Empowerment and self-management

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Therapeutic diabetes education: the Cuban experience

Cuba is a small island country in the Caribbean with 11 million inhabitants. As in other countries, diabetes is a major challenge to health in Cuba. In order to reduce the health and economic impact of diabetes and improve the quality of life of people with the condition, a country-wide diabetes education programme began development over 30 years ago, linking and promoting optimum care and education. Rosario García and Rolando Suárez report on the achievements of the programme and highlight the central role of diabetes education over three decades of care initiatives in Cuba.

Improving the quality of life of young people with diabetes in Egypt

In 2000, a group of committed members of the diabetes community in Egypt, including parents of children with the condition and health-care professionals, established ‘Assistance to Youngsters with Diabetes’ (AYD). This is an ambitious project. The ultimate objective of AYD – which recently won the DAWN International Award – is to enhance the quality of life of children with diabetes in

Gambling with addiction: dangerous beliefs about smoking and diabetes

Smoking among people with diabetes parallels that of the general population. However, compared to non-smokers with diabetes, people with diabetes who smoke have twice the risk of premature death. The risk of complications associated with tobacco use and diabetes in combination are nearly 14 times higher than the risk

Improving psycho-social care: the Indian experience

The number of people with diabetes in the Indian subcontinent has been increasing dramatically: approximately 30-33 million people have diabetes in India and this number could double by 2025. Compared to other ethnic groups, Indians have a high risk of developing diabetes. However, the impact of psycho-social factors related to diabetes care has also contributed to the growing pandemic.

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).

Meal-time blood sugar control in pregnancy

We have known for more than half a century that good control of blood sugar (glucose) is important for the normal development of the unborn baby throughout pregnancy. During those years there has been much progress in advising

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.

Keeping people at the centre of care: a challenge to health professionals?

The establishment of a practice which puts the person at the centre of care will require a change in the attitudes and beliefs of health professionals, and people with diabetes. A service which places the person with diabetes at the centre of care will undoubtedly demand the adoption of this philosophy by the organizations responsible for the delivery of diabetes care, as well as those networks serving the

Empowering children with diabetes and their parents

When a child is diagnosed with diabetes, the news usually comes as a shock to all family members. This often provokes a crisis which is associated with grief and sadness; a complex scenario emerges. Children with diabetes and their parents often feel overwhelmed by the amount of knowledge required to effectively manage the condition. Parents and children experience feelings of guilt. Parents sometimes feel they may have been able to prevent their child's diabetes; children may blame themselves for an illness, and perceive the condition and its treatment as a form of punishment.

Understanding the psychological barriers to effective diabetes therapy

In order to minimize the risk of diabetes complications, effective therapy for people with Type 2 diabetes involves lifestyle changes and poly-pharmacy targeting levels of blood glucose, blood pressure and blood fat. However, the strict targets set in recent guidelines are seldom achieved by the majority of people with diabetes. Barriers to effective diabetes therapy have been identified within the organization of health care and in the interaction between health-care providers and people with

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