Healthcare costs

President's editorial

Diabetes is a chronic condition that requires a life-long commitment of resources to the prevention and treatment of complications. The condition affects an increasing number of people all around the world, putting them at risk for foot ulcers and amputations. In addition to causing acute suffering, foot lesions in people with diabetes have substantial economic consequences: up to 20% of total expenditure on diabetes might be attributable to the diabetic foot. Jan Apelqvist and Gunnel Ragnarson Tennvall report on the economic impact of diabetes foot damage

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

In 1994, more than one million people died in Rwanda in one of the worst genocides in modern times. Rwandan society, at all levels including healthcare, continues to count the human and financial costs of the tragedy – a burden which is compounded by the debilitating scarcity of resources in the nation as a whole. Most of Rwanda’s 8 200 000 inhabitants are united by poverty: according to figures published by the World Bank, the yearly per capita income in Rwanda is 220 USD.

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.

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

Editor-in-Chief's editorial

President's editorial

The growing diabetes crisis in the United States is a well reported fact. Nevertheless, diabetes-affected families are often being left out in the cold. Many are forced to dig deeply into their own pockets because, in many cases, even if insurance is available, insulin, syringes and blood glucose testing equipment as well as medical services such as outpatient education, so essential for diabetes care, are not covered.