Health Delivery

Insulin is a life-sustaining medication and as such has been designated an ‘essential drug’ by the World Health Organization (WHO). Insulin therefore should be universally available to everyone who requires it for survival. However, accessibility to the drug is often not secure. This results in life-threatening complications for people who depend on insulin for survival. The authors of this article, in reporting on the results of the International Diabetes Federation (IDF) survey, 2002-2003, make a call for improvements to the pricing and availability

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'.

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.

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

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.

In diabetes care, the principal objective is to improve health outcomes and ensure the total well-being of people with the condition. In order to achieve this, it is important to reach the person beyond the laboratory results and blood glucose

The ultimate goal of diabetes care is to enhance the quality of life of people with the condition. Quality of life is increasingly used as a factor in the evaluation of the quality of care. The results of this evaluation are used by health-care providers in order to make recommendations for future care. Only the person receiving care is capable of evaluating their quality of life during and following medical care.

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

For the West, the availability of animal insulin is a question of freedom of choice. However, it is the only way of survival for a number of people with diabetes in the developing world. Will the plea for help from the people with diabetes in the developing countries, in search of life, go unnoticed, unheard?

The IDF Congress has historically served as an international forum for sharing scientific advances. For the first time in Congress history, education, nutrition and the psychosocial aspects of diabetes were showcased in a specific track and addressed in a plenary lecture at the 17th IDF Congress in Mexico City. The inclusion of these themes served as a reassuring confirmation that the world's diabetes experts recognize the relevance of education and psychosocial aspects in improving diabetes outcomes.