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Diabetes education with a Bali flavour

Diabetes is on the increase in Indonesia, with prevalence rates now at 4.6% compared with 2% to 3% just five years ago. This means that some four million people throughout Indonesia, from Sumatra to Irian Jaya, currently have the condition. Bali, an Indonesian island with three million inhabitants, has trained 86 diabetes educators since 1996. The educators, who come from all over the island, are expected to be able to return to their local areas and spread their knowledge about diabetes.

Diabetes guidelines for kids

Diabetes is one of the most common long-term progressive diseases of childhood. In many parts of the world Type 1 diabetes in children is increasing by 3% to 5% each year. Type 2 diabetes is also declaring itself in younger and younger age groups. These children have a lifetime of diabetes ahead of them. In an effort to contribute to an improvement in the care and quality of life of young people with diabetes, the International Society for Pediatric and Adolescent Diabetes (ISPAD) recently published comprehensive consensus guidelines.

Urban India: a breeding ground for diabetes

The global prevalence of diabetes is set to double over the next 25 years. Developing countries like India, already top of the diabetes league, are expected to shoulder much of this burden. Epidemiological studies show that the prevalence of diabetes is particularly high in urban areas in India. Cities are also home to a large pool of people with a great risk of developing diabetes in the future.

A challenge of acculturation: the Ethiopian community in Israel

For most Ethiopian immigrants arriving in Israel, diabetes was an unknown illness. However, current studies show that its prevalence is now high in this population. The diagnosis and management of diabetes among Ethiopian immigrants present a real challenge of acculturation. In response to this challenge, a community-based project called Tene Briut was created. Tene Briut promotes culturally-appropriate prevention, detection and management activities, with a major contribution from Ethiopian health professionals and community leaders.

Argentina's crisis triggers health emergency - The diabetes community's response

Diabetes affects an estimated 3.3% of the adult population in Argentina. For many of these people, insulin is a life-sustaining drug. Without uninterrupted access to insulin, people dependent on this drug for survival face the real possibility of death, some within days. The collapse of the reimbursement system and speculation have caused grave interruptions in the supply of medicines such as insulin and now an emergency response is expected from the Argentinean authorities.

Skills, strategies and sunshine: education in the Carribean

According to Diabetes Atlas 2000, there are 21.4 million people with diabetes living in the North American region of the International Diabetes Federation (IDF). Prevalence rates of diabetes are high in this region as compared to Europe and Africa. The Caribbean countries in particular have a disproportionately high number of inhabitants with diabetes. Indeed, several islands in the Caribbean rank in the top 10 of all IDF member countries in terms of diabetes prevalence. The need for diabetes education in the region is therefore high.

Barriers to insulin accessibility: a hazard to life and health

For many people with diabetes insulin is essential to health. Indeed, there are few other conditions where the replacement of a hormone that the body has ceased producing can make an acute difference between life and death. Nevertheless, a recent data-gathering project in Central and Eastern Europe illustrated that, almost 80 years after its discovery, access to insulin supplies is still problematic.

Comprehensive care in a low-income country: the Ghana experience

In the 1950s and 1960s diabetes prevalence in Ghana was estimated at between 0.2% and 0.4% in adults. However, a recent analysis of admissions to the largest hospital in the country reveals that diabetes accounts for 6.8% of all adult admissions. Despite the fact that diabetes is clearly a major health problem in Ghana, the country has no separate diabetes healthcare policy. To address these issues, a three-year national programme, the Ghana Diabetes Programme, was initiated in 1995.

Setting the standards in England

In England we are currently increasing public spending on health faster than any major country in Europe. But, along with investing more, we need to do things differently. We need to look more radically at how health services are provided within a network of health and social care, shifting the balance between what we do in hospitals and what we do elsewhere. These are the principles that we will apply to modernizing diabetes treatment and that will underpin the ongoing work of the National Service Frameworks (NSF).

Complementary therapies

'Complementary therapies' have been in use for thousands of years. Today they are increasingly popular with the general public and many health professionals, especially nurses and general practitioners. Despite the wide availability of conventional medications, over 50% of the populations of most Western countries use complementary therapies. This figure may be even higher in other cultures. Many complementary therapies can be used by people with diabetes, but there are associated risks that need to be considered.

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