Developing countries

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Diabetes to priority for Iranian National Advisory Committee

The first systematic epidemiological studies in Iran were begun in 1993. However, in light of the growing number of people with diabetes and the accruing costs, estimated to exceed US$400 million a year, a need was recognized in 1998 to study the more recent epidemiology of diabetes in Iran. In 1998 the National Committee for Diabetes was formed, and a project undertaken in 1999 involving nearly 2.5 million people. Many other substantial moves have been made in Iran to help deal with diabetes in the country.

Implementing national diabetes programmes in Latin America

The prevalence of diabetes in Latin America will double within the next couple of decades. Type 2 diabetes is already among the first 10 causes of mortality in the Latin American adult population due to chronic complications related to premature and accelerated atherosclerosis. It is also estimated that around one third of these women and half of these men remain undiagnosed for years. Latin America must, therefore, be prepared for an epidemic with serious consequences.

Diabetes education with a Bali flavour

Diabetes is on the increase in Indonesia, with prevalence rates now at 4.6% compared with 2% to 3% just five years ago. This means that some four million people throughout Indonesia, from Sumatra to Irian Jaya, currently have the condition. Bali, an Indonesian island with three million inhabitants, has trained 86 diabetes educators since 1996. The educators, who come from all over the island, are expected to be able to return to their local areas and spread their knowledge about diabetes.

Urban India: a breeding ground for diabetes

The global prevalence of diabetes is set to double over the next 25 years. Developing countries like India, already top of the diabetes league, are expected to shoulder much of this burden. Epidemiological studies show that the prevalence of diabetes is particularly high in urban areas in India. Cities are also home to a large pool of people with a great risk of developing diabetes in the future.

A challenge of acculturation: the Ethiopian community in Israel

For most Ethiopian immigrants arriving in Israel, diabetes was an unknown illness. However, current studies show that its prevalence is now high in this population. The diagnosis and management of diabetes among Ethiopian immigrants present a real challenge of acculturation. In response to this challenge, a community-based project called Tene Briut was created. Tene Briut promotes culturally-appropriate prevention, detection and management activities, with a major contribution from Ethiopian health professionals and community leaders.

Argentina's crisis triggers health emergency - The diabetes community's response

Diabetes affects an estimated 3.3% of the adult population in Argentina. For many of these people, insulin is a life-sustaining drug. Without uninterrupted access to insulin, people dependent on this drug for survival face the real possibility of death, some within days. The collapse of the reimbursement system and speculation have caused grave interruptions in the supply of medicines such as insulin and now an emergency response is expected from the Argentinean authorities.

Magazines in Africa

A publication that can help inform people with diabetes about their condition and keep them motivated to look after themselves would seem to be a valuable and cost-effective if not essential part of self-management. But in most parts of the poorly resourced continent of Africa, a magazine for people with diabetes is a luxury. Publishing is expensive and requires a supportive economy and a literate population with a common language.

Comprehensive care in a low-income country: the Ghana experience

In the 1950s and 1960s diabetes prevalence in Ghana was estimated at between 0.2% and 0.4% in adults. However, a recent analysis of admissions to the largest hospital in the country reveals that diabetes accounts for 6.8% of all adult admissions. Despite the fact that diabetes is clearly a major health problem in Ghana, the country has no separate diabetes healthcare policy. To address these issues, a three-year national programme, the Ghana Diabetes Programme, was initiated in 1995.

Poverty, stress and unmet needs: life with diabetes in the Gaza Strip

The political and social situation in the Gaza Strip remains tense, with considerable disruption of normal economic and social activity. Such an environment is rarely conducive to the delivery of continuing medical care. In this article Panagiotis Tsapogas, Medical Co-ordinator of the Greek section of Médecins Sans Frontières (Doctors Without Borders) in Gaza, 2002-2003, reports on the difficulties faced by Palestinian people with diabetes in Gaza, and makes a call for the provision of improved diabetes care.

Rural women: the Bangladesh perspective

Diabetes poses a serious threat to developing countries like Bangladesh. Despite advances in diabetes treatment, management and self-care, women with diabetes in rural Bangladesh are rarely able to enjoy the fruits of this progress.

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