Lifestyle interventions

The objective of holiday camps for children and adolescents with diabetes is to create an environment in which they can learn to embrace their condition and its treatment. Achieving and maintaining good blood glucose control is a key aim; the camps provide excellent opportunities for young people to learn and practise diabetes skills and become familiar with the latest techniques.

Early intervention to prevent or delay type 2 diabetes benefits people who are at high risk of developing the condition in terms of increased life expectancy and quality of life. It also benefits societies and healthcare systems in economic terms. In order to address the growing impact of type 2 diabetes, the International Diabetes Federation (IDF) Task Force on Prevention and Epidemiology convened a consensus workshop in 2006. Its primary goal was the prevention of type 2 diabetes in developed and developing countries.

Diabetes has become a significant public health problem in urban Nepal. Studies carried out by the Nepal Diabetes Association in towns and cities throughout the country have revealed a diabetes prevalence of around 15% among people aged 20 years and above, and 19% among people aged 40 years and above. The Association has identified a number of key issues which continue to exacerbate this epidemic in Nepal.

Typical diets for people with type 2 diabetes limit carbohydrates, reduce calories to facilitate weight loss, and limit saturated fats to reduce cardiovascular risk. These dietary changes are logical and sometimes helpful. For many people, however, this sort of change leads to no more than modest weight loss and a small improvement in blood glucose control. In this article, Neal Barnard looks at evidence to suggest there might be a more effective nutritional approach to prevent or manage type 2 diabetes.

When IDF brings together the global diabetes community at a World Diabetes Congress, it does so with a number of key objectives, which include raising overall diabetes awareness, sharing innovative ideas and best practices, and helping to build and consolidate networks – in line with the Federation’s mission to promote care, prevention and a cure for diabetes worldwide.

Diabetes has become a global health problem, reaching epidemic proportions worldwide with serious implications for health and well-being. The International Diabetes Federation estimates that by 2025, almost 350 million people will have diabetes. People who are most vulnerable to this chronic disease include those living in developing countries, and members of minority ethnic groups and socio-economically disadvantaged people in developed countries.

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.

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.

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.

Throughout the world, socially disadvantaged people with inadequate access to health resources suffer worse health status and die younger than people in more privileged social positions. Yet although the greatest share of health problems is attributable to living conditions, health policies are dominated by disease-focused solutions that largely ignore the social environment. As a result, inequalities have widened and health interventions have obtained less than optimal results.