Prevention and screening

English

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.

Epidemiology, clinical medicine and public health: at the interface

In today’s health-conscious world, ill health is no longer an inexplicable ‘act of God’, nor a punishment for wrong-doing nor an evil spell. The marriage of medicine and science, scarcely a century old, has revealed much about the causes of disease, how to treat it and, increasingly, how to prevent it. This is particularly valid for people with diabetes, a condition which, over the years, has prompted increased understanding and acquisition of knowledge. The disorder has been recognized and described almost since the written human record started.

Setting the standards in England

In England we are currently increasing public spending on health faster than any major country in Europe. But, along with investing more, we need to do things differently. We need to look more radically at how health services are provided within a network of health and social care, shifting the balance between what we do in hospitals and what we do elsewhere. These are the principles that we will apply to modernizing diabetes treatment and that will underpin the ongoing work of the National Service Frameworks (NSF).

Islam, women and diabetes

Islam instructs believers to take care of their health. Prophet Muhammad said, "There are two graces which many people misevaluate; (they are) health and free time (for doing good)". This is why taking care of the body is the foremost duty of the woman as she takes care of all the dietary and health concerns of herself and her family.

Pregnancy and eye disease

Diabetic retinopathy is a disease of the small blood vessels of the retina, which is the lining of the back of the eye that senses light. Several factors contribute to the progression of this complication of diabetes: poor metabolic control, rapidly improved metabolic control, long duration of diabetes, high blood pressure and pregnancy. Pregnancy-induced progression of diabetic retinopathy can be sight-threatening.

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