Research and studies


Understanding the evidence

Editor-in-chief's editorial

Reviving the St Vincent Declaration

On the occasion of the signing of the St Vincent Declaration in St Vincent, Italy in October 1989, representatives of diabetes organizations and government health departments from European countries agreed unanimously on key health objectives for people with diabetes. Five-year targets were incorporated within the framework of the Declaration, which effectively recognized that diabetes outcomes were measurable; European nations were thus challenged to improve standards of care.

The nutrition transition and the global shift towards obesity

Populations worldwide are becoming more corpulent. The levels of overweight and obesity in many low- to middle-income countries such as Mexico, Egypt, and South Africa rival that of the country used as the benchmark for this problem, the USA. Moreover, the rates of increase in obesity in these countries are double to quadruple those in the USA. In this article, Barry Popkin reports on the impact of important shifts in nutritional patterns and the trend towards inactivity.

New treatments for diabetes: generating new insulin-producing cells

A new generation of treatments for Type 1 diabetes is likely to come from within our own bodies. We know that a wide range of cell types have the ability to regenerate. Although some of these cells are found outside the pancreas, their regenerative capacity can be harnessed to replenish the insulin-producing islet cells in the pancreas that are destroyed in diabetes. In this article, Denise Faustman looks at the potential benefits and pitfalls of four biologically based therapies, all of which take advantage of the body’s own capacity for healing and renewal.

Socio-economic determinants of the costs of diabetes in India

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

The human perspective on health-care reform: coping with diabetes in Kyrgyzstan

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.

Enhancing insulin secretion: novel approaches to glucose control

When we eat, the concentration of glucose in our blood rises due to the uptake of glucose from the digestion of starch and other carbohydrates in the gut. In healthy people, the increase is modest; eating activates other processes that

Meal-time glucose control: the role of oral drugs

As a species, our condition has changed: from prolonged periods of fasting and occasional gorging, to nearly constant feeding with rarely occurring periods of fasting. The constant availability of ‘grazing opportunities’ has contributed to a change in the body build of humans towards increasing body weight, overweight, and obesity. With this change has come a massive increase in the number of people with diabetes and diabetes- and- obesity-related health problems.

Home blood glucose monitoring: a useful self-management tool

There is no doubt that the introduction of home blood glucose monitoring has helped to revolutionize diabetes management and reduce the amount of time people with diabetes need to spend in hospital to stabilize their condition. However, this has given rise to a series of compliance and management issues for the person with diabetes and the health professional who provides their care. Jan Alford reports.

The impact of low health literacy on diabetes outcome

According to the 1993 US National Adult Literacy Survey, approximately 90 million people in the USA have deficiencies in reading or computational skills that prevent them from fully participating in normal daily activities – such as reading a bus schedule or entering background information on an application form. Although the Survey did not evaluate the ability to read and comprehend health-related materials,