People with diabetes

In the three years since its inception and after two initial rounds of funding, the International Diabetes Federation’s BRIDGES programme has become one of the principal funding initiatives in diabetes worldwide. With the recent announcement of its third round of funding, BRIDGES has consolidated its position in the fast-developing and innovative sector of translational research.

Hypoglycaemia at the wheel is the most common acute risk for drivers with diabetes, and a concern for public road safety. Drivers with diabetes worldwide are subject to special legislation, although the restrictions and requirements vary considerably from one country to another. But are drivers with diabetes really a danger? Are they more likely to provoke an accident than people without the condition? João Manuel Valente Nabais steers us through the related research and reports from Europe on the EU’s latest laws on driving with diabetes.

On 12 January 2010, a violent earthquake, measuring 7.0 on the Richter scale, rocked the Haitian capital, Port-au-Prince, and its surroundings. The exact number of victims remains unclear, but the Haitian Government has put the death toll at 230,000 people; 250,000 more were injured and more than 1.5 million reported homeless in the immediate aftermath of the disaster. The Haitian Foundation for Diabetes and Cardiovascular Diseases (FHADIMAC) launched a major campaign to help all people with diabetes and hypertension in the region. Nancy Larco and René Charles report from Port-au-Prince.

Kris Freeman is arguably the best US cross-country distance skier for a generation. A key member of the US ski team, his absolute commitment is typical of the sporting elite. But he has another side: with three Winter Olympics under his belt, he is the only acknowledged endurance athlete with type 1 diabetes. He describes himself as an ardent spokesperson for diabetes awareness.

At the end of March 2010, a diabetes prevalence survey attracted the attention of the world’s general media. Diabetes prevalence surveys are not usually terribly exciting to audiences outside the world of epidemiology but the number of people in China estimated to have diabetes now was so large that it took the news world by surprise. The findings of the study have a number of important implications for China and beyond. International Diabetes Federation epidemiologist, David Whiting describes why this study is important and how it adds to our knowledge about the diabetes pandemic.

People  with  diabetes  face  a  range  of challenges. Having the condition affects all areas of life; a number of psychological and emotional factors are involved. Recently, one of the authors of this article, Robin Wynyard, was diagnosed with type 2 diabetes. The shock of being diagnosed provoked in him and his partner, Sue Shea, negative feelings that included fear, anxiety and uncertainty – a common emotional response which often goes unreported in the related literature.

Diabetes management involves more than just medical treatment (healthcare providers prescribing insulins and other medications to people with the condition in order to avoid or postpone diabetes complications); it is far more complex. People with diabetes are required to take responsibility, with the help of professional educators, for the day-to-day management of their condition. A major challenge inherent in diabetes management is striving to become a fully participating, active, productive member of society.

Diabetes distinguishes itself from many other chronic conditions because of the complexity of its day-to-day management – both medical management and self-management, which must be carried out by people with diabetes on a sometimes hourly basis. People require self-management education in order to master these complexities. Kate Lorig discusses the complexity of diabetes self-management education, how it is currently delivered, and suggests an effective additional means of offering this education.

Nowadays, few people would question the role of a person with diabetes as the central figure in his or her diabetes care team. But ‘patient’ empowerment extends well beyond the concept of self-determination. Diabetes does not occur in a vacuum, but interacts with a variety of emotional states and exists within many cultural and social boundaries. People with diabetes hold the power to manage their condition – not their healthcare providers or their family members.