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Where the search for a cure will take us: what to look for in type 1 diabetes research in the coming decade

In 1970, parents of children with type 1 diabetes in America organized what has become the Juvenile Diabetes Research Foundation (JDRF). The JDRF’s mission, then as now, has been constant: to find a cure for type 1 diabetes and its complications through the vehicle of research. JDRF has grown to be the world’s largest charitable funder and advocate for type 1 diabetes research. Although based in the USA, JDRF has always supported the best research in type 1 diabetes, wherever it may be.

D-START: supporting innovative translational research projects in developing countries

In the three years since its inception and after two initial rounds of funding, the International Diabetes Federation’s BRIDGES programme has become one of the principal funding initiatives in diabetes worldwide. With the recent announcement of its third round of funding, BRIDGES has consolidated its position in the fast-developing and innovative sector of translational research.

Promoting foot care education in developing countries: the Caribbean Diabetic Foot Care Programme

There are 285 million people living with diabetes worldwide, the number of affected people is predicted to reach 438 million by 2030. Because of the rapid increase in diabetes prevalence, the number of diabetes complications is rising equally quickly. Amputation is one of the most feared of these complications. People with diabetes are at risk for nerve damage and problems with the supply of blood to their feet. Nerve damage results in a reduced ability to feel pain and, as a consequence, injuries often go unnoticed. Moreover, poor blood supply can slow down the process of wound healing.


Access to insulin and barriers to care: results of the RAPIA in Vietnam

Access to diabetes care in many countries is problematic due to a variety of factors. These can range from the cost of medication to the distance that people with diabetes need to travel to access a trained healthcare provider. Without adequate access to medication and care, people with diabetes face complications and early death. The authors report on an evaluation of the provision of care and supplies for people with diabetes in Vietnam.

 


A multidisciplinary effort to improve the quality of chronic disease care

Although chronic diseases are leading causes of death and disability, they are neglected elements of the global health agenda. Of all deaths worldwide in 2005, 60% were caused by chronic diseases – principally cardiovascular diseases and diabetes (32%), cancer (13%), and chronic respiratory diseases (7%). Because the increase in chronic diseases is underappreciated, and their economic impact underestimated, many countries take little interest in their prevention, and leave the responsibility for management to individuals.


Barriers to self-management in people affected by chronic disease

Diabetes healthcare providers are no strangers to the self-management model. Indeed, it could be said that diabetes is the field in which the self-management model has been most thoroughly developed and implemented. The marriage of expert clinical care with self-management by the individual is an ideal union and an increasingly common objective. It is an excellent goal – one that is achievable by many. Yet a number of systematic barriers to self-management exists.

Challenges to diabetes self-management in developing countries

In developing countries, financial and human resources are limited despite serious needs and multiple health challenges. More than three-quarters of the people with diabetes worldwide live in developing countries. Between 2000 and 2025, the rise in the number of people with the condition in these countries will be around 170%. In  the developing world, diabetes, like other chronic diseases, is often ignored in terms of healthcare priorities; the focus remains largely on immediate and acute care rather than on prevention.

Self-monitoring of blood glucose for people with type 2 diabetes: the need for better understanding

Diabetes increases a person’s risk of developing multiple health complications. But the risk of these can be significantly reduced by close control of blood glucose. Although directly monitoring glucose levels to inform adjustments in insulin levels is now a proven part of self-management for people with type 1 diabetes, the role of glucose monitoring for people with type 2 diabetes is less well established.

IDF guideline on self-management of blood glucose

In October 2008, the IDF Task Force on Clinical Guidelines, in conjunction with the Self-Monitoring of Blood Glucose nternational Working Group, convened a workshop in Amsterdam to address the use of self-monitoring of blood glucose (SMBG) in people with type 2 diabetes who are not treated with insulin. The recently published guidelines on the use of SMBG in people with type 2 diabetes were developed based on the findings of that workshop. A summary of the findings and recommendations is provided in this article.

Diabetes self-management education and support: the key to diabetes care

Diabetes education can be delivered using a variety of methods and in a range of settings: a lecture on, say, carbohydrates and glucose monitoring; an individual face-to-face meeting with an educator or a dietitian; a group session where an educator and people with diabetes can all act as educational resources. It can take place  in a classroom, an office or under a tree, supported by professionally produced photographs and posters or hand-drawn signs.

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