Prevention and screening

Diabetes is closely associated with cardiovascular diseases (CVD), particularly heart attack, stroke and ischaemia of the lower limbs. People with diabetes are two to four times more likely to develop these diseases compared to people without the condition. Recent evidence, however, tells us that it is possible to prevent or delay these complications. IDF is very aware of the scale of the problem, and has entered the 21st century with the issue high on its agenda. Diabetes and Cardiovascular Disease has been selected as the theme for this year’s World Diabetes Day campaign.

The elevated cost of diabetes can be seen as the result of all previous failures of treatment. As illustrated in this article, treating diabetes complications is far more expensive than taking preventative measures. Future cost cutting, therefore, can only be achieved by improving the level of care, especially in the field of self-management. People with diabetes must be given the means to do this, which can only be attained by future investment.

The 37th Annual Meeting of the European Association for the Study of Diabetes (EASD) from 9-13 September, hosted by Diabetes UK, was the biggest meeting of the EASD to date. Ten thousand people in total attended the array of satellite symposia, lectures, poster sessions and the exhibition. However, the news of the terrorist attack in New York, shocking to everyone, dampened proceedings and caused logistical chaos for the American delegation. Following is a brief overview of some of the many interesting topics presented at the meeting.

Gestational diabetes is diabetes which is diagnosed when a woman is pregnant. It may have been there before pregnancy without her knowing it, or it may have been brought about by the pregnancy itself. Either way, the woman needs to be as well informed about it as possible, as it can affect both her baby and herself on the short and long term.

Diabetes is the commonest non-communicable disease worldwide. Researchers predict it will increase by around 160% by the year 2025. Sadly, most of this increase will occur in developing countries, which have the least resources to deal with the problem. Even in the most developed countries, health systems are struggling to meet demands for services. In recent years, this has led to a strong focus on prevention research.

Diabetes is one of the most costly diseases ever in both human and economic terms. To reduce today's burden and that on future generations, it is in everyone's interest that cost-effective measures to prevent diabetes are identified and implemented. The International Diabetes Federation (IDF) Task Force on Diabetes Health Economics has just completed a review of the evidence on cost-effective approaches to diabetes care and prevention. The timely publication shows that investment in diabetes care can be a cost-effective use of scarce resources. This article provides a brief summary.

President's editorial

In women with diabetes who come late in their pregnancy for antenatal care, it is difficult to calculate how many weeks pregnant they are, and hence difficult to optimize the time of delivery. Serious complications of diabetes can deteriorate and there is a high incidence of major birth defects in the babies. These abnormalities arise in the first ten weeks of pregnancy, which may be before a woman even knows she is pregnant or before she would come for antenatal care.

We know that in both Western and Asian adults in the vulnerable overweight groups with impaired glucose tolerance, modest weight loss with specific changes in diet and physical activity can reduce the likelihood of developing Type 2 diabetes. Marked weight loss in severely obese people with diabetes can also ameliorate the risks from their diabetes perhaps for a decade or more. However, clinical interventions to achieve this require intensive personal supervision, which,

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.