Prevention and screening

The Global Partnership for Effective Diabetes Management is a multidisciplinary task force of international diabetes experts. The group came together in 2004 with the objective of supporting improvements in treatment outcomes for people with type 2 diabetes. The aim of the Global Partnership was not to develop another set of guidelines, but to provide practical advice to help more people to achieve good glucose control.

An ongoing initiative of the Pan American Health Organization/World Health Organization focuses on the development of basic procedures to improve diabetes prevention and control: the Building Blocks project. A set of diabetes care guidelines based on the Building Blocks principles resulted from a number of regional workshops involving experts in a variety of diabetes-related fields

The effective delivery of health care requires a partnership between people and their health-care providers. Because of the multidisciplinary nature of diabetes care, this team-based approach is appropriate. Indeed, a multidisciplinary team approach involving people with diabetes and health-care providers, such as nurses, dietitians, pharmacists, and physicians, has been proven to result in lower average levels of blood glucose, a reduction in diabetes complications, and improved quality of life.

The world is facing a dramatic rise in diabetes prevalence, most of which is occurring in the low- and middle-income countries; it is projected that by 2025, more than 75% of people with diabetes will live in developing countries. This is having a major impact on the quality of life of hundreds of millions people and their families. Furthermore, the negative effects of the obesity-driven diabetes pandemic are being felt in the economy of those countries that are in most need of development.

Diabetes has become a major health problem in developing countries, where non-communicable conditions are rapidly overtaking communicable diseases as the most common cause of death. Recent World Health Organization (WHO)

Although diabetes-related amputations are preventable, for too many people around the world, losing a limb or part of a limb is a tragic consequence of having diabetes. The high rates of these amputations are an indication of inadequacies in the delivery of health care, which create enormous challenges for those attempting to access high quality foot education and care. In this article, Margaret McGill focuses on current recommendations for health-care providers and makes a call for an individualized approach to diabetes foot care.

Given the dimensions of the current global diabetes pandemic, the number of people who are at risk of developing a diabetes-related foot complication is enormous – and growing. Everybody with the condition is at risk, irrespective of the type or severity of their diabetes. The aim of screening is to identify the people who are at greatest risk in order to allocate to them limited medical resources. Several simple screening techniques exist that can help to distribute therapeutic and preventive foot care to those in greatest need. Edgar Peters reports.

Diabetes is a chronic condition that requires a life-long commitment of resources to the prevention and treatment of complications. The condition affects an increasing number of people all around the world, putting them at risk for foot ulcers and amputations. In addition to causing acute suffering, foot lesions in people with diabetes have substantial economic consequences: up to 20% of total expenditure on diabetes might be attributable to the diabetic foot. Jan Apelqvist and Gunnel Ragnarson Tennvall report on the economic impact of diabetes foot damage

The development of foot problems is not an inevitable consequence of having diabetes. Indeed, most foot lesions are preventable. However, recent statistics are somewhat depressing: approximately a quarter of all people with diabetes worldwide at some point during their lifetime will develop sores or breaks (ulcers) in the skin of their feet. Moreover, as the number of people with diabetes rises worldwide, there can be little doubt that the burden of diabetes-related foot

If current trends continue, within the next 10 years, a quarter of all people in Mexico will be living with diabetes. Diabetes already affects 12% of the general population and, astonishingly, one in three people over 65 years of age. Diabetes is the leading cause of blindness, kidney failure and lower-limb amputations. Indeed, in 2004, diabetes was declared the leading cause of death in Mexico due to its link