Patient-centred care


Multidisciplinary care: saving Mr L's toe

This is the story of ‘Mr L’, a man in Australia with type 2 diabetes and severe diabetes nerve damage (peripheral neuropathy). He developed neuropathy-related ulcers on one of his toes, which remained untreated for a number of months. He faced the prospect of having his left foot amputated. However, this was prevented because Mr L was linked to a multidisciplinary hospital-based diabetic foot clinic.

Can a peer-care model improve diabetes outcomes?

Recent studies have highlighted the importance of good blood glucose control in people with type 2 diabetes and emphasized the importance of reducing cardiovascular risk, particularly in relation to the control of blood pressure. However, achieving this represents a real challenge for people who live with diabetes and those who deliver diabetes care. By way of a response to the need for improved diabetes care, the authors describe plans to initiate a peer-care model in Ireland.

Meeting psycho-social needs in Poland: a new priority

The results of the Diabetes Attitudes, Wishes and Needs (DAWN) study confirmed the beliefs of many people with diabetes and health-care providers: that addressing only the physical symptoms of diabetes is not enough; to be truly effective, diabetes care must also take into account psychological issues. Nowhere was this more apparent than in Poland, where people with diabetes showed consistently higher concern for psycho-social issues than respondents in other countries. Andrzej Kokoszka reports from Poland on an award-winning educational initiative in response to these needs.

Project HOPE Mexico: empowering people to care for themselves and others

If current trends continue, within the next 10 years, a quarter of all people in Mexico will be living with diabetes. Diabetes already affects 12% of the general population and, astonishingly, one in three people over 65 years of age. Diabetes is the leading cause of blindness, kidney failure and lower-limb amputations. Indeed, in 2004, diabetes was declared the leading cause of death in Mexico due to its link

Therapeutic diabetes education: the Cuban experience

Cuba is a small island country in the Caribbean with 11 million inhabitants. As in other countries, diabetes is a major challenge to health in Cuba. In order to reduce the health and economic impact of diabetes and improve the quality of life of people with the condition, a country-wide diabetes education programme began development over 30 years ago, linking and promoting optimum care and education. Rosario García and Rolando Suárez report on the achievements of the programme and highlight the central role of diabetes education over three decades of care initiatives in Cuba.

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President's editorial

Achieving excellence in diabetes foot care: one step at a time

By the time you finish reading this paragraph, it is likely that at least one person has lost part of a foot or leg through diabetic foot disease. This happens every 30 seconds. An amputation is often preceded by an ulcer; 15% of people with diabetes are affected by a foot ulcer at some time in their life. With the global diabetes population set to rise to 333 million by 2025, there is an urgent need for a co-ordinated preventive clinical response to reduce the impact of the diabetic foot.

Improving psycho-social care: the Indian experience

The number of people with diabetes in the Indian subcontinent has been increasing dramatically: approximately 30-33 million people have diabetes in India and this number could double by 2025. Compared to other ethnic groups, Indians have a high risk of developing diabetes. However, the impact of psycho-social factors related to diabetes care has also contributed to the growing pandemic.

In practice: DAWN in Latin America and the Caribbean

Relatively few studies have examined the psycho-social impact of diabetes. The Diabetes Attitudes, Wishes and Needs (DAWN) Programme addressed this issue in a study involving people with diabetes from 13 countries. A key finding was that depression was much more common in people with diabetes than in those without the condition, and was associated with impaired self-management and quality of life. Other studies confirm that depression often impairs metabolic control in people with the condition.

Keeping people at the centre of care: a challenge to health professionals?

The establishment of a practice which puts the person at the centre of care will require a change in the attitudes and beliefs of health professionals, and people with diabetes. A service which places the person with diabetes at the centre of care will undoubtedly demand the adoption of this philosophy by the organizations responsible for the delivery of diabetes care, as well as those networks serving the