Diabetes treatment

English

A global guideline for type 2 diabetes: using a new 'levels of care' approach

The International Diabetes Federation (IDF) is not in the business of delivering clinical care to people with diabetes; but it is committed to the view that everyone with diabetes should benefit from the best possible care that could be available to them. One foundation of such care is to ensure that it is based on the best possible scientific knowledge. Here we describe the approach behind the recently published IDF Global guideline for Type 2 diabetes, an evidence-based guideline designed to assist care at different levels of resources.

Diabetes care and prevention in Iran

The world is facing a dramatic rise in diabetes prevalence, most of which is occurring in the low- and middle-income countries; it is projected that by 2025, more than 75% of people with diabetes will live in developing countries. This is having a major impact on the quality of life of hundreds of millions people and their families. Furthermore, the negative effects of the obesity-driven diabetes pandemic are being felt in the economy of those countries that are in most need of development.

Screening for the diabetic foot: how and why

Given the dimensions of the current global diabetes pandemic, the number of people who are at risk of developing a diabetes-related foot complication is enormous – and growing. Everybody with the condition is at risk, irrespective of the type or severity of their diabetes. The aim of screening is to identify the people who are at greatest risk in order to allocate to them limited medical resources. Several simple screening techniques exist that can help to distribute therapeutic and preventive foot care to those in greatest need. Edgar Peters reports.

Cause for concern: the pathology of the non-ulcerative foot

Those people with diabetes who are aware of the threat that is posed by diabetes foot complications are right to be terrified by the worst-case scenario: the loss by amputation of one of their feet or legs. People with diabetes are at risk of developing a series of common conditions that can represent a conduit for infection to their vulnerable feet. Andrew Clarke describes the apparently minor conditions that in fact require adequate attention or need to be prevented before chronic ulcers develop and the consequences become tragic.

Understanding the development of diabetic foot complications

Foot complications are the leading cause of hospitalization in people with diabetes. Losing a limb is one of the most dreaded complications of the condition – with reason: compared to those without the condition, people with diabetes have a 15-fold increased risk of suffering an amputation. In this article, Vilma Urbancic-Rovan describes the pathophysiology of diabetes foot damage and argues that the amputation rate could be significantly reduced with improved care and education for people with the condition.

The diabetic foot: epidemiology, risk factors and the status of care

The development of foot problems is not an inevitable consequence of having diabetes. Indeed, most foot lesions are preventable. However, recent statistics are somewhat depressing: approximately a quarter of all people with diabetes worldwide at some point during their lifetime will develop sores or breaks (ulcers) in the skin of their feet. Moreover, as the number of people with diabetes rises worldwide, there can be little doubt that the burden of diabetes-related foot

Keeping people's feet perfect

Guest editor's editorial

A new IDF worldwide definition of the metabolic syndrome: the rationale and the results

The metabolic syndrome is one of the major public health issues of our time. The International Diabetes Federation (IDF) believes that this cluster of factors is driving the twin global epidemics of type 2 diabetes and cardiovascular disease. If current trends continue, the premature deaths and disabilities resulting from these conditions will cripple the health budgets of many nations – both developed and

Key aspects of care after a lower-limb amputation

Of all the lower extremity amputations carried out worldwide, 40%-70% are related to diabetes. In people with the condition, ulceration is provoked by diabetesinduced nerve damage, reduced mobility due to alterations in the functioning of joints in the foot, and disorders in the blood vessels that supply the legs and feet (peripheral vascular disease). When a person’s ulcerated foot becomes infected or when the blood supply is severely impaired, amputation of the foot – or even the leg – may not be preventable. People with diabetes who have suffered an amputation

Making clever use of simple tools

Editor-in-chief's editorial

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