Prevention and screening

English

The history of diabetes nutrition therapy: from starvation to evidence-based recommendations

“For forty-eight hours after admission to the hospital the patient is kept on an ordinary diet, to determine the severity of his diabetes. Then he is starved, and no food allowed save whiskey and black coffee. The whiskey is given in the coffee: 1 ounce of whiskey every two hours, from 7am until 7pm. The whiskey is not an essential part of treatment; it merely furnishes a few calories and keeps the patient more comfortable while he is being starved.” Starvation (Allen) Treatment of Diabetes (1915).

Understanding the evidence

Editor-in-chief's editorial

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.

Integrating psycho-social issues into national diabetes programmes

It is widely agreed that people with diabetes can lead a 'normal' life. Like people who do not have the condition, people with diabetes can function fully in family, workplace, and community settings. However, it is also accepted that diabetes self-care is complex and demanding. Being obliged to balance food intake and exercise against medication, self-administer injections, and self-test blood for glucose levels is not 'normal'. The demands of diabetes self-management can impact negatively on the psychological status of people with the condition. In this article, Ruth

Minneapolis shows the way in improving large-scale diabetes care

More than 16 million Americans have diabetes. It is the sixth leading cause of death by disease in the USA. The American Diabetes Association’s Provider Recognition Programme, launched in 1997 to encourage and set standards for comprehensive and quality healthcare for people with diabetes, is working. Minneapolis has created such a model which has achieved ADA recognition. The result has been a significant improvement in blood glucose control among the HMOs’ patients, as well as better screening for – and control of – related risk factors for cardiovascular disease.

Real achievement possible through broad cooperation

Editor-in-Chief's editorial

The other global fuel crisis

President's editorial

Obesity: how to respond to a huge challenge

People with obesity have been illustrated by artists throughout our modern cultural history. Who would not recognize the clearly overweight Milon Venus or obese women in paintings by Rubens? These people, however, were rather rare exceptions during times when labour required physical work and food shortage was much more common than in the present. Although we lack specific data, it is likely that the industrial revolution together with improved food hygiene were associated with an increase in the prevalence of obesity at least among those whose labour was physically less demanding.

The next step: the diabetic foot - costs, prevention and future policies

Of all the serious and costly complications affecting individuals with diabetes – heart disease, kidney failure and blindness – foot complications take the greatest toll.

The case for and against screening for type 2 diabetes

The decision to screen for diabetes may seem an easy one to make as the condition is common, expensive, chronic and with a prognosis highly dependent on the correct treatment. On the other hand, there is a general lack of adequate screening tools, lack of knowledge regarding appropriate treatment, uncertainties regarding economic consequences and a total lack of knowledge regarding the psychological consequences of screening. Studies focusing on these issues should, therefore, be performed before systematic screening can be recommended.

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