Research and studies

Breastfeeding has numerous advantages for mothers with diabetes and their babies. Nursing mothers have lower insulin requirements and better control of their blood glucose; breastfed babies may have a lower risk of developing diabetes themselves. Alison Stuebe describes these potential benefits and highlights the special needs of breastfeeding mothers with diabetes.

The number of children with diabetes is growing. Some countries, particularly in the developed world, are seeing a significant increase in the incidence of type 1 diabetes; type 2 diabetes in children and adolescents is an emerging problem worldwide. Premature deaths as a result of undiagnosed diabetes are a large and hidden global problem. Moreover, children with diabetes risk developing disabling and life-threatening complications at an early age, placing a significant human and economic burden on families and societies.

The third edition of the Diabetes Atlas was launched in December 2006, at the 19th World Diabetes Congress of the International Diabetes Federation (IDF) in Cape Town, South Africa. The aim of the Atlas, which has been described as the flagship publication of IDF, is to provide the most recent and accurate information on diabetes in 2007 and provide estimates of the likely impact of the condition up to 2025. Its purpose is to disseminate the most up-to-date and salient facts concerning the scope, impact and burden of diabetes globally and on a regional and country-by-country basis.

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.

Editorial

The IDF Education Foundation was established in 1992 during the IDF Presidency of Wendell Mayes Jr. The Foundation is a practical benevolent initiative which, since its inception, has functioned exclusively in support of people with diabetes in developing regions. These countries constitute the bulk of the IDF membership; 60% of Member Associations are in countries with an annual GDP of less than 3500 USD per capita.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder to affect women of reproductive age. Although it was first described almost 70 years ago, there has been no universal agreement about its definition. Eleni Kousta and Stephen Franks describe the prevalence, symptoms, and cause of PCOS, and look at long-term health implications and the available and possible future treatments for women with the syndrome.

Diabetes care is inherently complex – hence the need for 19 chapters of evidence review and recommendations in the Global Guideline. Pulling all the recommendations together to ensure the implementation of effective delivery of care therefore needs some organization of its own, as is discussed in this article. A special situation is that of people with diabetes in hospital, who are often subject to disruption of lifestyle due to illness, procedures, or surgery, with knock-on effects on their diabetes management.

Diabetes increases the risks in pregnancy for both the mother and her infant. However, pre-pregnancy advice where possible, detection of undiagnosed or new (gestational) diabetes in pregnancy, and careful management of diabetes throughout pregnancy, with close liaison between healthcare professionals involved in diabetes, obstetric and neonatal care, can all help to achieve the desired outcome of a healthy mother and baby. The Global Guideline only addresses areas of pregnancy care that are commonly affected by the

Classically, diabetes complications are thought of as damaging the heart and blood vessels, eyes, kidneys and nervous system. Blood vessel damage, together with nerve damage, leads to foot problems. Protection of the heart, blood vessels and kidneys is dealt with in an earlier article, as is protection of all of these by control of blood glucose levels. Here we describe how disabling problems which are developing in the eyes, feet, and nervous system despite those measures can be managed optimally.