Type 2 diabetes

English

Lifestyle and nutritional management

It is often stated that dietary management is a cornerstone of diabetes care. More recently, physical activity has also been recognized as a useful fundamental intervention. When it is realized that both of these can affect a variety of the problems that bedevil people with diabetes – including excess body weight, high blood glucose levels, high blood fat levels, and high blood pressure – it is not difficult to see why these issues might be regarded as fundamental.

Patient education and psychological care

People with diabetes deliver most of their own care. This reflects the observation that diabetes and its associated features touch on most aspects of daily living, and aspects as fundamental as eating and physical activity. To deliver such care requires knowledge, but even with knowledge it may not be easy to adjust to optimal self-care. This makes patient education a complex therapeutic issue.

Outpatient and inpatient diabetes care delivery

Diabetes care is inherently complex – hence the need for 19 chapters of evidence review and recommendations in the Global Guideline. Pulling all the recommendations together to ensure the implementation of effective delivery of care therefore needs some organization of its own, as is discussed in this article. A special situation is that of people with diabetes in hospital, who are often subject to disruption of lifestyle due to illness, procedures, or surgery, with knock-on effects on their diabetes management.

National and regional organization: the key to effective diabetes care in Moscow

According to the federal statistics agency of the Russian Federation, the country’s population is in a phase of negative growth and currently stands at around 143 million. There are 2.3 million people registered with diabetes, 2 million of whom have type 2 diabetes. However, according to recent epidemiological research, there may be some 8 million people living with the condition in Russia. Success in addressing the problems relating to diabetes and its complications largely depends on the effective organization of diabetes care at regional and national levels.

Prevention of diabetes and its complications: key goals in Finland

The 10-year National Diabetes Programme in Finland (DEHKO) has been up and running for 6 years. The formal evaluations carried out to date indicate that the Programme continues to have a positive impact in a number of areas of diabetes care in Finland. Moreover, prevention of type 2 diabetes and cardiovascular complications remain the principle objectives of DEHKO. Timo Saaristo and Leena Etu-Seppälä report on FIN-D2D (2003-2007), the DEHKO project to implement primary prevention of type 2 diabetes in five regions – potentially affecting 1.5 million people.

Barriers to healthcare among homeless people with diabetes

It is estimated that about half of all homeless people suffer from chronic medical conditions. Unfortunately, these people frequently encounter many more barriers to care than the general population – exacerbating their health problems. The plight of homeless people with diabetes is particularly severe, since managing the condition requires adherence to a demanding care plan.

Time to consider our future

Editorial

Unite to protect health worldwide

President's Editorial

Children

The relatively recent emergence in children of type 2 diabetes, a condition once considered ‘late-onset’, has been viewed with consternation around the world. Guidelines directed at healthcare professionals dealing with children have generally focused on type 1 diabetes; it is only now becoming apparent that type 2 diabetes in children is a serious condition and that it is at least as demanding to manage. The chapter on children in the Global Guideline seeks to raise awareness of these problems, which are faced by increasing numbers of families.

Pregnancy

Diabetes increases the risks in pregnancy for both the mother and her infant. However, pre-pregnancy advice where possible, detection of undiagnosed or new (gestational) diabetes in pregnancy, and careful management of diabetes throughout pregnancy, with close liaison between healthcare professionals involved in diabetes, obstetric and neonatal care, can all help to achieve the desired outcome of a healthy mother and baby. The Global Guideline only addresses areas of pregnancy care that are commonly affected by the

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