Children

Brazil is a country of continental dimensions, the fifth largest in the world, and the fifth most populous – nearly 200 million inhabitants. It is characterized by its diversity, geographically, and in terms of its varied climate, ethnic and cultural complexity and economy; Brazil is the tenth largest economy in the world, a country where huge wealth and widespread  poverty co-exist at close quarters.

In Japan, the growing number of children and adolescents with overweight or obesity is driving an increase in youth-onset type 2 diabetes; the figures for type 1 diabetes remain constant among young people. In response, a number of initiatives have been developed and implemented in order to address diabetes-related issues and promote healthy living for young people affected by the condition.

In South Africa, managing diabetes in children and adolescents can be especially challenging. South Africa is a country of great socio-economic and ethnic diversity, where healthcare, like culture, languages and customs, varies significantly from one area to another. Furthermore, access to healthcare depends on affordability and availability, ranging in quality between developed- and developing-world standards. With these challenges in mind, the DAWN Youth South Africa survey was undertaken to evaluate the effects of diabetes on young people with the condition and their  family.

Since its launch in 2006, DAWN Youth has worked to complement a number of existing programmes in the USA which contribute to the well-being of young people with diabetes. The US WebTalk survey recorded first-hand testimonies from young people with diabetes, their parents and healthcare professionals on what it means to live with diabetes. As in all  participating countries, schools were identified as a key area for improvement in the USA. This article outlines two of the initiatives of DAWN Youth USA, which may be a source of  ideas for action and improvement in other countries.

India is undergoing an economic transformation – a financial boom according to many. Among India’s strong points contributing to this positive economic climate is its enormous young population. The potential for productivity, savings and investments by this generation will increase in the future, and is driving up levels of investments and confidence in the Indian economy. However, such gains are cancelled out to a large degree by excessive healthcare spending.

If a child with diabetes develops ketoacidosis, it is absolutely critical that his or her parents are able to contact a trained healthcare provider immediately, 24 hours a day. Many parents report particular difficulties finding an experienced paediatrician to manage this emergency at night, and during week-ends and holidays. It has been demonstrated that these difficult situations can be overcome effectively using widely available telephone technology.

The World Diabetes Day campaign is led by the International Diabetes Federation and its member associations. It is a multiple-stakeholder partnership that includes diabetes organizations and their members around the world and Official World Diabetes Day Partners. Each campaign is centred on a theme that is established by the IDF Executive Board and approved by the World Health Organization. This year sees the second half of a 24-month campaign focussing on diabetes in children and adolescents. The main campaign slogan is ‘Know the warning signs’.

South Africa is a land of paradoxes. South Africans deservedly celebrated an exceptional Rugby World Cup victory in 2007, but we most definitely are not yet winning the battle against inactivity and overweight among the nation’s young people – which is placing them at substantial risk for chronic diseases such as type 2 diabetes, obesity, heart disease, and certain types of cancer. South Africa has the added challenge of dealing with a double burden of disease: the chronic non-communicable diseases mentioned above and communicable diseases such as HIV/AIDS and tuberculosis.

Over recent decades, there has been a worldwide increase in the number of people with obesity – currently around 300 million according to the International Obesity Task Force – and there are no signs of a slow-down. Furthermore, rates of overweight and obesity in adults and children are rising dramatically in developing countries. A large and growing body of evidence points to the transformation of lifestyles worldwide – over-consumption of energy-dense food and decreased physical activity – as the driving force behind this pandemic.

Diabetes is a constant and daily challenge for children and adolescents, their parents and carers. Henk-Jan Aanstoot, a paediatric diabetologist, affirms that he is inspired and motivated to see many families dealing well with their condition. Very young children, teenagers and young adults all share the ability to teach him something important every day – about patience, commitment and an unbelievable desire to overcome adversity and to triumph. But there are serious shortcomings in the care afforded to these young people in developed as well as developing countries.