Diabetes care in China: meeting the challenge

In both human and economic terms, diabetes is becoming one of the most serious and costly health conditions worldwide. Economic development, bringing changes from a traditional to a modernized lifestyle, is driving a huge increase in the number of people with obesity-related type 2 diabetes in China. The extraordinary size of the problem is worrying; if current trends continue, diabetes will become a massive health burden in China. In this article, Changyu Pan looks at the status of diabetes care in China and highlights the need for regional and national initiatives to

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

A holistic approach to diabetes care in Bolivia

Bolivia is a land-locked country in central South America. Bordered by five nations, it is one of the so-called developing countries; levels of infant mortality and illiteracy are among the highest in the world. While Bolivia is rich in ethnic and cultural diversity and natural resources, including silver and natural gas, the development of the nation continues to be constrained by economic and societal problems which affect all levels of society. Furthermore, the areas of health and education have

Enhancing diabetes education and awareness using limited resources

In his Nobel Prize lecture, the writer VS Naipaul described from the point of view of a boy of Indian origin born in Trinidad in the 1930’s the ethnic and cultural diversity of this small southern Caribbean island state. In this culturally rich but challenging setting, with few available resources, diabetes educators have made significant advances in facilitating diabetes education in Trinidad and Tobago and in raising awareness of the condition countrywide. Zobida Ragbirsingh reports.

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.

Healthy food policy: is taxation an option?

Obesity is rising rapidly in adult and child populations in virtually every part of the world. This brings with it a high risk of diabetes, heart disease and other serious conditions requiring expensive long-term medical care. In this article, Tim Lobstein and Philip James look at the role of governments in influencing what we eat. The authors propose ways in which governments can help to ensure that healthy diets are chosen over unhealthy ones.

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).

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.

Enhancing health communication: the German experience

The recent euphoria surrounding the positive effects of preventative measures with people with impaired glucose tolerance or manifest Type 2 diabetes is rarely reflected in the experience of the health-care professionals working with people with diabetes. Despite efforts to advise and inform, there is very little lasting change in health-care behaviour. Many health-care professionals report feelings of frustration and anger. They often describe the people in their care as 'difficult'.

In practice: DAWN in Latin America and the Caribbean

Relatively few studies have examined the psycho-social impact of diabetes. The Diabetes Attitudes, Wishes and Needs (DAWN) Programme addressed this issue in a study involving people with diabetes from 13 countries. A key finding was that depression was much more common in people with diabetes than in those without the condition, and was associated with impaired self-management and quality of life. Other studies confirm that depression often impairs metabolic control in people with the condition.