Health Delivery


How does smoking affect insulin sensitivity?

It is well known that tobacco smoke is harmful to health and is of particular danger to people with diabetes. All of the chronic complications of diabetes – such as cardiovascular disease, foot problems, kidney disease, and eye damage – are exacerbated by breathing in tobacco smoke. Recently, it was suggested that smoking may increase the risk of developing type 2 diabetes. Although the exact mechanisms are not yet fully understood, it has been suggested that impaired sensitivity to the action of insulin in people who smoke tobacco could be linked to

Cause as well as effect: smoking and diabetes

People who smoke tobacco are at increased risk of cardiovascular disease. Tobacco use contributes to the risk of all the major types of cardiovascular disease, particularly heart attack, stroke and the blockage of blood vessels in the lower limbs. People with diabetes, especially type 2 diabetes, are also at high risk for

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.

Essential diabetes care: the prevention of fracture risk

Assessing the health of people’s bones should be a standard component of diabetes care. People with diabetes are at an increased risk for fractures; this risk increases with the development of diabetes complications. Bone fractures impose a major impact on a person’s quality of life and on healthcare budgets. Inge Van Pottelbergh explains bone loss in people with diabetes and looks at the current treatment options.

The year of the diabetic foot

The human and economic consequences of the diabetic foot are extreme. Due to various complications of diabetes, a person’s foot can become vulnerable. Nerve

Foods and their effects on blood sugar

Until the discovery of insulin in the 1920’s, dietary modification offered the only means of reducing raised blood sugar levels in people with diabetes. Now a wide variety of sophisticated insulin regimes are available; and for people with Type 2 diabetes, there is a range of oral medication. However, there is increasing appreciation that appropriate food selection remains a cornerstone of diabetes management. While it is important to remember that the way in which

Meal-time blood sugar control in pregnancy

We have known for more than half a century that good control of blood sugar (glucose) is important for the normal development of the unborn baby throughout pregnancy. During those years there has been much progress in advising

Designer insulins and meal-time blood glucose control

After the discovery of insulin in the 1920´s, available insulin was from natural sources (animal pancreas) until human insulin was made available in the early 1980s. None of these insulins was ideal for injection under the skin. Now, new

Glucose: sweetness and toxin

Glucose is the fuel on which many parts of our bodies depend. It is also the blood-borne chemical responsible for the damage which causes so many potential problems to people with diabetes. Here Philip Home examines the link between these properties of glucose.