood glucose control, and creates difficulties that hamper the development of harmonious relationships between the young person with diabetes and his or her healthcare providers.

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