Waking up to diabetes in Papua New Guinea - Jacklyin's story

My daughter Jacklyin was born in January 1990, three months premature. Her early birth gave her unusual status among her family and the rest of the community in our village, Gumine – in the Province of Chimbu, in the highlands of Papua New Guinea. She would always be given our special protection and ate the best of all children in the village.

Lifestyle and nutritional management

It is often stated that dietary management is a cornerstone of diabetes care. More recently, physical activity has also been recognized as a useful fundamental intervention. When it is realized that both of these can affect a variety of the problems that bedevil people with diabetes – including excess body weight, high blood glucose levels, high blood fat levels, and high blood pressure – it is not difficult to see why these issues might be regarded as fundamental.

Patient education and psychological care

People with diabetes deliver most of their own care. This reflects the observation that diabetes and its associated features touch on most aspects of daily living, and aspects as fundamental as eating and physical activity. To deliver such care requires knowledge, but even with knowledge it may not be easy to adjust to optimal self-care. This makes patient education a complex therapeutic issue.

Outpatient and inpatient diabetes care delivery

Diabetes care is inherently complex – hence the need for 19 chapters of evidence review and recommendations in the Global Guideline. Pulling all the recommendations together to ensure the implementation of effective delivery of care therefore needs some organization of its own, as is discussed in this article. A special situation is that of people with diabetes in hospital, who are often subject to disruption of lifestyle due to illness, procedures, or surgery, with knock-on effects on their diabetes management.

National and regional organization: the key to effective diabetes care in Moscow

According to the federal statistics agency of the Russian Federation, the country’s population is in a phase of negative growth and currently stands at around 143 million. There are 2.3 million people registered with diabetes, 2 million of whom have type 2 diabetes. However, according to recent epidemiological research, there may be some 8 million people living with the condition in Russia. Success in addressing the problems relating to diabetes and its complications largely depends on the effective organization of diabetes care at regional and national levels.

Access to care - the key to development


Glucose control: measures, levels and monitoring

Blood glucose control is central to the very nature of diabetes, and the late complications which can develop. Unfortunately, it cannot be sensed by the person with diabetes unless levels are very high or very low. Accordingly, blood glucose control has to be measured reliably, and this needs to be done in the clinic and in normal life. Evidently, the results have then to be related to the risks of developing complications – hence targets and intervention levels.

Focus on the front line: Diabetes South Africa

Diabetes is emerging as a serious public-health problem in South Africa, particularly in the urban areas, where social welfare and health systems are precarious, and there is a lack of access to appropriate health information. Diabetes South Africa (DSA), established in 1969, advocates for the rights of all people with diabetes in the country.

Diabetes management in a primary care setting: the Kenyatta National Hospital

Diabetes is increasingly common worldwide, and Kenya is no exception. The Ministry of Health estimates the prevalence of diabetes to be around 10% (3.5 million people). The cause of much human suffering, diabetes also places a considerable economic burden on individuals and families, and healthcare systems.

From research to policy: the development of a national diabetes programme in Cameroon

Ten years ago, without evidence to suggest otherwise, diabetes was not considered a public priority in Cameroon; the emphasis of Government health policy was on tackling the HIV/AIDS epidemic and attempting to eradicate communicable diseases. Efforts had been made to set up centres specializing in diabetes and hypertension, but without the backing of a national diabetes programme, most of these closed within a few years. The lack of data on non-communicable diseases constituted a major roadblock to the development of any such programme.