Prevention and screening

The World Health Organization (WHO) Regional Office for Africa, concerned about the escalating incidence of diabetes in the African Region, presented a regional strategy for diabetes to be adopted by health ministers during the 57th session of the WHO Regional Committee for Africa, held in August 2007 in Brazzaville, Republic of Congo. The strategy examined the situation of type 2 diabetes in the African Region and proposed methods to prevent and control the disease.

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 USA ranks third in the global prevalence of diabetes, preceded only by India and China. About 7% of the population has diabetes. A third of the total number of people with the condition is believed to be undiagnosed and therefore not receiving treatment to reduce the risk of disabling and life-threatening diabetes complications. The economic costs of diabetes are enormous – estimated at 132 billion USD in 2002. The mission of the US National Diabetes Education Program (NDEP) is to reduce diabetes-related illness and death.

The objective of holiday camps for children and adolescents with diabetes is to create an environment in which they can learn to embrace their condition and its treatment. Achieving and maintaining good blood glucose control is a key aim; the camps provide excellent opportunities for young people to learn and practise diabetes skills and become familiar with the latest techniques.

Early intervention to prevent or delay type 2 diabetes benefits people who are at high risk of developing the condition in terms of increased life expectancy and quality of life. It also benefits societies and healthcare systems in economic terms. In order to address the growing impact of type 2 diabetes, the International Diabetes Federation (IDF) Task Force on Prevention and Epidemiology convened a consensus workshop in 2006. Its primary goal was the prevention of type 2 diabetes in developed and developing countries.

Diabetes has become a significant public health problem in urban Nepal. Studies carried out by the Nepal Diabetes Association in towns and cities throughout the country have revealed a diabetes prevalence of around 15% among people aged 20 years and above, and 19% among people aged 40 years and above. The Association has identified a number of key issues which continue to exacerbate this epidemic in Nepal.

Typical diets for people with type 2 diabetes limit carbohydrates, reduce calories to facilitate weight loss, and limit saturated fats to reduce cardiovascular risk. These dietary changes are logical and sometimes helpful. For many people, however, this sort of change leads to no more than modest weight loss and a small improvement in blood glucose control. In this article, Neal Barnard looks at evidence to suggest there might be a more effective nutritional approach to prevent or manage type 2 diabetes.

Editor-in-Chief's editorial

President's editorial

Left untreated, diabetic ketoacidosis has a 100% death rate. Indeed, ketoacidosis is a leading cause of death and disability in children with type 1 diabetes. Severe acidosis often develops during an extended period in which hyperglycaemia-related symptoms are misdiagnosed. Reducing this period may be sufficient to prevent severe acidosis in newly diagnosed children with diabetes.