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Diabetes foot damage in developing countries: the urgent need for education

Figures released by the International Diabetes Federation suggest that worldwide in 2003 there were almost 200 million people with diabetes – a global prevalence of 5.1%. The report predicted that over the coming decade, the greatest increases in the numbers of people with the condition will occur in Africa and Asia, provoking hugely increased rates of death and disability. Diabetes foot complications constitute a major public health problem, particularly for people with diabetes in developing countries. In this article, Zulfiqarali Abbas and Stephan Morbach look

The dietetics of smoking cessation in people with diabetes

Compared to people without the condition, people with diabetes are at increased risk from vascular diseases – including heart attack and stroke. This risk is further increased in people with diabetes who smoke; smokers with the condition should be advised by their health carers to stop smoking as a matter of urgency. But giving up the habit is not easy. Successful cessation requires people to surmount a number of difficulties, including strong physical, psychological and behavioural

A very bad start: smoking, pregnancy and diabetes

The disease process that leads to the development of type 2 diabetes may start in the womb at the very beginning of life. Fetal growth and birth weight are predictive of diabetes risk in later years. This suggests that the factors that influence the rate of fetal growth – and therefore birth weight – may also activate the process that leads to type 2 diabetes in adult life. It is well known that smoking during

Worsening the blow: the effects of smoking on diabetes complications

Cigarette smoking is a serious hazard to health. Yet, although as a group people with diabetes are at increased risk of developing cardiovascular disease, this does not appear to influence smoking habits among them. Tobacco use among people with diabetes is strongly associated with a further increase in the risk of developing cardiovascular complications. Furthermore, research has indicated that smoking has negative effects on the metabolism of glucose and lipids (fat), leading

The diabetic foot: epidemiology, risk factors and the status of care

The development of foot problems is not an inevitable consequence of having diabetes. Indeed, most foot lesions are preventable. However, recent statistics are somewhat depressing: approximately a quarter of all people with diabetes worldwide at some point during their lifetime will develop sores or breaks (ulcers) in the skin of their feet. Moreover, as the number of people with diabetes rises worldwide, there can be little doubt that the burden of diabetes-related foot

Providing care for all people with diabetes in the Netherlands

The health system in the Netherlands is set for an overhaul. In January 2006, new health legislation, which includes important reforms in the provision of diabetes care, comes into effect. Having played an important advisory role in the design of this new legislation, the Dutch Diabetes Association (DVN) predicts signifi cant improvements in diabetes care as a result of the reforms. However, not all the stakeholders in diabetes care are happy with the changes, which were the central issue in several national and regional strikes by primary care doctors. As a

The Mediterranean diet and the prevention of diabetes

In the 1950s, the relationship between dietary habits and cardiovascular disease was explored for the first time in an epidemiological study: the Seven Countries Study, which is considered a milestone of research in cardiology and nutrition. It was found that cardiovascular disease was 50% less common in the populations living in the Mediterranean area than in those living in northern Europe or the USA. The marked difference in the diets of the respective populations largely accounted for this disparity in rates of cardiovascular disease. In this article, Gabriele Riccardi

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.

Diabetes education in Africa: what we need to know

Education is the cornerstone of diabetes care and management. Yet while many health-care professionals subscribe to this idea, it is not applied universally. In developing countries in particular, much work remains to be done in order to improve the content, structure and provision of diabetes education. Margueritte de Clerck looks at education needs in Africa and makes some recommendations on the role and responsibilities of fellow health-care professionals, particularly those who work in low-income countries.

Childhood obesity and type 2 diabetes: a growing public health challenge in UAE

In the oil-exporting Arab countries – Saudi Arabia, Kuwait and the United Arab Emirates (UAE) – the economic growth and development of the past three decades have been dramatic. This socio-economic progress has brought benefits to many people in the region, such as improved access to health care, education, and safe drinking water. However, economic development has set the scene for the

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