Patient-centred care

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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

Integrating psycho-social issues into national diabetes programmes

It is widely agreed that people with diabetes can lead a 'normal' life. Like people who do not have the condition, people with diabetes can function fully in family, workplace, and community settings. However, it is also accepted that diabetes self-care is complex and demanding. Being obliged to balance food intake and exercise against medication, self-administer injections, and self-test blood for glucose levels is not 'normal'. The demands of diabetes self-management can impact negatively on the psychological status of people with the condition. In this article, Ruth

Diabetes education: overcoming affective roadblocks

In diabetes care, the principal objective is to improve health outcomes and ensure the total well-being of people with the condition. In order to achieve this, it is important to reach the person beyond the laboratory results and blood glucose

Diabetes attitudes, wishes and needs

The overall objective of Diabetes Attitudes, Wishes and Needs (DAWN) is to improve the psycho-social support for people with diabetes. This global Programme is led by Novo Nordisk, in partnership with the International Diabetes Federation (IDF), and an advisory panel of leading diabetes experts. The DAWN activities began with the DAWN Study in 2001. This global investigation into the affective aspects of the condition facilitated comparisons and cross-referencing between the key players in the diabetes community. The key finding was that critical gaps

Understanding the human side of diabetes

The findings of the recently-conducted DAWN study (Diabetes Attitudes, Wishes and Needs) tell us that people with diabetes who are cut off from a community of support not only manage their condition ineffectively, but also feel worse within themselves. Networks of supportive family, colleagues or friends appear to be at least as important as medication in relation to the ability of a person with diabetes to manage their condition.

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