Health Delivery


Learning the lessons - preventing type 2 diabetes in Nepal

Diabetes has become a significant public health problem in urban Nepal. Studies carried out by the Nepal Diabetes Association in towns and cities throughout the country have revealed a diabetes prevalence of around 15% among people aged 20 years and above, and 19% among people aged 40 years and above. The Association has identified a number of key issues which continue to exacerbate this epidemic in Nepal.

The impact of a low-fat vegan diet on people with type 2 diabetes

Typical diets for people with type 2 diabetes limit carbohydrates, reduce calories to facilitate weight loss, and limit saturated fats to reduce cardiovascular risk. These dietary changes are logical and sometimes helpful. For many people, however, this sort of change leads to no more than modest weight loss and a small improvement in blood glucose control. In this article, Neal Barnard looks at evidence to suggest there might be a more effective nutritional approach to prevent or manage type 2 diabetes.

Helping people in times of crisis - mobilizing the power of humanity

Average temperatures are rising due primarily to the release of increased amounts of carbon dioxide and other greenhouse gases through the burning of fossil fuels. This is provoking other changes, including rising sea levels and changes in rainfall. These changes appear to be increasing the frequency and intensity of extreme weather events – floods, droughts, heat waves, hurricanes, and tornados – which have the potential to provoke large-scale human crises.

Addressing inequalities in access through long-term collaboration

Diabetes is a life-long chronic condition. Herein lies one of the major challenges to addressing global inequalities in diabetes care. The costs of insulin and monitoring are often beyond the resources of people with diabetes or their country’s healthcare system. While it is easier to secure temporary price reductions or short-term financial support in the form of donations or grants than it is to find long-term ongoing support, diabetes needs in most countries are not temporary.

Diabetes monitoring in developing countries

The latest statistics suggest that in the future the majority of people with diabetes will live in developing countries. There are an estimated 35 million people living with diabetes in India, for example, and it is estimated that this number will rise to more than 73 million by 2025. Sadly, it follows that the majority of people with diabetes complications will come from countries whose health systems are not able to deliver quality diabetes care.

Global access to and availability of insulin

The first practical use of insulin by Banting and Best in 1921 heralded a medical revolution. Overnight, type 1 diabetes went from being a uniformly fatal disease to a manageable disorder. Thousands of people around the world have received awards for surviving 50 years on insulin – some reaching 80 years. Insulin is classified by WHO as an essential drug. Yet, 85 years after its discovery, untold thousands of people with type 1 diabetes and type 2 diabetes in developing countries die each year because they can neither readily access nor afford insulin.

Education and public information: preventing diabetic ketoacidosis in Italy

Left untreated, diabetic ketoacidosis has a 100% death rate. Indeed, ketoacidosis is a leading cause of death and disability in children with type 1 diabetes. Severe acidosis often develops during an extended period in which hyperglycaemia-related symptoms are misdiagnosed. Reducing this period may be sufficient to prevent severe acidosis in newly diagnosed children with diabetes.

Nutrition and diabetes: global challenges for children and parents

Many children around the world are starving or undernourished. In contrast, obesity and type 2 diabetes in children are major problems in many countries. These contradicting nutritional crises strongly affect the way we care for children with diabetes and their families. Recent international guidelines on the care of children with type 1 diabetes and type 2 diabetes recognize that effective nutritional management and the adoption of a healthy lifestyle can improve diabetes outcomes.

What is so different about diabetes in children?

While both type 1 diabetes and type 2 diabetes can occur in children and adolescents, the overwhelming majority of people affected by diabetes worldwide are adults. Consequently, the specific needs of children are often overlooked. Type 1 diabetes, the most common chronic disease in children in developed countries, is growing by 5% among pre-school children and by 3% in children and adolescents each year – 70 000 new cases every year in children aged 14 years and younger worldwide.

Variations in risk perception: South Asians living in the UK and their healthcare professionals

Diabetes has become a global health problem, reaching epidemic proportions worldwide with serious implications for health and well-being. The International Diabetes Federation estimates that by 2025, almost 350 million people will have diabetes. People who are most vulnerable to this chronic disease include those living in developing countries, and members of minority ethnic groups and socio-economically disadvantaged people in developed countries.