Insulin

The health system in the Netherlands is set for an overhaul. In January 2006, new health legislation, which includes important reforms in the provision of diabetes care, comes into effect. Having played an important advisory role in the design of this new legislation, the Dutch Diabetes Association (DVN) predicts signifi cant improvements in diabetes care as a result of the reforms. However, not all the stakeholders in diabetes care are happy with the changes, which were the central issue in several national and regional strikes by primary care doctors. As a

We have known for more than half a century that good control of blood sugar (glucose) is important for the normal development of the unborn baby throughout pregnancy. During those years there has been much progress in advising

After the discovery of insulin in the 1920´s, available insulin was from natural sources (animal pancreas) until human insulin was made available in the early 1980s. None of these insulins was ideal for injection under the skin. Now, new

Diabetes is rapidly emerging as a major health-care problem in India, especially in urban areas where the prevalence of Type 2 diabetes has been reported as 12% of the adult population. Furthermore, there is an equally large pool of people with

Kyrgyzstan is a small mountainous country with a predominantly agricultural economy; it gained independence with the break-up of the Soviet Union in 1991. For a significant sector of the Kyrgyzstani population, economic difficulties at national level translate into high unemployment and widespread impoverishment. Kyrgyzstan inherited an extensive but basic health-care system, with a functioning – albeit fragmented – structure for managing chronic diseases.

When we eat, the concentration of glucose in our blood rises due to the uptake of glucose from the digestion of starch and other carbohydrates in the gut. In healthy people, the increase is modest; eating activates other processes that

As a species, our condition has changed: from prolonged periods of fasting and occasional gorging, to nearly constant feeding with rarely occurring periods of fasting. The constant availability of ‘grazing opportunities’ has contributed to a change in the body build of humans towards increasing body weight, overweight, and obesity. With this change has come a massive increase in the number of people with diabetes and diabetes- and- obesity-related health problems.

Insulin is a life-sustaining medication and as such has been designated an ‘essential drug’ by the World Health Organization (WHO). Insulin therefore should be universally available to everyone who requires it for survival. However, accessibility to the drug is often not secure. This results in life-threatening complications for people who depend on insulin for survival. The authors of this article, in reporting on the results of the International Diabetes Federation (IDF) survey, 2002-2003, make a call for improvements to the pricing and availability

President's editorial

In order to minimize the risk of diabetes complications, effective therapy for people with Type 2 diabetes involves lifestyle changes and poly-pharmacy targeting levels of blood glucose, blood pressure and blood fat. However, the strict targets set in recent guidelines are seldom achieved by the majority of people with diabetes. Barriers to effective diabetes therapy have been identified within the organization of health care and in the interaction between health-care providers and people with