Prevention and screening


A threat to ethnic communities: diabetes and heart disease

The Centers for Disease Control and Prevention (CDC) in the USA has labelled diabetes 'the epidemic of our time'. Indeed, diabetes is the sixth leading cause of death by disease in the USA, with 75% of diabetes-related deaths attributable to cardiovascular disease. According to the US Office of Minority Health, the prevalence of diabetes among African-Americans is about 70% higher than in Caucasians, and the prevalence in Hispanics is nearly double that of Caucasians. Currently it is estimated that 2.3 million African-Americans and 1.2 million Hispanics have Type 2 diabetes in the USA alone.

Diabetes: its indirect costs. The costs of lost production

When someone is sick, be it short-term or long-term, we immediately think of the costs this person has to bear in terms of both physical pain and of the money needed to buy drugs and other supplies to get better or keep the condition under control. We might also go as far as to consider the financial costs borne by national healthcare systems. But there is more to health economics that this. Delve into this article to find out why we cannot remain blind to the so-called indirect costs of diabetes.

Diabetes research caught in the European spotlight

It all started in 1996, when the European Association for the Study of Diabetes (EASD) published a document entitled 'European Dimension of Diabetes Research'. Since then, enormous progress has been made towards a greater recognition of the relevance of diabetes research at European Union level.

DEHKO: Finland moves on primary prevention

In January 2000, the Development Programme for the Prevention and Care of Diabetes 2000-2010 (DEHKO) was officially approved as Finland's national diabetes programme. The first audit of the programme in 2003 has reported that the implementation process is well underway in both primary and specialized healthcare. The atmosphere among healthcare providers is positive and enthusiastic, and the word DEHKO is now firmly established in the lexicon of diabetes care in Finland.

Japanese school programmes combat type 2 diabetes

So-called 'late onset diabetes' is now more widely termed Type 2 diabetes. And for very good reasons. It was previously the case that childhood and adolescent diabetes was nearly exclusively Type 1 diabetes and that Type 2 diabetes very rarely affected the young. Sadly, this is no longer true. As the spread of 'westernized' lifestyles gives rise to a steep increase in rates of obesity worldwide, Type 2 diabetes is rapidly emerging among children and adolescents.

Fighting fat: with TAF in Singapore

In 1992, the Singapore government noted that the obesity prevalence among schoolchildren was 14%. Singapore's population has a relatively high prevalence of diabetes, at 9.2%. Rates of obesity and overweight are high – 6% of the adult population has a body mass index (BMI) of more than 30 kg/m2, and around 25% have a BMI above 25 kg/m2. Recent years have also seen the increasing appearance of young onset Type 2 diabetes and impaired glucose

Going down: lipids and all that cholesterol

Diabetes prevention takes many forms. Other articles in this issue of Diabetes Voice describe primary prevention of Type 2 diabetes (the diabetes of obesity and Western lifestyles), while secondary prevention is the use of lifestyle

Successful multiple risk factor intervention in type 2 diabetes: the Steno-2 triumph

Type 2 diabetes increases the risk of cardiovascular disease (CVD) between two- and six-fold, and shortens life expectancy by 5 to 10 years. Once a person with diabetes has developed severe vascular complications, they will

Clinical trials confirm that type 2 diabetes is preventable

Until recently, randomized clinical trials offered only limited proof that Type 2 diabetes is preventable by changes in lifestyle. Fortunately, this gap has now been filled. Several major lifestyle intervention trials have been successfully completed. The results are consistent: the risk of Type 2 diabetes can be halved in people who are at high risk; the effect of lifestyle change is rapid; the lifestyle changes required to achieve a significant risk reduction do not have to be drastic; and benefits are similar in different ethnic groups.

Fetal origins of diabetes in developing countries

There is a rapidly rising epidemic of Type 2 diabetes throughout the world. It is particularly severe in developing countries. In 1995, 62% of people with diabetes in the world lived in developing countries. By 2025 this is predicted to rise to more than 75%. In India there are an estimated 25 million people with diabetes, and this will rise to more than 60 million by 2025. One in five people with diabetes in the world will then be Indian. A parallel rise in ischaemic heart disease (IHD) is also projected. Other developing countries will be similarly affected.