Research and studies

People with type 2 diabetes suffer badly from heart disease, strokes, and damage to the blood supply to their feet. Indeed, these cardiovascular conditions are the major causes of ill-health and death in people with the condition. A significant proportion of that ill-health is preventable, including by attention to the levels of fats and sugar in the blood, the clotting tendency of the blood, and blood pressure. Raised blood pressure is also responsible for worsening of eye damage and kidney damage in people with type 2 diabetes, and is therefore particularly well worth treating.

It is important not to think of diabetes as being ‘treated’. And it is important not to think of diabetes management as being about lowering blood glucose levels alone. Other aspects of management are important enough to require separate chapters, both in the Global Guideline and in this Supplement. Nevertheless, the control of blood glucose is central to the management of type 2 diabetes, and nearly all people with the condition will need oral glucose-lowering drugs or insulin to help optimize this important cardiovascular risk factor.

Blood glucose control is central to the very nature of diabetes, and the late complications which can develop. Unfortunately, it cannot be sensed by the person with diabetes unless levels are very high or very low. Accordingly, blood glucose control has to be measured reliably, and this needs to be done in the clinic and in normal life. Evidently, the results have then to be related to the risks of developing complications – hence targets and intervention levels.

The International Diabetes Federation (IDF) is not in the business of delivering clinical care to people with diabetes; but it is committed to the view that everyone with diabetes should benefit from the best possible care that could be available to them. One foundation of such care is to ensure that it is based on the best possible scientific knowledge. In this Supplement to Diabetes Voice we summarize in non-technical language the evidence base and recommendations of the IDF Global Guideline.

Ten years ago, without evidence to suggest otherwise, diabetes was not considered a public priority in Cameroon; the emphasis of Government health policy was on tackling the HIV/AIDS epidemic and attempting to eradicate communicable diseases. Efforts had been made to set up centres specializing in diabetes and hypertension, but without the backing of a national diabetes programme, most of these closed within a few years. The lack of data on non-communicable diseases constituted a major roadblock to the development of any such programme.

We can take advantage of the metabolic syndrome: it can be used as a simple and effective tool to assess health risks in people with type 2 diabetes and those without the condition. We can benefit from the universal availability of the tools needed to make a diagnosis – at no further cost. Given the excessive levels of death and disability suffered by people with type 2 diabetes and its associated conditions, it is of the utmost importance that early and appropriate steps are taken once a diagnosis of the metabolic syndrome is made. Fortunately, there

Over a few million years, human genes gradually evolved, enabling us to survive frequent periods of famine. Our genes are still essentially the same; but we are currently exposed to lifestyles for which we are not programmed. We were

In the ongoing debates surrounding the metabolic syndrome, perhaps the key issue is whether this cluster of medical disorders arises from obesity or insensitivity to insulin. The lack of consensus on the principal underlying

The drastic rise in childhood obesity worldwide reflects the impact of unhealthy modern lifestyles. Over the last decade and a half, the increase of high-sugar, high-fat processed foods in our diets has combined with sedentary behaviour to radically and negatively affect the health of our societies. Initiatives are urgently required which can reduce the resulting individual and societal burden to physical and psychological health and economic development.

Indigenous Australians have poorer health than the rest of the Australian population; for Aboriginal people, life expectancy is about 20 years less than for the general population. Significantly though, the low expectation of life in Indigenous Australians is less associated with high child mortality, as occurs in many groups in developing countries; the big differences are among young to middle-aged adults.